Association of the short-chain fatty acid levels and dietary quality with type 2 diabetes: a case-control study based on Henan Rural Cohort

Abstract Evidence of the relationship between fecal short-chain fatty acids (SCFAs) levels, dietary quality, and T2DM in rural populations is limited. Here, we aimed to investigate the association between fecal SCFA levels and T2DM and the combined effects of dietary quality on T2DM in rural China. 100 adults were included in the case-control study. Dietary quality was assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), and SCFA levels were analyzed using the GC-MS system. Generalized linear regression was conducted to calculate the odds ratio (ORs) and 95% confidence intervals (CIs) to evaluate the effect of SCFA level and dietary quality on the risk of T2DM. Finally, an interaction was used to study the combined effect of SCFA levels and AHEI-2010 scores on T2DM. T2DM participants had lower levels of acetic and butyric acid. Generalized linear regression analysis revealed that the OR (95% CI) of the highest acetic and butyric acid levels were 0.099 (0.022, 0.441) and 0.210 (0.057, 0.774), respectively, compared to the subjects with the lowest tertile of level. We also observed a significantly lower risk of T2DM with acetic acid levels >1330.106μg/g or butyric acid levels >585.031μg/g. Moreover, the risks of higher acetic and butyric acid levels of T2DM were 0.007 (95% CI:0.001, 0.148), 0.005 (95% CI:0.001, 0.120) compared to participants with lower AHEI-2010 scores (all P <0.05). Acetate and butyrate levels may be important modifiable beneficial factors affecting T2DM in rural China. Improving dietary quality for body metabolism balance should be encouraged to promote good health.