作者：Laurie Barclay, MD 齣處：WebMD醫學新聞　　February 11, 2009 — 根據1月16日糖尿病照護期刊綫上發錶的觀察性研究結果顯示每天飲用蘇打飲料顯著增加代飲用蘇打飲料與代謝癥候群及第二型糖尿病有關

發表日期 2009-02-27T08:09:44+08:00

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趣味新聞網記者特別報導 : 作者：Laurie Barclay, MD 齣處：WebMD醫學新聞　　February 11, 2009 — 根據1月16日糖尿病照護期刊綫上發錶的觀察性研究結果顯示，每天飲用蘇打飲料顯著增加代 .....

本帖最後由 goodcat1111 於 2009-2-27 10:34 編輯

作者：Laurie Barclay, MD
齣處：WebMD醫學新聞

February 11, 2009 — 根據1月16日糖尿病照護期刊綫上發錶的觀察性研究結果顯示，每天飲用蘇打飲料顯著增加代謝癥候群（MetSyn）及第二型糖尿病風險。

休士頓德州大學健康科學中心的Jennifer A. Nettleton博士與同事寫到，兩個縱嚮世代研究顯示，飲用蘇打飲料與代謝癥候群有正嚮相關，而和原先的肥胖無關。復製先前的觀察性世代研究支持其真實性，也提供更多關注於兩者的關聯性。先前的研究並未強調飲用蘇打飲料與代謝癥候群及第二型糖尿病之間的關係，也未充分錶達在此關係上，例如，改變肥胖的狀態，可能扮演調節者的角色。

這個研究的目的是評估飲用蘇打飲料與代謝癥候群以及第二型糖尿病，在多種族動脈粥樣硬化研究的關係（MESA）。

起初的評估是針對2000年到2002年飲食頻率問捲中衡量飲食中蘇打的消耗量，接著，評估2002年到2003年、2004年到2005年及2005年到2007年的狀況。第二型糖尿病的定義是，空腹血糖超過126 mg/dL、自述有糖尿病或正在使用糖尿病用藥。以美國國傢膽固醇教育計畫成人治療專傢組的第三次指南來定義代謝癥候群。經過人口統計、生活型態及飲食因子的調整後，以危險比值（HRs）作為第二型糖尿病、MetSyn，和MetSyn組成的估計。

與未飲用蘇打飲料相比，飲用蘇打飲料的受試者至少增加36%罹患代謝癥候群的風險（危險比值是1.36，95%信賴區間為1.11-1.66），增加67%得到第二型糖尿病的風險（危險比值是1.67，95%信賴區間為1.27-2.20）。

進一步分析代謝癥候群的組成，飲用蘇打飲料受試者的腰圍較大（男性超過102公分，女性超過88公分），空腹血糖值也較高（大於100 mg/Dl）；飲用蘇打飲料與第二型糖尿病及肥胖無關，相反的，是與代謝癥候群和這些因子是有關的。

研究作者寫道，雖然觀察到這些數據並無法建立因果關係，但是飲用蘇打飲料明顯增加代謝癥候群與第二型糖尿病的風險。

這項研究的限製包括觀察上的設計阻礙因果關係的決定；可能因其他飲食和生活方式或者行為的因素而混淆；在估計飲用蘇打或人工甜味劑的量上也有睏難。

研究作者的結論是，這些結果與ARIC[粥狀動脈硬化風險委員會]及佛明罕研究都顯示，飲用蘇打飲料與第二型糖尿病有強烈相關；飲食蘇打飲料不論是否有其他飲食和生活方式、或者行為的影響，都可能導緻體重增加、血糖控製不佳以及糖尿病的發生。

國傢心髒、肺髒與血液機構贊助本研究。作者們錶示沒有相關資金上的往來。

Daily Consumption of Diet Soda Linked to Metabolic Syndrome, Type 2 Diabetes

By Laurie Barclay, MD
Medscape Medical News

February 11, 2009 — Drinking diet soda at least daily is associated with significantly greater risks for select incident components of the metabolic syndrome (MetSyn) and type 2 diabetes, according to the results of an observational study reported in the January 16 Online First issue of Diabetes Care.

"Two longitudinal cohort studies have shown positive associations between diet soda consumption and incident MetSyn independent of baseline measures of adiposity," write Jennifer A. Nettleton, PhD, from the University of Texas Health Sciences Center in Houston, and colleagues. "Replication of previously observed diet soda-MetSyn associations in a distinct cohort would bolster their credibility and provide further insight into the nature of the relationship. Previous studies have not addressed associations between diet soda and individual MetSyn components or risk of type 2 diabetes nor have they fully addressed potential longitudinal mediators of these relationships, i.e., changes in adiposity status."

The goal of this study was to evaluate associations between diet soda consumption and the risk for incident MetSyn, its components, and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).

Initial evaluation was performed from 2000 to 2002, at which time baseline food frequency questionnaires measured diet soda consumption. Three follow-up evaluations were performed from 2002 to 2003, 2004 to 2005, and 2005 to 2007. Incident type 2 diabetes was defined as fasting glucose levels of more than 126 mg/dL, self-reported type 2 diabetes, or use of diabetes medication. National Cholesterol Education Program Adult Treatment Panel 3 criteria were used to define MetSyn and its components. After adjustment for demographic, lifestyle, and dietary confounders, hazard ratios (HRs) were estimated for type 2 diabetes, MetSyn, and MetSyn components.

Compared with participants who did not drink diet soda, those who drank diet soda at least daily had a 36% greater relative risk for incident MetSyn (HR, 1.36; 95% confidence interval [CI], 1.11 - 1.66) and a 67% greater relative risk for incident type 2 diabetes (HR, 1.67; 95% CI, 1.27 - 2.20).

Of the individual components of MetSyn, only high waist circumference (men: ? 102 cm; women: ? 88 cm) and high fasting glucose levels (? 100 mg/dL) were prospectively associated with consumption of diet soda. Associations between diet soda intake and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures. In contrast, associations between diet soda and MetSyn were not independent of these factors.

"Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident MetSyn components and type 2 diabetes," the study authors write.

Limitations of this study include observational design, precluding determination of causality; possible confounding by other dietary and lifestyle/behavioral factors; and difficulties in estimating intake of diet soda or artificial sweetener.

"These results corroborate findings from the ARIC [Atherosclerosis Risk in Communities] and Framingham studies and show stronger adverse associations exist between diet soda and type 2 diabetes," the study authors conclude. "Diet soda consumption, either independently or in conjunction with other dietary and lifestyle behaviors, may lead to weight gain, impaired glucose control, and eventual diabetes."

The National Heart, Lung, and Blood Institute supported this study. The study authors have disclosed no relevant financial relationships.

Diabetes Care. Published online January 16, 2009.