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Dietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study.
- Source :
-
Asia Pacific Journal of Clinical Nutrition . Jun2016, Vol. 25 Issue 2, p414-423. 10p. - Publication Year :
- 2016
-
Abstract
- <bold>Background and Objective: </bold>The increased mortality risk of hyperhomocysteinaemia in diabetes may be mitigated by dietary quality.<bold>Methods and Study Design: </bold>The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were referent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated.<bold>Results: </bold>Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocysteinaemia (>=15 vs <15 μmol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hyperhomocysteinaemia and a low dietary diversity score (DDS <=4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant interaction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death.<bold>Conclusions: </bold>In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09647058
- Volume :
- 25
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Asia Pacific Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 116224400
- Full Text :
- https://doi.org/10.6133/apjcn.112015.06