Abstract 17285: Frequent Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes Among American Men and Women

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Geng Zong ◽  
David M Eisenberg ◽  
Frank B Hu ◽  
Qi Sun
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Lower Risk ◽  
Fruits And Vegetables ◽  
Hazard Ratio ◽  
Health Study ◽  
Sugar Sweetened Beverage ◽  
At Home

Introduction: The frequency of eating meals prepared at home (MPAH) decreased among Americans over the last 50 years. Eating out has been associated with poor diet quality and weight gain in adolescents and adult. Few studies have examined MPAH frequency in relation to diabetes risk. Hypothesis: Having MPAH is associated with lower risk of Type 2 Diabetes (T2D). Methods: We followed 57,994 women in the Nurses’ Health Study and 41,679 men in the Health Professionals Follow-up Study from 1986 to 2012. Participants were free of diabetes, cardiovascular disease, and cancer at baseline. Weekly frequencies of consuming MPAH were collected at baseline, and summed up as overall MPAH. Results: Participants with more MPAH had higher intake of whole grains, total and low-fat dairy products, fruits, and vegetables, and lower sugar sweetened beverage (SSB) at baseline. However, MPAH turned to be associated with more red meat and low coffee intakes. MPAH was moderately associated with less weight gain during follow-up. Compared to those with 0-6 overall MPAH/week, women with 11-14 MPAH/week had 0.45±0.08kg less weight gain over 8 years, whereas men had 0.41±0.07 kg less weight gain (P<0.001) for the same comparison. During 2.3 million person-years of follow-up, 8959 T2D cases were identified and confirmed in both cohorts. After multivariate adjustment of demographic and lifestyle factors, pooled hazard ratio (95% confidence interval) of T2D were 0.96 (0.90, 1.01), 0.96 (0.87, 1.06), 0.88 (0.83, 0.94) for participants who had 7-8, 9-10, and 11-14 MPAH/week (P for trend<0.001), comparing with those eating 0-6 MPAH/week. Each additional MPAH for lunch was associated with 2% lower risk of T2D, whereas the corresponding value was 4% for dinner (P<0.001 for both). These findings were attenuated when BMI or SSB were further adjusted: the hazard ratio comparing participants with 11-14 MPAH/week to those with 0-6 MPAH/week were 0.95 (0.90, 1.01; P for trend=0.13) with adjusting of BMI, and 0.94 (0.89, 1.00; P for trend=0.09) with adjustment of SSB. Conclusions: These findings suggest that eating more MPAH is associated with a lower risk of T2D overtime, and this relationship may be partly ascribed to less weight gain and lower SSB intake by those who prepare their own meals at home more often.

scholarly journals Association of Baseline and Longitudinal Changes in Body Composition Measures With Risk of Heart Failure and Myocardial Infarction in Type 2 Diabetes

Circulation ◽  
2020 ◽  
Vol 142 (25) ◽  
pp. 2420-2430
Author(s):  
Kershaw V. Patel ◽  
Judy L. Bahnson ◽  
Sarah A. Gaussoin ◽  
Karen C. Johnson ◽  
Xavier Pi-Sunyer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Body Composition ◽  
Lifestyle Intervention ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Longitudinal Changes

