Dose‐response relationships between dairy intake and chronic metabolic diseases in a Chinese population

This study investigated associations between dairy intake and chronic metabolic diseases (CMDs), and evaluated possible dose-response relationships in Chinese.This cross-sectional study included 6073 adults aged ≥18 years from China. General characteristics were gathered using a validated dietary questionnaire. Multivariable logistic regression analyses investigated associations between dairy intake and chronic metabolic diseases (CMDs) (overweight/obesity, obesity, central obesity, and hyperlipidemia). Restricted cubic spline models explored dose-response relationships between dairy intake and CMDs, and possible dairy intake in the prevention of CMDs. Structural equation modeling explored the potential mechanisms of the effects of dairy intake on CMDs.Significant inverse associations were found between dairy intake and overweight/obesity, obesity, central obesity, and hyperlipidemia, with odds ratios (ORs) of 0.66 (95% confidence interval [CI] 0.56-0.79), 0.63 (95% CI 0.47-0.85), 0.71 (95% CI 0.60-0.85), and 0.81 (95% CI 0.56-1.17), respectively (P < 0.05 for all). The intake of yogurt, milk, and total dairy to prevent CMDs differed according to age group (16-74, 29-187, and 159-269 mL/d, respectively, in the entire group; 69-110, 59-152, and 138-167 mL/d, respectively, in the young group, ≤ 44 years; 9-58, 57-149, and 117-145 mL/d, respectively, in the middle-aged group, 45-59 years; and 23-59 mL/d yogurt only in the old group, ≥ 60 years). Structural equation modeling showed that dairy intake could reduce body mass index and waist circumference by regulating carbohydrate, fat, protein, and total energy.Dairy intake was inversely associated with the prevalence of overweight, obesity, central obesity, and hyperlipidemia, and the optimal range of dairy intake differed with age. The beneficial effects of dairy intake in preventing CMDs could involve regulation of carbohydrate, fat, protein, and total energy.摘要: 背景 心血管自主神经病变(Cardiovascular autonomic neuropathy，CAN)是心律失常与心血管不良事件的危险因素，但CAN严重程度与2型糖尿病患者夜间心律失常的关系尚不明确。本研究旨在探讨2型糖尿病患者不同严重程度的CAN与夜间心律失常的关系。 方法 选取2017年1月至2018年5月采纳219例2型糖尿病患者作为研究对象。根据心血管自主神经反射试验(CARTs)得分，将患者分为正常组、早期病变组、明确诊断组和严重病变组。使用24小时动态心电图记录患者白天(7:00-23:00)和夜间(23:00-7:00)的心跳分别进行分析。 结果 校正年龄后，夜间室性心律失常发生率随CAN的严重程度增加而上升(正常组:18.6%, 早期病变组:29.9%，明确诊断组:36.2%，严重病变组:60.0%, P趋势 =0.034)。此外，发生夜间室性心律失常(Nocturnal Ventricular Arrhythmias，NVA)的病人CARTs得分(2.0±1.0 vs. 1.5±0.9，P<0.001)更高；副交感神经功能相关的深呼吸心率差(9.5±5.7 bpm vs. 11.6±6.6 bpm，P=0.021)、Valsalva比值(1.2±0.1 vs. 1.2±0.2，P=0.006)显著变小，交感神经功能相关的卧立位收缩压差(-8.8±15.5 mmHg vs. -4.1±11.2 mmHg，P=0.023)显著下降。多元回归分析显示，CAN严重程度(OR=1.765，95% CI: 1.188 -2.632，P=0.005)与2型糖尿病患者夜间室性心律失常的发生独立相关。 结论 2型糖尿病患者CAN严重程度与夜间室性心律失常的发生存在独立相关性，对CAN的早期检测、诊断和治疗可能有助于预测和防止2型糖尿病患者心血管不良事件及死亡。.