Effect of long-term Mediterranean versus low-fat diet on neutrophil count, and type 2 diabetes mellitus remission in patients with coronary heart disease: results from the CORDIOPREV study.

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Nutrition & Diabetes Pub Date : 2025-03-27 DOI:10.1038/s41387-025-00360-3

Hatim Boughanem, Francisco M Gutierrez-Mariscal, Antonio Pablo Arenas-de Larriva, José D Torres-Peña, Juan L Romero-Cabrera, Oriol Alberto Rangel-Zuñiga, Helena García-Fernández, Alicia Podadera-Herreros, Fernando Rodríguez-Cantalejo, Oliver Soehnlein, Manuel Macias-Gonzalez, Francisco J Tinahones, Elena M Yubero Serrano, Pablo Perez-Martinez, Javier Delgado-Lista, José López-Miranda

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引用次数: 0

Abstract

Background: Recent evidence links diet and physical activity with type 2 diabetes mellitus (T2DM) remission, but emerging findings suggest that immune system dysregulation may play a crucial role. This study aimed to investigate the associations between neutrophils and T2DM remission.

Methods: We conducted a comprehensive analysis of newly-diagnosed T2DM patients (N = 183) from the CORDIOPREV study, without glucose-lowering treatment, and were randomized to follow either a Mediterranean or low-fat diet. Patients were classified into two groups: Responders, who achieved T2DM remission (n = 73), and Non-Responders, who did not achieve remission during the 5-year dietary intervention (n = 110). Neutrophil count and their related-ratio (NER, NBR, NLR and NHR, normalized with erythrocytes, basophils, lymphocytes, and HDL respectively) were measured at the baseline and 5 years of follow-up.

Results: The lowest baseline tertile of neutrophil count was associated with an increased likelihood of T2DM remission among patients following a Mediterranean diet (but not for low-fat diet) when compared with the highest tertile [adjusted HR of 4.23 (95% CI: 1.53-11.69)], in which similar results were observed for NER and NHR. When considering clinical and neutrophil variables, the predictive capacity of this model yielded an AUC of 0.783 (95% CI: 0.680-0.822). Furthermore, after 5-years, Responders exhibited lower neutrophil count compared to Non-responders (p = 0.006) and a significant decrease in neutrophil count (p = 0.001) compared to baseline. This decrease in neutrophil count in Responders who consumed a Mediterranean diet exhibited a significant increase in Insulin Sensitivity and Disposition Index (p = 0.011 and p = 0.018) after the follow-up period.

Conclusion: These findings suggest that neutrophil count can help in identifying patients that are more likely to achieve T2DM remission following a Mediterranean diet, suggesting a role on insulin sensitivity and β-cell function. Further research holds promise for providing valuable insights into the pathophysiology of T2DM.

Clinical trial registration: ID: NCT00924937; URL Clinical trial: https://clinicaltrials.gov/study/NCT00924937?cond=NCT00924937&rank=1 .

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背景：最近的证据表明，饮食和体育锻炼与2型糖尿病（T2DM）的缓解有关，但新的研究结果表明，免疫系统失调可能起着至关重要的作用。本研究旨在探讨中性粒细胞与 T2DM 缓解之间的关系：我们对 CORDIOPREV 研究中新诊断的 T2DM 患者（N = 183）进行了全面分析，这些患者未接受降糖治疗，被随机分配为地中海饮食或低脂饮食。患者被分为两组：应答者（T2DM 缓解者，人数为 73 人）和非应答者（5 年饮食干预期间未缓解者，人数为 110 人）。中性粒细胞计数及其相关比率（NER、NBR、NLR 和 NHR，分别与红细胞、嗜碱性粒细胞、淋巴细胞和高密度脂蛋白正常化）在基线和 5 年随访时进行了测量：结果：与最高三分位数相比，中性粒细胞计数的最低基线三分位数与地中海饮食（但不包括低脂饮食）患者 T2DM 缓解的可能性增加有关[调整后 HR 为 4.23（95% CI：1.53-11.69）]，其中 NER 和 NHR 也观察到类似的结果。考虑到临床和中性粒细胞变量，该模型的预测能力的AUC为0.783（95% CI：0.680-0.822）。此外，5 年后，与非应答者相比，应答者的中性粒细胞计数较低（p = 0.006），与基线相比，中性粒细胞计数显著下降（p = 0.001）。食用地中海饮食的应答者中性粒细胞数量减少，但在随访期后，其胰岛素敏感性和处置指数显著增加（p = 0.011 和 p = 0.018）：这些研究结果表明，中性粒细胞计数有助于确定哪些患者更有可能通过地中海饮食获得 T2DM 缓解，这表明中性粒细胞计数对胰岛素敏感性和 β 细胞功能有影响。进一步的研究有望为 T2DM 的病理生理学提供有价值的见解：临床试验注册：ID：NCT00924937; URL 临床试验：https://clinicaltrials.gov/study/NCT00924937?cond=NCT00924937&rank=1 。

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来源期刊

Nutrition & Diabetes ENDOCRINOLOGY & METABOLISM-NUTRITION & DIETETICS

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Nutrition & Diabetes is a peer-reviewed, online, open access journal bringing to the fore outstanding research in the areas of nutrition and chronic disease, including diabetes, from the molecular to the population level.