A U-shaped association between dietary phosphorus intake and new-onset diabetes: A nationwide cohort study in China

Association between dietary mineral intake and new onset diabetes/pre-diabetes after chronic pancreatitis

Background and aims

As the main type of pancreatic diabetes, patients with new diabetes after chronic pancreatitis are often difficult to manage and have poor prognosis. This study aimed to figure out the association between dietary mineral intake and glucose metabolism with chronic pancreatitis.

Method

The study included 114 patients with chronic pancreatitis, who were grouped based on the sequence of onset for chronic pancreatitis and diabetes: normoglycaemia after chronic pancreatitis (NCP), type 2 diabetes (T2DM), and new-onset diabetes or pre-diabetes after chronic pancreatitis (NODCP). The habitual intake of 10 minerals (calcium, chlorine, iodine, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc) was assessed using a dietary health questionnaire. The differences in mineral intake between the groups were compared, and the relationship between mineral intake and key glucose metabolism markers, including fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and fasting insulin, was analyzed using regression models.

Results

Compared with normal glycaemic status after chronic pancreatitis, the intake of iron and phosphorus in patients with new diabetes/pre-diabetes after chronic pancreatitis (NODCP) has changed significantly. In the NODCP group, FPG levels were significantly negatively correlated with magnesium intake, while HbA1c levels were significantly negatively correlated with average phosphorus intake. In addition, there is a correlation between fasting insulin and average magnesium intake in the NODCP group. No correlation was found between the intake of other minerals and glucose metabolism in chronic pancreatitis.

Conclusion

The intake of minerals in the diet affects the glycaemic status after chronic pancreatitis. It is necessary to further explore the possible causal relationship and mechanism between mineral intake and diabetes after chronic pancreatitis, so as to provide evidence for nutritional intervention of high-risk patients.

Joint associations among non-essential heavy metal mixtures and nutritional factors on glucose metabolism indexes in US adults: evidence from the NHANES 2011-2016

Dietary intake can modify the impact of metals on human health, and is also closely related to glucose metabolism in human bodies. However, research on their interaction is limited. We used data based on 1738 adults aged ≥20 years from the National Health and Nutrition Examination Survey 2011-2016. We combined linear regression and restricted cubic splines with Bayesian kernel machine regression (BKMR) to identify metals associated with each glucose metabolism index (P < 0.05 and the posterior inclusion probabilities of BKMR >0.5) in eight non-essential heavy metals (barium, cadmium, antimony, tungsten, uranium, arsenic, lead, and thallium) and glucose metabolism indexes [fasting plasma glucose (FPG), blood hemoglobin A1c (HbA1c) and homeostatic model assessment of insulin resistance (HOMA-IR)]. We identified two pairs of metals associated with glucose metabolism indexes: cadmium and tungsten to HbA1c and barium and thallium to HOMA-IR. Then, the cross-validated kernel ensemble (CVEK) approach was applied to identify the specific nutrient group (nutrients) that interacted with the association. By using the CVEK model, we identified significant interactions between the energy-adjusted diet inflammatory index (E-DII) and cadmium, tungsten and barium (all P < 0.05); macro-nutrients and cadmium, tungsten and barium (all P < 0.05); minerals and cadmium, tungsten, barium and thallium (all P < 0.05); and A vitamins and thallium (P = 0.043). Furthermore, a lower E-DII, a lower intake of carbohydrates and phosphorus, and a higher consumption of magnesium seem to attenuate the positive association between metals and glucose metabolism indexes. Our finding identifying the nutrients that interact with non-essential heavy metals could provide a feasible nutritional guideline for the general population to protect against the adverse effects of non-essential heavy metals on glucose metabolism.

Prevalence of hyperuricaemia among adults from Ningxia Hui Autonomous Region, China: a cross-sectional study

OBJECTIVE

This study aimed to estimate the prevalence of hyperuricaemia (HUA) and investigate its risk factors in the general adult population of Ningxia Hui Autonomous Region (NHAR), China.

DESIGN

Cross-sectional study.

SETTING

Survey of cardiovascular disorders and their related risk factors in NHAR, China.

PARTICIPANTS

10 803 permanent residents aged 18 and older.

MAIN OUTCOME MEASURES

HUA was defined as serum uric acid levels >420 µmol/L for men and >360 µmol/L for women.

RESULTS

The overall prevalence of HUA in NHAR adults was 19.81% (95% CI 19.06 to 20.57), with prevalence values of 24.91% (95% CI 23.70 to 26.14) in men and 15.58% (95% CI 14.66 to 16.53, p<0.001) in women. The prevalence of HUA was higher in urban residents than in rural residents (23.26% vs 17.02%, p<0.001). HUA prevalence was relatively high in individuals younger than 30 years for both men and women, then decreased with age, and began to increase at the age of 40 for women and 60 for men. Higher level of education, being overweight or obese, alcohol consumption, hypertension, diabetes, higher triglycerides, higher total cholesterol and poorer renal function were associated with an increased risk of HUA.

CONCLUSIONS

HUA prevalence is high among adults in NHAR. Young adults under 30 years and women over 50 years were identified as populations at high risk for HUA. Further attention ought to be placed to promoting healthy diets and implementing early interventions to manage dyslipidaemia, obesity and blood glucose level, as well as advocating for moderation of alcohol consumption.