Background: Intentional weight loss is associated with lower risk of heart failure (HF) and atherosclerotic cardiovascular disease among patients with type 2 diabetes. However, the contribution of baseline measures and longitudinal changes in fat mass (FM), lean mass (LM), and waist circumference (WC) to the risk of HF and myocardial infarction (MI) in type 2 diabetes is not well established. Methods: Adults from the Look AHEAD trial (Action for Health in Diabetes) without prevalent HF were included. FM and LM were predicted using validated equations and compared with dual-energy x-ray absorptiometry measurements in a subgroup. Adjusted Cox models were used to evaluate the associations of baseline and longitudinal changes in FM, LM, and WC over 1- and 4-year follow-up with risk of overall HF, HF with preserved ejection fraction (EF; EF ≥50%), HF with reduced EF (EF <50%), and MI. Results: Among 5103 participants, there were 257 incident HF events over 12.4 years of follow-up. Predicted and measured FM/LM were highly correlated ( R 2 =0.87–0.90; n=1369). FM and LM decreased over 4-year follow-up with greater declines in the intensive lifestyle intervention arm. In adjusted analysis, baseline body composition measures were not significantly associated with HF risk. Decline in FM and WC, but not LM, over 1 year were each significantly associated with lower risk of overall HF (adjusted hazard ratio per 10% decrease in FM, 0.80 [95% CI, 0.68–0.95]; adjusted hazard ratio per 10% decrease in WC, 0.77 [95% CI, 0.62–0.95]). Decline in FM was significantly associated with lower risk of both HF subtypes. In contrast, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF. Similar patterns of association were observed for 4-year changes in body composition and HF risk. Longitudinal changes in body composition were not significantly associated with risk of MI. Conclusions: In adults with type 2 diabetes, a lifestyle intervention is associated with significant loss of FM and LM. Declines in FM and WC, but not LM, were each significantly associated with lower risk of HF but not MI. Furthermore, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00017953.

scholarly journals Dairy fat intake and risk of type 2 diabetes in 3 cohorts of US men and women

2019 ◽  
Vol 110 (5) ◽  
pp. 1192-1200 ◽  
Author(s):  
Andres V Ardisson Korat ◽  
Yanping Li ◽  
Frank Sacks ◽  
Bernard Rosner ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dairy Products ◽  
Lower Risk ◽  
Whole Grains ◽  
Health Study ◽  
Fat Intake ◽  
Men And Women ◽  
Dairy Fat

ABSTRACT Background Previous studies have examined dairy products with various fat contents in relation to type 2 diabetes (T2D) risk, although data regarding dairy fat intake per se are sparse. Objectives We aimed to evaluate the association between dairy fat intake and risk of T2D in 3 prospective cohorts. We also examined associations for isocalorically replacing dairy fat with other macronutrients. Methods We prospectively followed 41,808 men in the Health Professionals Follow-Up Study (HPFS; 1986–2012), 65,929 women in the Nurses’ Health Study (NHS; 1984–2012), and 89,565 women in the NHS II (1991–2013). Diet was assessed quadrennially using validated FFQs. Fat intake from dairy products and other relevant sources was expressed as percentage of total energy. Self-reported incident T2D cases were confirmed using validated supplementary questionnaires. Time-dependent Cox proportional hazards regression was used to estimate the HR for dairy fat intake and T2D risk. Results During 4,219,457 person-years of follow-up, we documented 16,511 incident T2D cases. Dairy fat was not associated with risk of T2D when compared with calories from carbohydrates (HR for extreme quintiles: 0.98; 95% CI: 0.95, 1.02). Replacing 5% of calories from dairy fat with other sources of animal fat or carbohydrate from refined grains was associated with a 17% (HR: 1.17; 95% CI: 1.13, 1.21) and a 4% (HR: 1.04; 95% CI: 1.00, 1.08) higher risk of T2D, respectively. Conversely, a 5% calorie replacement with carbohydrate from whole grains was associated with a 7% lower risk of T2D (HR: 0.93; 95% CI: 0.88, 0.98). Conclusions Dairy fat intake was not associated with T2D risk in these cohort studies of US men and women when compared with calories from carbohydrate. Replacing dairy fat with carbohydrates from whole grains was associated with lower risk of T2D. Replacement with other animal fats or refined carbohydrates was associated with higher risk.

scholarly journals Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

2021 ◽  
Author(s):  
Zhangling Chen ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Y. Baden ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Health Study ◽  
Weight Changes ◽  
Subsequent Risk

<b>Objective</b> <p>We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.</p> <p><b>Methods</b></p> <p>We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis.</p> <p><b>Results</b></p> <p>We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. </p> <p><b>Conclusions</b></p> <p>Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk. </p>

