Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Effects of Korean Food-based Dietary Inflammatory Index Potential on the incidence of diabetes and HbA1c level in Korean adults aged 40 years and older

40세 이상 성인 한국인에서 한국형 식사염증지표 수준에 따른 당뇨병 발생률 및 당화혈색소 수준 변화 연구

  • Yoon, Hyun Seo (Graduate School of Converging Clinical and Public Health, Ewha Womans University) ;
  • Shon, Jinyoung (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Park, Yoon Jung (Graduate School of Converging Clinical and Public Health, Ewha Womans University)
  • 윤현서 (이화여자대학교 임상보건융합대학원 임상보건학과 임상영양전공) ;
  • 손진영 (이화여자대학교 신산업융합대학 식품영양학과) ;
  • 박윤정 (이화여자대학교 임상보건융합대학원 임상보건학과 임상영양전공)
  • Received : 2021.10.01
  • Accepted : 2022.03.08
  • Published : 2022.04.30
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Abstract

Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes. Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13-2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion: These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

본 연구 결과 우리나라 40세 이상 성인에서 FBDI와 당뇨병 발생률 간의 상관성은 없었으나 당화혈색소 수준과 상관관계를 가지고, 이러한 경향은 여성이거나 운동을 하지 않는 사람, 그리고 비만인 경우 영향을 더 많이 받는다는 결과를 도출해냈다. 이는 앞으로 우리나라 당뇨병 관리 측면에서 염증을 고려한 다각화된 임상영양치료의 발판이 되리라 사료된다. 또한 추후 장기간의 추적 연구를 통해 식사염증지표와 당뇨병의 발생에 대한 추가적인 연구가 필요한 것으로 보이며, 당뇨병의 심각성에 관한 연구는 거의 없는 실정이기 때문에 추후 연구가 반드시 필요하다고 사료된다. 본 연구를 발판 삼아 추가적인 연구를 기반으로 임상현장에서 식사염증지표가 당뇨병 관리 도구로 활용될 수 있기를 기대하는 바이다.

Keywords

Acknowledgement

This work was supported by the National Research Foundation (NRF) funded by the Korea government (2021R1A2C2012578).

