Hong-Li Dong1, Xin-Yi Tang2, Yun-Yang Deng1, Qing-Wei Zhong1, Cheng Wang1, Zhe-Qing Zhang3, Yu-Ming Chen4. 1. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. 2. The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People's Republic of China. 3. Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, 510515, People's Republic of China. zzqaa501@smu.edu.cn. 4. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. chenyum@mail.sysu.edu.cn.
Abstract
PURPOSE: Many studies have examined the association of isoflavone intake with type 2 diabetes (T2D), and produced inconsistent results. Few studies, however, explored the association using objective biomarkers (particular for daidzein metabolite-equol) of isoflavones. We aimed to explore the association of urinary equol, daidzein and genistein concentrations with T2D and examine the mediating roles of high-sensitivity C-reactive protein (hsCRP) and retinol binding protein 4 (RBP4). METHODS: This prospective study included 2818 subjects. Urinary concentrations of equol, daidzein and genistein were measured by high-performance liquid chromatography-tandem mass spectrometry. The associations between urinary isoflavones and T2D incidence were evaluated by cox proportional hazards model. RESULTS: After adjustment for covariates, urinary equol except daidzein and genistein was inversely associated with T2D incidence. In comparison with the first tertile, multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for T2D incidence in the second and third tertile of equol concentration were 0.52 (0.37, 0.73) and 0.72 (0.53, 0.97), respectively. In stratified analyses by sex, the HR (95% CI) of men in the second vs. first tertile of equol was 0.29 (0.14, 0.58). Equivalent estimation in women was 0.67 (0.45, 1.01). Neither women nor men in the third tertile showed significant difference of T2D incidence compared with the first tertile. In path analyses, there was no evidence of mediating effects of hsCRP and RBP4 on the "equol-T2D" relationship. CONCLUSIONS: Urinary equol was favorably associated with a decreased T2D incidence in Chinese adults. The equol-T2D relationship might not be mediated by hsCRP and RBP4. TRIAL REGISTRATION: This study has been registered at http://www.clinicaltrials.gov as NCT03179657.
PURPOSE: Many studies have examined the association of isoflavone intake with type 2 diabetes (T2D), and produced inconsistent results. Few studies, however, explored the association using objective biomarkers (particular for daidzein metabolite-equol) of isoflavones. We aimed to explore the association of urinary equol, daidzein and genistein concentrations with T2D and examine the mediating roles of high-sensitivity C-reactive protein (hsCRP) and retinol binding protein 4 (RBP4). METHODS: This prospective study included 2818 subjects. Urinary concentrations of equol, daidzein and genistein were measured by high-performance liquid chromatography-tandem mass spectrometry. The associations between urinary isoflavones and T2D incidence were evaluated by cox proportional hazards model. RESULTS: After adjustment for covariates, urinary equol except daidzein and genistein was inversely associated with T2D incidence. In comparison with the first tertile, multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for T2D incidence in the second and third tertile of equol concentration were 0.52 (0.37, 0.73) and 0.72 (0.53, 0.97), respectively. In stratified analyses by sex, the HR (95% CI) of men in the second vs. first tertile of equol was 0.29 (0.14, 0.58). Equivalent estimation in women was 0.67 (0.45, 1.01). Neither women nor men in the third tertile showed significant difference of T2D incidence compared with the first tertile. In path analyses, there was no evidence of mediating effects of hsCRP and RBP4 on the "equol-T2D" relationship. CONCLUSIONS: Urinary equol was favorably associated with a decreased T2D incidence in Chinese adults. The equol-T2D relationship might not be mediated by hsCRP and RBP4. TRIAL REGISTRATION: This study has been registered at http://www.clinicaltrials.gov as NCT03179657.
Entities:
Keywords:
Daidzein; Equol; Genistein; Type 2 diabetes
Authors: Mohammed M Alshehri; Javad Sharifi-Rad; Jesús Herrera-Bravo; Evelyn L Jara; Luis A Salazar; Dorota Kregiel; Yadav Uprety; Muhammad Akram; Mehwish Iqbal; Miquel Martorell; Margalida Torrens-Mas; Daniel Gabriel Pons; Sevgi Durna Daştan; Natália Cruz-Martins; Fethi Ahmet Ozdemir; Manoj Kumar; William C Cho Journal: Oxid Med Cell Longev Date: 2021-09-09 Impact factor: 6.543