Abstract P074: Caffeine Intake May be Associated with a Lower Risk of Type 2 Diabetes in the Physicians’ Health Study and Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Chisa Matsumoto ◽  
Howard D Sesso ◽  
Howard D Sesso ◽  
J. Michael Gaziano ◽  
Luc Djoussé
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Linear Trend ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Health Study ◽  
Caffeine Intake

Objectives: Short-term metabolic studies have shown that caffeine improves insulin-sensitivity. However, epidemiological studies evaluating the relationship of caffeine intake with risk of type 2 diabetes (DM) have shown inconsistent results. We examined whether caffeine intake is associated with the risk of DM in the Physicians’ Health Study and supplemented the results with a meta-analysis. Methods: We prospectively analyzed data on 18,432 PHS participants that were free of DM at baseline (1997-2001). Caffeine intake was assessed using a food-frequency questionnaire. Incident DM was ascertained via annual follow-up questionnaires and validated in a subsample by review of medical records. We used Cox proportional hazards models to estimate the HR and 95% CI of DM. Meta-analysis was conducted through a systematic literature search using PubMed and EMBASE. A random-effect model was used and between-studies heterogeneity was estimated with I 2 . Results: In the PHS, mean age at baseline was 66.4 ± 9.3 years, and 1,137 men (6.2%) developed DM during mean follow up of 9.2 years. In a multivariable model adjusted for conventional risk factors of DM, HRs (95% CI) for DM were 1.0 (ref), 1.08 (0.90-1.29), 1.03 (0.85-1.24), 0.98 (0.81-1.18), and 0.86 (0.70-1.04) across consecutive quintiles of caffeine intake (p for linear trend= 0.69). Meta-analysis included 6 studies consisted of 7 separate cohorts comprising 275,971 individuals and 10,048 cases of incident DM. The pooled odds ratio (95% CI) for DM was 0.79 (0.68-0.93) when the highest caffeine intake was compared to the lowest group in random effects model (I 2 =75%). Conclusion: While only the highest category of caffeine intake was associated with a modest and non-significant association with DM in the PHS, results from the meta-analysis were consistent with a lower risk of DM.

scholarly journals Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study

2020 ◽  
Author(s):  
Anne Mette L Würtz ◽  
Marianne U Jakobsen ◽  
Monica L Bertoia ◽  
Tao Hou ◽  
Erik B Schmidt ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Dietary Protein ◽  
Lower Risk ◽  
Red Meat ◽  
Health Study ◽  
Protein Sources ◽  
Processed Red Meat

ABSTRACT Background Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice. Objective We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM. Methods We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses’ Health Study, and 75,196 females in the Nurses’ Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source. Results During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat. Conclusions Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.

scholarly journals Dietary Inflammatory and Insulinemic Potential and Risk of Type 2 Diabetes: Results from Three Prospective U.S. Cohort Studies

2020 ◽  
Author(s):  
Dong Hoon Lee ◽  
Jun Li ◽  
Yanping Li ◽  
Gang Liu ◽  
Kana Wu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Repeated Measures ◽  
Hazard Ratio ◽  
Diabetes Risk ◽  
Health Study ◽  
Diabetes Incidence ◽  
Incident Type ◽  
Increased Risk

<b>Objective: </b>To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes. <p><b> </b></p> <p><b>Research Design and Methods: </b>We prospectively followed 74,767 women from the Nurses’ Health Study (1984-2016), 90,786 women from the Nurses’ Health Study 2 (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires. </p> <p><b> </b></p> <p><b>Results: </b>We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI, 2.96-3.27) and 3.40 times (95% CI, 3.23-3.58) higher type 2 diabetes risk, respectively, compared to those in the lowest quintile. Additional adjustment for body mass index (BMI) attenuated the associations (Hazard ratio, 1.95; 95% CI, 1.85-2.05 for EDIP; Hazard ratio, 1.87; 95% CI, 1.78-1.98 for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI, 2.17-2.52), compared to those in both lowest quintiles, after adjustment for BMI.</p> <p> </p> <p><b>Conclusions: </b><a>H</a>igher dietary inflammatory and insulinemic potential were associated with an increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development. </p>

scholarly journals Dietary Inflammatory and Insulinemic Potential and Risk of Type 2 Diabetes: Results from Three Prospective U.S. Cohort Studies

