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Diabetes Care:30年长期随访研究,年轻时多摄入叶酸或可降低糖尿病患病风险!

2020-08-14 生物探索 生物探索

2型糖尿病(T2DM)的高患病率目前已成为全球范围内较为严重的公共卫生问题。据《中国2型糖尿病防治指南》数据显示,我国糖尿病患者有1.144亿人,位居全球第一,18岁以上成人2型糖尿病发病率已达10.

2型糖尿病(T2DM)的高患病率目前已成为全球范围内较为严重的公共卫生问题。据《中国2型糖尿病防治指南》数据显示,我国糖尿病患者有1.144亿人,位居全球第一,18岁以上成人2型糖尿病发病率已达10.4%。

前期研究发现,与胰岛素抵抗(IR)相关的高同型半胱氨酸血症是引起T2DM的危险因素之一,且其多是由遗传缺陷,肾功能不全或叶酸等维生素摄入不足而引起的。也有一些随机临床试验报告称,补充叶酸可改善IR并降低炎症介质的水平。由此引发一种推测,叶酸等维生素可能对T2DM的患病风险和治疗有一定的有益影响。

2020年7月31日,来自美国哥伦比亚大学欧文医学中心和德克萨斯州立大学的研究人员在糖尿病方面的顶级杂志《Diabetes Care》上发表了叶酸和维生素摄入与糖尿病间相关性的最新研究成果,发现叶酸及维生素B 6的摄入量与糖尿病的患病率呈负相关性,且这种负相关可能是由于叶酸参与调控高半胱氨酸水平,胰岛素敏感性和全身性炎症而产生的。

https://doi.org/10.2337/dc20-0828

研究人员从美国的4个不同地点招募了共4704名未患糖尿病的18至30岁的参与者,女性占比为52%。对其进行长达30年的随访,期间通过饮食调查评估叶酸和维生素B6及B12的摄入量,并统计身高,体重,吸烟状况,家族糖尿病史等协变量信息。

除此之外,还对参与者的葡萄糖,胰岛素,糖化血红蛋白HbA1c,炎症标志物,血同型半胱氨酸Hcy,空腹血糖及非空腹血糖进行定期测定,以评估叶酸等维生素的摄入量与糖尿病,炎症等的相关性。

随访期间,共发生了655例糖尿病。根据参与者维生素B摄入量的分布将其分为五分位数,使用Cox比例风险回归模型分析维生素B摄入量与糖尿病发病率间的关系,发现叶酸摄入量与糖尿病的发生率呈负相关,经协变量调整后,叶酸摄入最高千分位的糖尿病风险与最低叶酸摄入量相比降低了30%。维生素B6摄入量也与糖尿病的发生率显著负相关,其摄入最高千分位的风险比为0.64。而维生素B12摄入量与糖尿病患病率无明显相关性。

B族维生素摄入量五分位的糖尿病发病的多变量调整HRs

叶酸摄入量水平和糖尿病发病率之间的多变量调整HRs

为了探索摄入叶酸对糖尿病有益的潜在机制,研究人员分析了叶酸摄入量与血清Hcy,IR的生物标志物(空腹血糖水平,胰岛素水平,胰岛素抵抗得分(HOMA-IR)和胰岛β细胞功能指数(HOMA-b),以及全身性炎症(CRP,纤维蛋白原和IL-6)之间的关系。

结果发现,叶酸摄入量与Hcy及胰岛素水平呈显著负相关性;与CRP浓度成反比;与空腹血糖、HOMA-IR、HOMA-b、纤维蛋白原和IL-6水平也呈逆相关。由此猜测,叶酸与糖尿病患病风险间的负相关或许可以通过叶酸具有胰岛素敏感性,促进Hcy代谢或参与调控炎症的途径来解释。

叶酸摄入量与同型半胱氨酸、胰岛素和CRP的多变量调整MDs

简而言之,该研究通过长达30年的监测发现增加叶酸摄入量可显著降低糖尿病的患病风险,并探索了其潜在作用机制。这一发现为人们提供了一种新型的糖尿病预防策略,为了健康,谨记多吃富含叶酸和维生素B的瓜果蔬菜噢!

原始出处:

Jie Zhu, Cheng Chen, Liping Lu, et.al. Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study. Diabetes Care 2020 Jul; dc200828.

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topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Fri Aug 14 16:50:57 CST 2020, time=2020-08-14, status=1, ipAttribution=)]
    2020-08-14 lovetcm

    #叶酸##糖尿病#都是好东西

    0

  8. 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topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Fri Aug 14 16:50:57 CST 2020, time=2020-08-14, status=1, ipAttribution=)]
    2020-08-14 misszhang

    谢谢MedSci提供最新的资讯

    0

  9. 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createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Fri Aug 14 21:15:46 CST 2020, time=2020-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043286, encodeId=dab3104328603, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Aug 14 17:15:50 CST 2020, time=2020-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=808926, encodeId=0b408089264a, content=多吃绿叶蔬菜,补充叶酸。多摄入叶酸可降低患<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, 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    2020-08-14 Jessica

    多吃绿叶蔬菜,补充叶酸。多摄入叶酸可降低患#糖尿病#风险

    0

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