The Prospective Associations of Lipid Metabolism-Related Dietary Patterns with the Risk of Diabetes in Chinese Adults.

Qi Liu,Qiaorui Wen,Liming Li,Huaidong Du,Zumin Shi,Yiping Chen,Ling Yang,Junshi Chen,Jun Lv,Yu Guo,Sam Sansome,Pei Pei,Zhengming Chen,Xiaofang Zhang,Canqing Yu,Dan Schmidt

doi:10.3390/nu14050980

Abstract

Background: This study aimed to identify lipid metabolism-related dietary patterns with reduced rank regression (RRR) among Chinese adults and examine their associations with incident diabetes. Methods: We derived lipid metabolism-related dietary patterns using an RRR with 21 food groups as predictors as well as total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, body mass index (BMI), and waist circumference from the responses of 17,318 participants from the second resurvey of the China Kadoorie Biobank (CKB). The dietary scores were calculated for the entire cohort. We followed up 479,207 participants for diabetes incidence from the baseline and used multivariable Cox regression models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Two lipid metabolism-related dietary patterns were extracted. The dietary pattern—characterized by high intakes of fish, poultry, and other staples as well as fresh fruit and vegetables—was correlated with a higher BMI, waist circumference, and LDL cholesterol. Participants in the highest quintile (Q5) had a 44% increased risk of diabetes incidence when compared with those in the lowest quintile (Q1) (HR = 1.44; 95% CI: 1.31–1.59). Conclusions: A dietary pattern characterized by high intakes of both animal and plant foods was related to obesity and dyslipidemia and could increase the risk of diabetes incidence.

Highlights

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough of the blood sugar-regulating hormone insulin or when the body cannot effectively use the insulin it produces
Two lipid metabolism-related dietary patterns were extracted with the rank regression (RRR) method, explaining 4.23% and 1.44% of the variation of response variables from 17,318 participants from the second resurvey of the China Kadoorie Biobank (CKB)
The dietary pattern score was positively correlated with the total cholesterol, low-density lipoprotein (LDL) cholesterol, and highdensity lipoprotein (HDL) cholesterol (p < 0.001)

Summary

Introduction

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough of the blood sugar-regulating hormone insulin or when the body cannot effectively use the insulin it produces. Neither a priori nor exploratory approaches (e.g., principal component, factor, and cluster analyses) could utilize the information of the biological pathways for diseases and the underlying dietary data. Hybrid approaches such as the reduced rank regression (RRR) model have been introduced to identify dietary patterns that are more related to the disease outcomes of interest [7,8]. This study aimed to identify lipid metabolism-related dietary patterns with reduced rank regression (RRR) among Chinese adults and examine their associations with incident diabetes. Conclusions: A dietary pattern characterized by high intakes of both animal and plant foods was related to obesity and dyslipidemia and could increase the risk of diabetes incidence

Objectives

Methods

Results

Discussion

Conclusion