2020 ◽  
Author(s):  
Dong Hoon Lee ◽  
Jun Li ◽  
Yanping Li ◽  
Gang Liu ◽  
Kana Wu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Repeated Measures ◽  
Hazard Ratio ◽  
Diabetes Risk ◽  
Health Study ◽  
Diabetes Incidence ◽  
Incident Type ◽  
Increased Risk

<b>Objective: </b>To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes. <p><b> </b></p> <p><b>Research Design and Methods: </b>We prospectively followed 74,767 women from the Nurses’ Health Study (1984-2016), 90,786 women from the Nurses’ Health Study 2 (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires. </p> <p><b> </b></p> <p><b>Results: </b>We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI, 2.96-3.27) and 3.40 times (95% CI, 3.23-3.58) higher type 2 diabetes risk, respectively, compared to those in the lowest quintile. Additional adjustment for body mass index (BMI) attenuated the associations (Hazard ratio, 1.95; 95% CI, 1.85-2.05 for EDIP; Hazard ratio, 1.87; 95% CI, 1.78-1.98 for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI, 2.17-2.52), compared to those in both lowest quintiles, after adjustment for BMI.</p> <p> </p> <p><b>Conclusions: </b><a>H</a>igher dietary inflammatory and insulinemic potential were associated with an increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development. </p>

Abstract MP94: Consumption of Specific Fruits and Incidence of Type 2 Diabetes in Men and Women

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Isao Muraki ◽  
Fumiaki Imamura ◽  
Frank B Hu ◽  
Walter C Willett ◽  
Rob van Dam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Fruit Juice ◽  
Dietary Factors ◽  
Health Study ◽  
Significant Heterogeneity ◽  
Men And Women ◽  
Increased Risk

Background: Consumption of whole fruits, but not fruit juice, has been associated with lower risk of type 2 diabetes. However, individual fruits have different compositions of carbohydrate, phytochemicals and other nutrients, and may thus have different effects on diabetes risk. We examined whether consumption of specific fruits was prospectively associated with risk of type 2 diabetes in US men and women. In addition, we evaluated whether the associations of fruits with diabetes were determined by the glycemic load (GL) of fruits consumption. Methods: After excluding participants with chronic diseases at baseline, we evaluated 66,720 women from the Nurses' Health Study (1984-2008); 85,961 women from the Nurses’ Health Study II (1991-2009); and 26,149 men from the Health Professionals Follow-up Study (1986-2008). Validated semi-quantitative food frequency questionnaires were administered to assess habitual consumption of fruits and other foods every two to four years. Incidences of type 2 diabetes were identified using biennial self-reported questionnaires and confirmed using supplementary questionnaires. The associations were prospectively assessed in each cohort, using Cox proportional hazard regression. Sociodemographics, lifestyle, caloric intakes, intakes of other fruits, and other dietary factors were adjusted for to control for confounding. Cohort-specific estimates were pooled by a random-effects meta-analysis. Results: During 3,447,866 person-years of follow-up, 11,521 participants were newly diagnosed with type 2 diabetes. The pooled multivariable-adjusted hazard ratios (HRs) for type 2 diabetes (for every 3 servings/week increase of fruit intake) were 0.74 [95% confidence interval (CI): 0.66, 0.83] for blueberries; 0.86 (0.80, 0.93) for grapes or raisins; 0.86 (0.75, 0.99) for prunes; 0.91 (0.81, 1.03) for bananas; 0.93 (0.88, 0.97) for apples or pears; 0.95 (0.91, 1.00) for grapefruits; 0.96 (0.90, 1.02) for peaches, plums or apricots; 1.01 (0.97, 1.05) for oranges; 1.06 (0.96, 1.19) for strawberries; and 1.11 (1.03, 1.20) for cantaloupe. No significant heterogeneity was found among the three cohorts, except associations with banana consumption. In contrast, each drink per day of fruit juice was associated with a HR (95% CI) of 1.07 (1.00, 1.14). The HRs for type 2 diabetes were 0.81 (0.69, 0.96) per 1 serving/day of high GL fruits, 0.96 (0.86, 1.07) for moderate GL fruits, and 1.05 (0.92, 1.19) for low GL fruits. Conclusion: Our data suggest that intakes of certain whole fruits, including grapes or raisins, prunes, apples or pears, grapefruits, and blueberries, are associated with lower risk of type 2 diabetes, whereas high consumption of fruit juice may lead to increased risk. Future research is needed to confirm our findings and elucidate mechanism underlying the associations for individual fruits.

