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Whole fresh fruit intake and risk of incident diabetes in different glycemic stages: a nationwide prospective cohort investigation

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单位: [1]Guangxi Med Univ, Affiliated Hosp 1, Dept Endocrinol, 6 Shuangyong Rd, Nanning 530021, Guangxi, Peoples R China [2]Guangxi Med Univ, Affiliated Hosp 1, Dept Ultrasonog, Nanning, Peoples R China [3]Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Dept Endocrine & Metab Dis,Sch Med, Shanghai, Peoples R China [4]Shanghai Natl Ctr Translat Med, Shanghai Natl Clin Res Ctr Metab Dis, Key Lab Endocrine & Metab Dis, Natl Hlth Commiss PR China, Shanghai, Peoples R China [5]Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China [6]Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Zhejiang, Peoples R China [7]Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China [8]Shandong Univ, Qilu Hosp, Jinan, Peoples R China [9]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China [10]Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China [11]Dalian Municipal Cent Hosp, Dalian, Peoples R China [12]Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China [13]Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China [14]Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Peoples R China [15]Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China [16]Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China [17]Guiyang Med Coll, Affiliated Hosp, Guiyang, Peoples R China [18]Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Shanghai, Peoples R China [19]Southwest Med Univ, Affiliated Hosp, Luzhou, Peoples R China [20]First Hosp Jilin Univ, Changchun, Peoples R China [21]Anhui Med Univ, Affiliated Hosp 1, Hefei, Peoples R China [22]Karamay Municipal Peoples Hosp, Karamay, Xinjiang, Peoples R China [23]Shanghai Jiao Tong Univ, Ruijin Hosp, Clin Trials Ctr, Sch Med, Shanghai, Peoples R China [24]Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China [25]Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Peoples R China [26]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China [27]Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China [28]Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China [29]Lanzhou Univ, Hosp 1, Lanzhou, Peoples R China
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关键词: Fruit consumption Type 2 diabetes Prediabetes Normal glucose tolerance Hazzard ratio

摘要:
Purpose Fruit intake is beneficial to several chronic diseases, but controversial in diabetes. We aimed to investigate prospectively the associations of whole fresh fruit intake with risk of incident type 2 diabetes (T2D) in subjects with different glucose regulation capacities. Methods The present study included 79,922 non-diabetic participants aged >= 40 years from an ongoing nationwide prospective cohort in China. Baseline fruit intake information was collected by a validated food frequency questionnaire. Plasma HbA1c, fasting and 2 h post-loading glucose levels were measured at both baseline and follow-up examinations. Cox proportional hazards models were used to calculate hazard ratio (HR) and 95% confidence intervals (CI) for incident diabetes among participants with normal glucose tolerance (NGT) and prediabetes, after adjusted for multiple confounders. Restricted cubic spline analysis was applied for dose-response relation. Results During a median 3.8-year follow-up, 5886 (7.36%) participants developed diabetes. Overall, we identified a linear and dose-dependent inverse association between dietary whole fresh fruit intake and risk of incident T2D. Each 100 g/d higher fruit intake was associated with 2.8% lower risk of diabetes (HR 0.972, 95%CI [0.949-0.996], P = 0.0217), majorly benefiting NGT subjects with 15.2% lower risk (HR 0.848, 95%CI [0.766-0.940], P = 0.0017), while not significant in prediabetes (HR 0.981, 95%CI 0.957-4.005, P = 0.1268). Similarly, the inverse association was present in normoglycemia individuals with a 48.6% lower risk of diabetes when consuming fruits > 7 times/week comparing to those < 1 time/week (HR 0.514, 95% CI [0.368-0.948]), but not in prediabetes (HR 0.883, 95% CI [0.762-1.023]). Conclusion These findings suggest that higher frequency and amount of fresh fruit intake may protect against incident T2D, especially in NGT, but not in prediabetes, highlighting the dietary recommendation of higher fresh fruit consumption to prevent T2D in normoglycemia population.

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大类 | 2 区 医学
小类 | 2 区 营养学
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大类 | 2 区 医学
小类 | 2 区 营养学
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出版当年[2021]版:
Q2 NUTRITION & DIETETICS
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Q2 NUTRITION & DIETETICS

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第一作者单位: [1]Guangxi Med Univ, Affiliated Hosp 1, Dept Endocrinol, 6 Shuangyong Rd, Nanning 530021, Guangxi, Peoples R China
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