德清县农村居民饮茶与2型糖尿病发病风险的前瞻性队列研究

Association between tea drinking and the risk of type 2 diabetes mellitus among rural adults in Deqing County:a prospective cohort study

目的探索饮茶与2型糖尿病(type 2 diabetes mellitus, T2DM)发病的关联。方法采用动态前瞻性队列研究方法于2006—2008年、2011—2012年、2013—2014年分别随机抽取浙江省德清县2个、6个和7个农村社区未患糖尿病的27 841名居民作为研究对象进行问卷调查、体格检查和实验室检测,于2018年12月通过德清县居民电子健康档案进行随访。采用Cox回归模型分析饮茶及饮绿茶与T2DM发病风险之间的关系。结果德清县27 841名农村社区居民中,有饮茶习惯者10 726名(38.53%),其中饮绿茶者8215名(76.59%)。至2018年12月,德清县27 841名农村社区居民中新发T2DM 883例,发病密度为4.43/千人年,有饮茶习惯者和无饮茶习惯者发病密度分别为4.07/千人年和4.71/千人年,其中有饮绿茶习惯者发病密度为3.79/千人年。在调整性别、年龄、文化程度、是否务农、是否吸烟、是否饮酒、饮食偏好、体质指数、是否高血压、是否空腹血糖受损和糖尿病家族史后,有饮茶习惯的农村社区居民T2DM发病风险为无饮茶习惯居民的0.79倍(95%CI 0.65~0.96),有饮绿茶习惯的居民T2DM发病风险为无饮茶习惯居民的0.72倍(95%CI 0.58~0.89),未发现饮用其他茶叶和饮绿茶量与T2DM发病风险之间存在显著关联(P<0.05)。结论饮绿茶可降低德清县农村居民T2DM的发病风险。

OBJECTIVE To explore the associations between tea drinking and the incident risk of type 2 diabetes mellitus(T2 DM). METHODS A dynamic prospective cohort study among a total of 27 841 diabetes-free permanent adult residents randomly selected from 2, 6 and 7 rural communities between 2006-2008, 2011-2012 and 2013-2014, respectively. Questionnaire survey, physical examination, and laboratory test were carried out among the participants. In 2018, we conducted a follow-up through the electronic health records of residents. Cox regression model were applied to explore the association between tea drinking and the incident risk of T2 DM and estimate the hazard ratio(HR), and its 95%CI. RESULTS Among the 27 841 rural community residents in Deqing County, there were 10 726(38.53%) were tea drinkers, 8215 of which were green tea drinkers, accounting for 76.59%. Totally 883 new T2 DM incidents were identified until December 31, 2018, and the incidence density was 4.43 per 1000 person years(PYs). The incidence density was 4.07/1000 PYs in those with tea drinking habits and 4.71/1000 PYs in those without tea drinking habits, among which the incidence density was 3.79/1000 PYs in those with green tea drinking habits. After controlling for sex, age, education, farming, smoking, alcohol consumption, dietary preference, body mass index, hypertension, impaired fasting glucose, family history of diabetes, the risk of T2 DM among rural residents with tea drinking habits in Deqing County was 0.79 times higher than that among residents without tea drinking habits(HR=0.79, 95%CI 0.65-0.96), and the risk of T2 DM among residents with green tea drinking habits was 0.72 times higher than that among residents without tea drinking habits(HR=0.72, 95%CI 0.58-0.89). However, no significant associations were found between other kinds of tea and the risk of T2 DM, nor the amount of green tea to drink. CONCLUSION Drinking green tea may reduce the risk of T2 DM among adult population in rural China.