糖尿病前期
医学
胰岛素抵抗
内科学
全国健康与营养检查调查
卡路里
危险系数
碳水化合物
内分泌学
稳态模型评估
比例危险模型
糖尿病
胰岛素
生理学
2型糖尿病
人口
环境卫生
置信区间
作者
Chia-Lin Lee,Wei-Ju Liu,Jun‐Sing Wang
标识
DOI:10.1016/j.clnu.2020.12.019
摘要
Background & aims We investigated the associations of low-carbohydrate and low-fat diets with all-cause mortality in people with prediabetes according to insulin resistance status using data from the National Health and Nutrition Examination Survey (NHANES). Methods We analyzed the NHANES participants with prediabetes from 2005 to 2008, and their vital status was linked to the National Death Index through the end of 2011. Low-carbohydrate and low-fat diets were defined as ≦40% and ≦30% of calories from carbohydrate and fat, respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to determine insulin resistance. Weighted Cox proportional hazards regression models were used to compare the hazard ratios for the associations of low-carbohydrate and low-fat diets with all-cause mortality. Results Among the 1687 participants with prediabetes, 96 of them had died after a median follow-up of 4.5 years. Participants with a HOMA-IR >3.0 had an increase in all-cause mortality compared with those who had a HOMA-IR ≦3.0 (HR 1.797, 95% CI 1.110 to 2.909, p = 0.019). Participants with ≦40% of calories from carbohydrate and >30% from fat (3.75 per 1000 person-years) had a lower all-cause mortality rate compared with those who had >40% from carbohydrate and >30% from fat (10.20 per 1000 person-years) or >40% from carbohydrate and ≦30% from fat (8.09 per 1000 person-years), with statistical significance observed in those who had a HOMA-IR ≦3.0. Conclusions A low-carbohydrate intake (≦40%) was associated with a lower all-cause mortality rate in people with prediabetes.
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