Association of dietary factors with insulin resistance and inflammatory markers in subjects with diabetes mellitus and coronary artery disease in Indian population

J Diabetes Complications. 2014 Jul-Aug;28(4):536-41. doi: 10.1016/j.jdiacomp.2012.09.008. Epub 2014 Apr 16.

Abstract

Background: Insulin resistance (IR) and inflammation have been implicated in pathogenesis of diabetes and cardiovascular disease. Dietary factors have been reported to be associated to insulin resistance and inflammation. Hence, we studied the association of dietary factors with IR and inflammation in known patients with diabetes mellitus and coronary artery disease with the hypothesis that carbohydrate and fat will be positively; and protein, fiber and mineral will be negatively associated with IR and inflammatory markers.

Methods: Three hundred patients (M: 216; F: 84, age: 25-92) who had coronary disease on angiography were included in this study consecutively. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical and inflammatory markers. Nutrition assessment was done once at the time of recruitment, based on 24h dietary recall.

Results and conclusions: Diabetic patients had significantly lower protein and total dietary fiber intake as compared to non diabetics. Diabetic patients had lower intake of vitamin A, riboflavin and vitamin B12. There was significantly lower intake of minerals by diabetic patients. Dietary carbohydrate and fat were positively, and protein and dietary fiber intakes were negatively correlated with HOMA-IR and IL-6. There was no correlation of individual amino acids with HOMA-IR but showed strong negative correlation with inflammatory markers (hsCRP; IL-6 and TNF-α). Intake of vitamins and minerals was negatively correlated with HOMA-IR and inflammatory markers. There is a strong correlation between dietary factors, insulin resistance and inflammatory markers.

Keywords: Coronary artery disease; Diabetes mellitus; Hypertension; Inflammatory markers.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / ethnology
  • Coronary Artery Disease / immunology
  • Cross-Sectional Studies
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / ethnology
  • Diabetic Angiopathies / etiology*
  • Diabetic Angiopathies / immunology
  • Diet / adverse effects*
  • Diet / ethnology
  • Diet, High-Fat / adverse effects
  • Diet, High-Fat / ethnology
  • Diet, Protein-Restricted / adverse effects
  • Diet, Protein-Restricted / ethnology
  • Dietary Carbohydrates / adverse effects
  • Female
  • Health Transition*
  • Humans
  • India / epidemiology
  • Inflammation Mediators / blood*
  • Insulin Resistance* / ethnology
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Risk Factors

Substances

  • Dietary Carbohydrates
  • Inflammation Mediators