Background

Plant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes mellitus (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets.

Methods

Prospective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations.

Results

Of 113,097 study participants 2,628 developed T2DM over 12 years of follow-up. Participants with the highest hPDI scores (Quartile 4) had a 24 % lower T2DM risk compared to those with the lowest scores (Quartile 1) [Hazard Ratio (HR): 0.76, 95 % Confidence Interval (CI): 0.68–0.85]. This association was mediated by a lower BMI (proportion mediated: 28 %), lower waist circumference (28 %), and lower concentrations of HBA1c (11 %), triglycerides (9 %), alanine aminotransferase (5 %), gamma glutamyl transferase (4 %), C-reactive protein (4 %), insulin-like growth factor 1 (4 %), cystatin C (4 %) and urate (4 %). Higher uPDI scores were associated with a 37 % higher T2DM risk [HR: 1.37, 95 % CI:1.22- 1.53], with higher waist circumference (proportion mediated: 17 %), BMI (7 %), and higher concentrations of triglycerides (13 %) potentially playing mediating roles.

Conclusion

Healthful plant-based diets may protect against T2DM via lower body fatness, but also via normoglycaemia, lower basal inflammation as well as improved kidney and liver function.

中文翻译：

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健康的植物性饮食通过改善代谢状态和器官功能与降低 2 型糖尿病风险相关：一项前瞻性队列研究

背景

由于良好的环境足迹，植物性饮食变得越来越受欢迎，并且可以降低 2 型糖尿病 (T2DM) 的风险。在这里，我们研究了解释植物性饮食个体中 T2DM 风险较低的潜在机制。

方法

对来自英国生物银行的前瞻性数据进行了评估，这是一项基线年龄为 40 至 69 岁的参与者的队列研究。通过多变量 Cox 回归模型分析健康和不健康植物性指数（hPDI 和 uPDI）与 T2DM 风险之间的关联，然后进行因果中介分析，以调查哪些心脏代谢风险因素解释了观察到的关联。

结果

在 113,097 名研究参与者中，有 2,628 人在 12 年的随访中患上了 T2DM。与得分最低（四分位数 1）的参与者相比，hPDI 得分最高（四分位数 4）的参与者 T2DM 风险降低 24% [风险比 (HR)：0.76，95% 置信区间 (CI)：0.68–0.85]。这种关联是由较低的 BMI（比例介导：28%）、较低的腰围（28%）以及较低浓度的 HBA1c（11%）、甘油三酯（9%）、丙氨酸氨基转移酶（5%）、γ 谷氨酰转移酶介导的(4 %)、C 反应蛋白 (4 %)、胰岛素样生长因子 1 (4 %)、胱抑素 C (4 %) 和尿酸盐 (4 %)。较高的 uPDI 评分与较高 37% 的 T2DM 风险相关 [HR: 1.37, 95% CI:1.22-1.53​​]、较高的腰围（介导比例：17%）、BMI (7%) 和较高的甘油三酯浓度（ 13%）可能发挥中介作用。

结论

健康的植物性饮食可以通过降低身体脂肪、使血糖正常、降低基础炎症以及改善肾和肝功能来预防 T2DM。