References

  1. World Health Organization (WHO). Global report on diabetes [Internet]. Geneva: WHO; 2016 [cited 2021 Jan 13]. Available from: https://www.who.int/publications/i/item/9789241565257.
  2. Adeghate E, Schattner P, Dunn E. An update on the etiology and epidemiology of diabetes mellitus. Ann N Y Acad Sci 2006; 1084(1): 1-29. https://doi.org/10.1196/annals.1372.029
  3. Tsalamandris S, Antonopoulos AS, Oikonomou E, Papamikroulis GA, Vogiatzi G, Papaioannou S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol 2019; 14(1): 50-59. https://doi.org/10.15420/ecr.2018.33.1
  4. Yuan M, Konstantopoulos N, Lee J, Hansen L, Li ZW, Karin M, et al. Reversal of obesity- and diet-induced insulin resistance with salicylates or targeted disruption of Ikkbeta. Science 2001; 293(5535): 1673-1677. https://doi.org/10.1126/science.1061620
  5. Hirosumi J, Tuncman G, Chang L, Gorgun CZ, Uysal KT, Maeda K, et al. A central role for JNK in obesity and insulin resistance. Nature 2002; 420(6913): 333-336. https://doi.org/10.1038/nature01137
  6. Larsen CM, Faulenbach M, Vaag A, Volund A, Ehses JA, Seifert B, et al. Interleukin-1-receptor antagonist in type 2 diabetes mellitus. N Engl J Med 2007; 356(15): 1517-1526. https://doi.org/10.1056/NEJMoa065213
  7. Tricon S, Burdge GC, Kew S, Banerjee T, Russell JJ, Grimble RF, et al. Effects of cis-9,trans-11 and trans10,cis-12 conjugated linoleic acid on immune cell function in healthy humans. Am J Clin Nutr 2004; 80(6): 1626-1633. https://doi.org/10.1093/ajcn/80.6.1626
  8. Lefevre M, Jonnalagadda S. Effect of whole grains on markers of subclinical inflammation. Nutr Rev 2012; 70(7): 387-396. https://doi.org/10.1111/j.1753-4887.2012.00487.x
  9. Holt EM, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, et al. Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc 2009; 109(3): 414-421. https://doi.org/10.1016/j.jada.2008.11.036
  10. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids 2010; 45(10): 893-905. https://doi.org/10.1007/s11745-010-3393-4
  11. Arulselvan P, Fard MT, Tan WS, Gothai S, Fakurazi S, Norhaizan ME, et al. Role of antioxidants and natural products in inflammation. Oxid Med Cell Longev 2016; 2016: 5276130. https://doi.org/10.1155/2016/5276130
  12. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13(1): 3-9. https://doi.org/10.1097/00041433-200202000-00002
  13. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 2014; 17(8): 1689-1696. https://doi.org/10.1017/s1368980013002115
  14. Tabung FK, Smith-Warner SA, Chavarro JE, Wu K, Fuchs CS, Hu FB, et al. Development and validation of an empirical dietary inflammatory index. J Nutr 2016; 146(8): 1560-1570. https://doi.org/10.3945/jn.115.228718
  15. Na W, Yu TY, Sohn C. Development of a food-based index of dietary inflammatory potential for Koreans and its relationship with metabolic syndrome. Nutr Res Pract 2019; 13(2): 150-158. https://doi.org/10.4162/nrp.2019.13.2.150
  16. Lee DH, Li J, Li Y, Liu G, Wu K, Bhupathiraju S, et al. Dietary inflammatory and insulinemic potential and risk of type 2 diabetes: results from three prospective U.S. cohort studies. Diabetes Care 2020; 43(11): 2675-2683. https://doi.org/10.2337/dc20-0815
  17. Jin Q, Shi N, Aroke D, Lee DH, Joseph JJ, Donneyong M, et al. Insulinemic and inflammatory dietary patterns show enhanced predictive potential for type 2 diabetes risk in postmenopausal women. Diabetes Care 2021; 44(3): 707-714. https://doi.org/10.2337/dc20-2216
  18. Vahid F, Shivappa N, Karamati M, Naeini AJ, Hebert JR, Davoodi SH. Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study. Appl Physiol Nutr Metab 2017; 42(4): 399-404. https://doi.org/10.1139/apnm-2016-0395
  19. Laouali N, Mancini FR, Hajji-Louati M, El Fatouhi D, Balkau B, Boutron-Ruault MC, et al. Dietary inflammatory index and type 2 diabetes risk in a prospective cohort of 70,991 women followed for 20 years: the mediating role of BMI. Diabetologia 2019; 62(12): 2222-2232. https://doi.org/10.1007/s00125-019-04972-0
  20. Guinter MA, Merchant AT, Tabung FK, Wirth MD, Shivappa N, Hurley TG, et al. Adiposity does not modify the effect of the dietary inflammatory potential on type 2 diabetes incidence among a prospective cohort of men. J Nutr Intermed Metab 2019; 16: 100095. https://doi.org/10.1016/j.jnim.2019.100095
  21. Kim Y, Han BGKoGES group. Cohort profile: The Korean Genome and Epidemiology Study (KoGES) consortium. Int J Epidemiol 2017; 46(2): e20. https://doi.org/10.1093/ije/dyv316
  22. Korean Diabetes Association. Treatment for diabetes, 6th ed. Seoul; 2019.
