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Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study

The appropriate proportions of macronutritional intake have been controversial in medical nutritional therapy for diabetes, and evidence of the effects of carbohydrate consumption on diabetes complications in prospective settings is sparse. We investigated the relationships between proportions of ca...

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Autores principales: Horikawa, Chika, Yoshimura, Yukio, Kamada, Chiemi, Tanaka, Shiro, Tanaka, Sachiko, Matsunaga, Satoshi, Hanyu, Osamu, Araki, Atsushi, Ito, Hideki, Tanaka, Akira, Ohashi, Yasuo, Akanuma, Yasuo, Sone, Hirohito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331544/
https://www.ncbi.nlm.nih.gov/pubmed/28178180
http://dx.doi.org/10.3390/nu9020113
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author Horikawa, Chika
Yoshimura, Yukio
Kamada, Chiemi
Tanaka, Shiro
Tanaka, Sachiko
Matsunaga, Satoshi
Hanyu, Osamu
Araki, Atsushi
Ito, Hideki
Tanaka, Akira
Ohashi, Yasuo
Akanuma, Yasuo
Sone, Hirohito
author_facet Horikawa, Chika
Yoshimura, Yukio
Kamada, Chiemi
Tanaka, Shiro
Tanaka, Sachiko
Matsunaga, Satoshi
Hanyu, Osamu
Araki, Atsushi
Ito, Hideki
Tanaka, Akira
Ohashi, Yasuo
Akanuma, Yasuo
Sone, Hirohito
author_sort Horikawa, Chika
collection PubMed
description The appropriate proportions of macronutritional intake have been controversial in medical nutritional therapy for diabetes, and evidence of the effects of carbohydrate consumption on diabetes complications in prospective settings is sparse. We investigated the relationships between proportions of carbohydrate intake as the % of total energy and diabetes complications in a nationwide cohort of Japanese patients with type 2 diabetes aged 40–70 years with hemoglobin A1c ≥6.5%. The analysis was of 1516 responders to a baseline dietary survey assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes were times to overt nephropathy, diabetic retinopathy, and cardiovascular disease (CVD) after 8 years. Hazard ratios (HRs) for proportions of carbohydrate intake were estimated by Cox regression adjusted for confounders. High carbohydrate intake was significantly related to higher intakes of grain, fruits, and sweets/snacks and lower intakes of soybean and soy products, vegetables, seaweed, meat and processed meat, fish and processed fish, eggs, milk and dairy products, oil, and alcoholic beverages. During the eight-year follow-up, there were 81, 275, and 129 events of overt nephropathy, diabetic retinopathy, and CVD, respectively. After adjustment for confounders, HRs for complications in patients with carbohydrate intake in the second or third tertiles (51.0%–56.4% and ≥56.5%, respectively) compared with carbohydrate intake in the first tertile (<50.9%, referent) were analyzed. No significant associations were shown in the second and third tertiles relative to first tertile (overt nephropathy: 1.05 (95% Confidence Interval, 0.54–2.06) and 0.98 (0.40–2.44); diabetic retinopathy: 1.30 (0.90–1.88) and 1.30 (0.78–2.15); and CVD: 0.95 (0.55–1.63) and 1.37 (0.69–2.72)). By exploring potentially nonlinear relationships, trends for the incidence of diabetes complications according to proportions of carbohydrate intake were not clearly shown. Findings suggested that proportions of carbohydrate intake were not associated with the incidence of diabetes complications among type 2 diabetes patients in Japan.
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spelling pubmed-53315442017-03-13 Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study Horikawa, Chika Yoshimura, Yukio Kamada, Chiemi Tanaka, Shiro Tanaka, Sachiko Matsunaga, Satoshi Hanyu, Osamu Araki, Atsushi Ito, Hideki Tanaka, Akira Ohashi, Yasuo Akanuma, Yasuo Sone, Hirohito Nutrients Article The appropriate proportions of macronutritional intake have been controversial in medical nutritional therapy for diabetes, and evidence of the effects of carbohydrate consumption on diabetes complications in prospective settings is sparse. We investigated the relationships between proportions of carbohydrate intake as the % of total energy and diabetes complications in a nationwide cohort of Japanese patients with type 2 diabetes aged 40–70 years with hemoglobin A1c ≥6.5%. The analysis was of 1516 responders to a baseline dietary survey assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes were times to overt nephropathy, diabetic retinopathy, and cardiovascular disease (CVD) after 8 years. Hazard ratios (HRs) for proportions of carbohydrate intake were estimated by Cox regression adjusted for confounders. High carbohydrate intake was significantly related to higher intakes of grain, fruits, and sweets/snacks and lower intakes of soybean and soy products, vegetables, seaweed, meat and processed meat, fish and processed fish, eggs, milk and dairy products, oil, and alcoholic beverages. During the eight-year follow-up, there were 81, 275, and 129 events of overt nephropathy, diabetic retinopathy, and CVD, respectively. After adjustment for confounders, HRs for complications in patients with carbohydrate intake in the second or third tertiles (51.0%–56.4% and ≥56.5%, respectively) compared with carbohydrate intake in the first tertile (<50.9%, referent) were analyzed. No significant associations were shown in the second and third tertiles relative to first tertile (overt nephropathy: 1.05 (95% Confidence Interval, 0.54–2.06) and 0.98 (0.40–2.44); diabetic retinopathy: 1.30 (0.90–1.88) and 1.30 (0.78–2.15); and CVD: 0.95 (0.55–1.63) and 1.37 (0.69–2.72)). By exploring potentially nonlinear relationships, trends for the incidence of diabetes complications according to proportions of carbohydrate intake were not clearly shown. Findings suggested that proportions of carbohydrate intake were not associated with the incidence of diabetes complications among type 2 diabetes patients in Japan. MDPI 2017-02-06 /pmc/articles/PMC5331544/ /pubmed/28178180 http://dx.doi.org/10.3390/nu9020113 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Horikawa, Chika
Yoshimura, Yukio
Kamada, Chiemi
Tanaka, Shiro
Tanaka, Sachiko
Matsunaga, Satoshi
Hanyu, Osamu
Araki, Atsushi
Ito, Hideki
Tanaka, Akira
Ohashi, Yasuo
Akanuma, Yasuo
Sone, Hirohito
Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title_full Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title_fullStr Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title_full_unstemmed Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title_short Is the Proportion of Carbohydrate Intake Associated with the Incidence of Diabetes Complications?—An Analysis of the Japan Diabetes Complications Study
title_sort is the proportion of carbohydrate intake associated with the incidence of diabetes complications?—an analysis of the japan diabetes complications study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331544/
https://www.ncbi.nlm.nih.gov/pubmed/28178180
http://dx.doi.org/10.3390/nu9020113
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