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Background and aim <p>This cohort study investigated the potential association between dietary fat intakes and returning to normal glucose regulation (NGR) in different prediabetes (Pre-DM) phenotypes.</p> Methods <p>A total of 1587 Pre-DM subjects consisting of 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT), and 18.8% combined IFG–IGT, were recruited for baseline dietary assessment and were followed for changes in glycemic status (i.e., returned to NGR, remained Pre-DM, or progressed to diabetes) over 9&#xa0;years. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for returning to NGR across categories of fat intake (&lt; 20%, 20–30%, and &gt; 30% of total energy intake), and tertiles of major fat patterns identified through principal component analysis (PCA).</p> Results <p>The mean age of the participants was 47.2 ± 12.9&#xa0;years, and 52.2% were men. Over a median of 5.8&#xa0;years of follow-up, 46.8% of Pre-DM subjects regressed to NGR. Low-fat diet (LFD) was associated with an increased chance of returning to NGR in the iIGT phenotype (HR = 1.44, 95% CI 1.05–1.98). Two major dietary fat patterns, i.e., Mixed Fat Pattern (MFP, whit a higher load of saturated fat, cholesterol, oleic, linoleic, and trans fatty acids) and ω<sub>3</sub>FP (i.e., loaded heavily on docosahexaenoic, eicosapentaenoic, and α-linolenic acids), extracted by PCA, were corresponded to 58.4% of the total variance of&#xa0;fat intake. In both&#xa0;iIFG and iIGT phenotypes, highest&#xa0;MFP score&#xa0;was inversely associated with NGR (HR = 0.71, 95% CI 0.50–0.99 and HR = 0.60, 95% CI 0.37–0.97), while the highest&#xa0;ω3FP score&#xa0;was associated with an elevated incidence of NGR in subjects with combined IFG–IGT phenotype by twofold (HR = 2.29, 95% CI 1.00–5.29).</p> Conclusions <p>Subjects with iIGT phenotype may take more advantage from adhering a LFD. Dietary fat patterns may differentially affect chance of returning to NGR across Pre-DM phenotypes.</p>

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Total fat intake and fatty acid patterns and prediabetes regression: differential effects across phenotypes in a population-based cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月17日

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  • Zahra Bahadoran,
  • Zahra Kashani,
  • Maryam Mahdavi,
  • Parvin Mirmiran,
  • Fereidoun Azizi

摘要

Background and aim

This cohort study investigated the potential association between dietary fat intakes and returning to normal glucose regulation (NGR) in different prediabetes (Pre-DM) phenotypes.

Methods

A total of 1587 Pre-DM subjects consisting of 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT), and 18.8% combined IFG–IGT, were recruited for baseline dietary assessment and were followed for changes in glycemic status (i.e., returned to NGR, remained Pre-DM, or progressed to diabetes) over 9 years. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for returning to NGR across categories of fat intake (< 20%, 20–30%, and > 30% of total energy intake), and tertiles of major fat patterns identified through principal component analysis (PCA).

Results

The mean age of the participants was 47.2 ± 12.9 years, and 52.2% were men. Over a median of 5.8 years of follow-up, 46.8% of Pre-DM subjects regressed to NGR. Low-fat diet (LFD) was associated with an increased chance of returning to NGR in the iIGT phenotype (HR = 1.44, 95% CI 1.05–1.98). Two major dietary fat patterns, i.e., Mixed Fat Pattern (MFP, whit a higher load of saturated fat, cholesterol, oleic, linoleic, and trans fatty acids) and ω3FP (i.e., loaded heavily on docosahexaenoic, eicosapentaenoic, and α-linolenic acids), extracted by PCA, were corresponded to 58.4% of the total variance of fat intake. In both iIFG and iIGT phenotypes, highest MFP score was inversely associated with NGR (HR = 0.71, 95% CI 0.50–0.99 and HR = 0.60, 95% CI 0.37–0.97), while the highest ω3FP score was associated with an elevated incidence of NGR in subjects with combined IFG–IGT phenotype by twofold (HR = 2.29, 95% CI 1.00–5.29).

Conclusions

Subjects with iIGT phenotype may take more advantage from adhering a LFD. Dietary fat patterns may differentially affect chance of returning to NGR across Pre-DM phenotypes.