scholarly journals Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

2021 ◽  
Author(s):  
Zhangling Chen ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Y. Baden ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Health Study ◽  
Weight Changes ◽  
Subsequent Risk

<b>Objective</b> <p>We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.</p> <p><b>Methods</b></p> <p>We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis.</p> <p><b>Results</b></p> <p>We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. </p> <p><b>Conclusions</b></p> <p>Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk. </p>

scholarly journals Shortened Relative Leukocyte Telomere Length is Associated with Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes- Analysis from the Hong Kong Diabetes Register

2020 ◽  
Author(s):  
Feifei Cheng ◽  
Andrea O Luk ◽  
Claudia HT Tam ◽  
Baoqi Fan ◽  
Hongjiang Wu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hong Kong ◽  
Telomere Length ◽  
Cox Regression ◽  
Quantitative Polymerase Chain Reaction ◽  
Hazard Ratio ◽  
Chinese Patients ◽  
Diabetes Register

<b>Objective</b>: Several studies support potential links between leukocyte relative telomere length (rLTL), a biomarker of biological aging and type 2 diabetes. This study investigates relationships between rLTL and subsequent cardiovascular disease (CVD) in patients with type 2 diabetes. <p><b>Research design and methods</b>: Consecutive Chinese patients with type 2 diabetes (N=5349) from the Hong Kong Diabetes Register with stored baseline DNA and available follow-up data were studied. rLTL was measured using quantitative polymerase chain reaction. CVD was diagnosed based on ICD-9 code.</p> <p><b>Results: </b>Mean (SD) follow-up was 13.4(5.5) years. rLTL was correlated inversely with age, diabetes duration, blood pressure, HbA<sub>1c</sub>, urine ACR and positively with eGFR (all P<0.001). Subjects with versus without CVD at baseline had shorter rLTL (4.3±1.2 vs. 4.6±1.2, P<0.001). Of the 4541 CVD-free subjects at baseline, the 1140 who developed CVD during follow-up had shorter rLTL than those remaining CVD-free after adjusting for age, sex, smoking and albuminuria status (4.3±1.2 vs. 4.7±1.2, P<0.001). In Cox regression models, shorter rLTL was associated with higher risk of incident CVD (hazard ratio (95% CI) for each unit decrease: 1.252 (1.195-1.311), P<0.001), which remained significant after adjusting for age, sex, BMI, SBP, LDL-C, HbA<sub>1c</sub>, eGFR and ACR (hazard ratio (95% CI): 1.141 (1.084-1.200), P<0.001).</p> <p><b>Conclusions: </b>rLTL is significantly shorter in type 2 diabetes patients with CVD, is associated with cardiometabolic risk factors, and is independently associated with incident CVD. Telomere length may be a useful biomarker for CVD risk in type 2 diabetes.</p> <b><br> </b>

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