당뇨병

Cross-Sectional Assessment Of Nut Consumption And Obesity, Metabolic Syndrome And Other Cardiometabolic Risk Factors.

By Ibarrola-Jurado N, Bulló M, Guasch-Ferré M, Ros E, Martínez-González MA, Corella D, Fiol M, Wärnberg J, Estruch R, Lapetra J, Arós F, Muñoz MA, Serra-Majem L, Pintó X, Covas MI, Basora J, Salas-Salvadó J; on behalf of the PREDIMED Study Investigators.

BACKGROUND
Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors.

OBJECTIVE
To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk.

METHOD
Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as < 1, 1-3, and >3 servings/wk. Control of confounding was done with multivariate logistic regression.

RESULT
Compared to participants consuming < 1 serving/wk of nuts, those consuming >3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend < 0.001), MetS (0.74, 0.65 to 0.85; P-trend< 0.001), and diabetes (0.87, 0.78 to 0.99; P-trend=0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend< 0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose.

CONCLUSION
Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.

PUBLISHED : FEBRUARY 27, 2013
STUDY TYPE : RANDOMIZED CONTROLLED CLINICAL TRIAL
TOPICS : DIABETES, HEART HEALTH, WEIGHT MANAGEMENT, RANDOMIZED CONTROLLED CLINICAL TRIAL
SOURCE : http://www.plosone.org/article/related/info%3Adoi%2F10.1371%2Fjournal.pone.0057367;jsessionid=33F225900DC478AA99FE6685415892B3

Plasma Fatty Acid Composition, Estimated Desaturase Activities, And Their Relation With The Metabolic Syndrome In A Population At High Risk Of Cardiovascular Disease

By Mayneris-Perxachs J, Guerendiain M, Castellote AI, Estruch R, Covas MI, Fitó M, Salas-Salvadó J, Martínez-González MA, Aros F, Lamuela-Raventós RM, López-Sabater MC; for PREDIMED Study Investigators

BACKGROUND
The metabolic syndrome (MetS) is a clustering of various metabolic abnormalities which is associated with increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus. Due to its increasing prevalence, it has become an important public health concern. Altered fatty acid (FA) composition and desaturase activities have been associated with several metabolic diseases, including MetS. The aim of the present study was to evaluate the relationship of the plasma FA profile and desaturase activities with the MetS in a Mediterranean population at high risk of CVD.

METHOD
Baseline data from 427 participants aged 55-80 years who took part in the interventional PREDIMED study were obtained. Individual FA was determined in plasma and desaturase activities were estimated from product/precursor ratios. Odds ratios (OR) and partial correlation coefficients were used to examine these relations with MetS and its components, respectively.

RESULT
We found higher levels of C14:0, C16:0, C16:1n-7, estimated Δ9- or stearoyl-CoA desaturase (SCD), and estimated Δ6 desaturase (D6D), and lower levels of C18:2n-6 in people with MetS compared to those without it. After adjustment for several confounders, only higher quartiles of C14:0, C16:0, C16:1n-7, and D6D were found to be associated with an increasing prevalence of MetS, while higher quartiles of C18:2n-6 were inversely associated with MetS. High proportions of C14:0, C16:0, C16:1n-7, C20:3n-6, SCD, and D6D, and decreased proportions of C18:2n-6 and estimated Δ5-desaturase (D5D) were associated with adverse profiles of several metabolic risk factors. Women showed more unhealthy FA pattern and lipid profiles than men, but only among those with MetS.

CONCLUSION
A FA composition and estimated desaturase activities consisting in high levels of SFA, SCD and D6D, and low levels of PUFA and D5D are associated with increased MetS probability and are characteristic of people presenting MetS, especially women. These findings support those observed in non-Mediterranean populations in which an altered FA profile and estimated desaturase activities are associated with MetS.

