Relationship between dietary choline intake and diabetes mellitus in the National Health and Nutrition Examination Survey 2007-2010
膳食胆碱摄入量与糖尿病的关系:美国国民健康与营养调查2007-2010
Abstract
enBackground
Little is known about the relationship between dietary intake of choline, which is a major dietary precursor for gut microbiome-derived trimethylamine N-oxide (TMAO), and diabetes mellitus (DM) in the general population. The present study aims to explore the relationship between dietary choline intake and DM in the US adult population.
Methods
Cross-sectional data were derived from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 of 8621 individuals aged 20 years or older. Multivariable logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs) for DM of each quartile category of energy-adjusted choline intakes. The restricted cubic spline model was used for the dose–response analysis. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of choline intake for predicting DM.
Results
A linear dose–response relationship between dietary choline intake and the odds of DM was found after adjustment for multiple potential confounding factors. With the lowest quartile category of choline as the reference, the multivariable-adjusted ORs and 95% CIs of the second, third, and highest quartile categories were 1.23 (0.99-1.53), 1.27 (1.02-1.58), and 1.49 (1.20-1.85), respectively, P for trend =0.0004. The ROC analysis identified energy-adjusted choline of 331.7 mg/8.37-MJ per day as the optimal cutoff value for predicting DM, with 52.5% sensitivity and 60.7% specificity.
Conclusion
This study supports a positive and linear relationship between dietary choline intake and DM in the US adult population.
摘要
zh背景
胆碱作为肠道微生物代谢产物氧化三甲胺(TMAO)的主要膳食前体，与一般人群罹患糖尿病之间的关系很少为人所知。本研究目的是在美国成年人中探讨膳食胆碱摄入量与糖尿病之间的关系。
方法
从美国国民健康与营养调查2007-2010中提取了8621名20岁以上成年人的横断面数据资料。使用多因素logistic回归模型计算每个四分位数组能量校正胆碱摄入量与糖尿病的比值比(OR)和95%置信区间(CI)。利用限制性立方样条模型进行剂量-反应关系分析。利用受试者工作特征(ROC)曲线探讨能量校正的膳食胆碱摄入量预测糖尿病的最佳切点值。
结果
经过校正多种潜在混杂因素后发现膳食胆碱摄入量与糖尿病患病风险之间存在线性剂量-反应关系。当以膳食胆碱摄入量最低四分位数组作为参照时，第二、三和最高四分位数组的OR(95% CI)分别为1.23(0.99-1.53)、1.27(1.02-1.58)和1.49(1.20-1.85)，趋势检验P值=0.0004。ROC曲线显示当每日膳食胆碱摄入量在331.7 mg/8.37 MJ时预测糖尿病的效果最佳，对应的灵敏度为52.5%，特异度为60.7%。
结论
膳食胆碱摄入量与美国成年人糖尿病患病风险之间存在正向的线性剂量-反应关系。