  23. American Diabetes Association. Prevention or delay of type 2 diabetes: standards of medical care in diabetes-2018. Diabetes Care 2018; 41(Suppl 1): S51-S54. https://doi.org/10.2337/dc18-S005
  24. Ahn Y, Kwon E, Shim JE, Park MK, Joo Y, Kimm K, et al. Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 2007; 61(12): 1435-1441. https://doi.org/10.1038/sj.ejcn.1602657
  25. Ginwala R, Bhavsar R, Chigbu DI, Jain P, Khan ZK. Potential role of flavonoids in treating chronic inflammatory diseases with a special focus on the anti-inflammatory activity of apigenin. Antioxidants (Basel) 2019; 8(2): 35. https://doi.org/10.3390/antiox8020035
  26. Wu D. Modulation of immune and inflammatory responses by dietary lipids. Curr Opin Lipidol 2004; 15(1): 43-7. https://doi.org/10.1097/00041433-200402000-00009
  27. Bray GA, Lovejoy JC, Smith SR, DeLany JP, Lefevre M, Hwang D, et al. The influence of different fats and fatty acids on obesity, insulin resistance and inflammation. J Nutr 2002; 132(9): 2488-2491. https://doi.org/10.1093/jn/132.9.2488
  28. Denova-Gutierrez E, Munoz-Aguirre P, Shivappa N, Hebert JR, Tolentino-Mayo L, Batis C, et al. Dietary inflammatory index and type 2 diabetes mellitus in adults: the diabetes mellitus survey of Mexico City. Nutrients 2018; 10(4): 385. https://doi.org/10.3390/nu10040385
  29. van Woudenbergh GJ, Theofylaktopoulou D, Kuijsten A, Ferreira I, van Greevenbroek MM, van der Kallen CJ, et al. Adapted dietary inflammatory index and its association with a summary score for low-grade inflammation and markers of glucose metabolism: the Cohort study on Diabetes and Atherosclerosis Maastricht (CODAM) and the Hoorn study. Am J Clin Nutr 2013; 98(6): 1533-1542. https://doi.org/10.3945/ajcn.112.056333
  30. King DE, Xiang J. The dietary inflammatory index is associated with diabetes severity. J Am Board Fam Med 2019; 32(6): 801-806. https://doi.org/10.3122/jabfm.2019.06.190092
  31. Lin M, Shivappa N, Hebert JR, Huang H, Cai L, Liang J, et al. Dietary inflammatory index and cardiorenal function in women with diabetes and prediabetes. Nutr Metab Cardiovasc Dis 2021; 31(8): 2319-2327. https://doi.org/10.1016/j.numecd.2021.05.011
  32. Braun A, Samann A, Kubiak T, Zieschang T, Kloos C, Muller UA, et al. Effects of metabolic control, patient education and initiation of insulin therapy on the quality of life of patients with type 2 diabetes mellitus. Patient Educ Couns 2008; 73(1): 50-59. https://doi.org/10.1016/j.pec.2008.05.005
  33. Phillips CM, Chen LW, Heude B, Bernard JY, Harvey NC, Duijts L, et al. Dietary inflammatory index and non-communicable disease risk: a narrative review. Nutrients 2019; 11(8): 1873. https://doi.org/10.3390/nu11081873
  34. Chong S, Ding D, Byun R, Comino E, Bauman A, Jalaludin B. Lifestyle changes after a diagnosis of type 2 diabetes. Diabetes Spectr 2017; 30(1): 43-50. https://doi.org/10.2337/ds15-0044
  35. Levy J, Atkinson AB, Bell PM, McCance DR, Hadden DR. Beta-cell deterioration determines the onset and rate of progression of secondary dietary failure in type 2 diabetes mellitus: the 10-year follow-up of the Belfast Diet Study. Diabet Med 1998; 15(4): 290-296. https://doi.org/10.1002/(SICI)1096-9136(199804)15:4<290::AID-DIA570>3.0.CO;2-M
  36. Kanmani S, Kwon M, Shin MK, Kim MK. Association of C-reactive protein with risk of developing type 2 diabetes mellitus, and role of obesity and hypertension: a large population-based Korean cohort study. Sci Rep 2019; 9(1): 4573. https://doi.org/10.1038/s41598-019-40987-8
  37. Lee KW, Woo HD, Cho MJ, Park JK, Kim SS. Identification of dietary patterns associated with incidence of hyperglycemia in middle-aged and older Korean adults. Nutrients 2019; 11(8): 1801. https://doi.org/10.3390/nu11081801
  38. Zhou K, Donnelly LA, Morris AD, Franks PW, Jennison C, Palmer CN, et al. Clinical and genetic determinants of progression of type 2 diabetes: a DIRECT study. Diabetes Care 2014; 37(3): 718-724. https://doi.org/10.2337/dc13-1995
  39. Jiang G, Luk AO, Tam CH, Lau ES, Ozaki R, Chow EY, et al. Obesity, clinical, and genetic predictors for glycemic progression in Chinese patients with type 2 diabetes: a cohort study using the Hong Kong Diabetes Register and Hong Kong Diabetes Biobank. PLoS Med 2020; 17(7): e1003209. https://doi.org/10.1371/journal.pmed.1003209
  40. Kadoglou NP, Perrea D, Iliadis F, Angelopoulou N, Liapis C, Alevizos M. Exercise reduces resistin and inflammatory cytokines in patients with type 2 diabetes. Diabetes Care 2007; 30(3): 719-721. https://doi.org/10.2337/dc06-1149
  41. Arnetz L, Ekberg NR, Alvarsson M. Sex differences in type 2 diabetes: focus on disease course and outcomes. Diabetes Metab Syndr Obes 2014; 7: 409-420. https://doi.org/10.2147/DMSO.S51301