PUBLISHED : MARCH 28, 2013
STUDY TYPE : RANDOMIZED CONTROLLED CLINICAL TRIAL
TOPIC : DIABETES, HEART HEALTH, MEDITERRANEAN DIET, PREDIMED, RANDOMIZED CONTROLLED CLINICAL TRIAL
SOURCE : http://www.ncbi.nlm.nih.gov/pubmed/23591154

The Mediterranean Diet Improves The Systemic Lipid And DNA Oxidative Damage In Metabolic Syndrome Individuals. A Randomized, Controlled, Trial

By Mitjavila MT, Fandos M, Salas-Salvadó J, Covas MI, Borrego S, Estruch R, Lamuela-Raventós R, Corella D, Martínez-Gonzalez MÁ, Sánchez JM, Bulló M, Fitó M, Tormos C, Cerdá C, Casillas R, Moreno JJ, Iradi A, Zaragoza C, Chaves J, Sáez GT

BACKGROUND
Metabolic syndrome (MetS), in which a non-classic feature is an increase in systemic oxidative biomarkers, presents a high risk of diabetes and cardiovascular disease (CVD). Adherence to the Mediterranean Diet (MedDiet) is associated with a reduced risk of MetS. However, the effect of the MedDiet on biomarkers for oxidative damage has not been assessed in MetS individuals. We have investigated the effect of the MedDiet on systemic oxidative biomarkers in MetS individuals.

METHOD
Randomized, controlled, parallel clinical trial in which 110 female with MetS, aged 55-80, were recruited into a large trial (PREDIMED Study) to test the efficacy of the traditional MedDiet on the primary prevention of CVD. Participants were assigned to a low-fat diet or two traditional MedDiets (MedDiet + virgin olive oil or MedDiet + nuts). Both MedDiet group participants received nutritional education and either free extra virgin olive oil for all the family (1 L/week), or free nuts (30 g/day). Diets were ad libitum. Changes in urine levels of F2-Isoprostane (F2-IP) and the DNA damage base 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxo-dG) were evaluated at 1-year trial.

RESULT
After 1-year urinary F2-IP decreased in all groups, the decrease in MedDiet groups reaching a borderline significance versus that of the Control group. Urinary 8-oxo-dG was also reduced in all groups, with a higher decrease in both MedDiet groups versus the Control one (P < 0.001).

CONCLUSION
MedDiet reduces oxidative damage to lipids and DNA in MetS individuals. Data from this study provide evidence to recommend the traditional MedDiet as a useful tool in the MetS management.

PUBLISHED : APRIL 1, 2013
STUDY TYPE : RANDOMIZED CONTROLLED CLINICAL TRIAL
TOPIC : DIABETES, HEART HEALTH, MEDITERRANEAN DIET, PREDIMED, RANDOMIZED CONTROLLED CLINICAL TRIAL
SOURCE : http://www.ncbi.nlm.nih.gov/pubmed/22999065

Nut Consumption With Risk Of Hypertension And Type 2 Diabetes Mellitus: A Meta-Analysis Of Prospective Cohort Studies

By Kai Guo, Yibo Jiang, Zhiwen Zhou and Yigang Li; Eur J Prev Cardiol. 2013 Aug 30.

BACKGROUND
The consumption of nuts was reported to be associated with risk of hypertension and type 2 diabetes mellitus (T2DM), but the results were inconclusive.

OBJECTIVE
The aim of this study was to systematically examine longitudinal studies investigating nut intake in relation to risk of hypertension and T2DM.

METHOD
A systematic search of the PubMed and EMBASE databases to 31 March 2013 was performed. Reference lists of retrieved articles were also screened. Summary relative risks (SRRs) and 95% confidence interval(CIs) were calculated using a random-effects model. Q and I2 statistics were used to examine between-study heterogeneity.

RESULT
A total of nine prospective cohort studies (three for hypertension and six for T2DM) were identified. Using random effects models, we found that based on the highest vs lowest analysis, nut consumption were inversely asso- ciated with risk of hypertension (SRR 1⁄4 0.84, 95% CI: 0.76–0.93, pheterogeneity 1⁄4 0.831, I2 1⁄4 0%). Dose-response analyses indicated that nut consumption at more than two servings/wk, but not ne serving/wk, had a preventative role in the hypertension. In addition, nut consumption was not associated with risk of T2DM (SRRs 1⁄4 0.98, 95% CI: 0.84–1.15; pheterogeneity 1⁄4 0.008, I2 1⁄4 67.7%) on the basis of the highest vs lowest analysis. This null association was also shown in the dose-response analysis.

CONCLUSION
In our meta-analysis, nut consumption is found to be inversely associated with hypertension risk but is not associated with the risk of T2DM.

PUBLISHED : AUGUST 30, 2013
STUDY TYPE : META-ANALYSIS AND/OR SYSTEMATIC REVIEW
TOPIC : DIABETES, HEART HEALTH, META-ANALYSIS AND/OR SYSTEMATIC REVIEW
SOURCE : http://cpr.sagepub.com/content/early/2013/08/08/2047487313501120.abstract