研究课题：瑞典人的咖啡消耗、2型糖尿病和糖耐量改善之间的关系
供稿： 分子医学系，内分泌和糖尿病部，larolinska研究所，斯德哥尔摩，瑞典

    主要内容：目的：分析瑞典人的咖啡消耗、2型糖尿病和糖耐量改善之间的关系。另外用内环境平衡模型分析了胰岛素敏感性和β-细胞功能指标与咖啡消耗量之间的关系。模式和参加人员：调查了斯德哥尔摩五个行政区的7949名健康瑞典人，年龄35－56岁。口服糖耐量实验发现55名男性，52名妇女有2型糖尿病（从前未发现）；172名男性，167名女性糖耐量异常。咖啡消耗量及其它相关因素通过问卷调查的方式完成。结果：用潜在伴随影响因素纠正后，每天喝5杯以上咖啡与喝不到2杯相比，2型DM和糖耐量异常的相对风险在男性分别为0.45（95％CI: 0.22-0.92）和0.63（95％CI: 0.41－0.97），在妇女分别为0.27（95％CI: 0.11－0.66）和0.47（95％CI: 0.29－0.76）。在2型DM病人和糖耐量异常的人群中，大量饮用咖啡（每天5杯以上）与胰岛素抗性成反相关。而且，2型DM病人和女性糖耐量异常人群（男性不然），大量饮用咖啡与β-细胞功能低下负相关。糖耐量正常的女性，咖啡消耗量与胰岛素抗性风险降低相关；但男性不明显。

    结论：本研究结果表明大量饮用咖啡可以降低2型DM和糖耐量异常的发病率，这种有益效果可能包括改善胰岛素敏感性及增加胰岛素产生两方面的原因。

Coffee consumption, type 2 diabetes and impaired glucose tolerance in Swedish men and women.
Agardh EE, Carlsson S, Ahlbom A, Efendic S, et al. J Intern Med. 2004 Jun;255(6):645-52.Department of Molecular Medicine, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden.
    OBJECTIVES: The association between coffee consumption, type 2 diabetes and impaired glucose tolerance was examined. In addition, indicators of insulin sensitivity and beta-cell function according to homeostasis model assessment were studied in relation to coffee consumption. DESIGN: Population-based cross-sectional study. SETTING AND SUBJECTS: The study comprised 7949 healthy Swedish subjects aged 35-56 years residing within five municipalities of Stockholm. An oral glucose tolerance test identified 55 men and 52 women with previously undiagnosed type 2 diabetes and 172 men and 167 women with impaired glucose tolerance. Information about coffee consumption and other factors was obtained by questionnaire. RESULTS: The relative risks (adjusted for potential confounders) of type 2 diabetes and impaired glucose tolerance when drinking >/=5 cups of coffee per day compared with </=2 cups per day in men were 0.45 [95% confidence intervals (CI) 0.22-0.92] and 0.63 (CI: 0.41-0.97), respectively, and in women 0.27 (CI: 0.11-0.66) and 0.47 (CI: 0.29-0.76) respectively. In subjects with type 2 diabetes and impaired glucose tolerance, high coffee consumption (>/=5 cups day(-1)) was inversely associated with insulin resistance. In addition, in those with type 2 diabetes and in women (not in men) with impaired glucose tolerance high coffee consumption was inversely associated with low beta-cell function. In women, but not obviously in men, with normal glucose tolerance, coffee consumption was associated with a reduced risk of insulin resistance. CONCLUSIONS: The results of this study indicated that high consumers of coffee have a reduced risk of type 2 diabetes and impaired glucose tolerance. The beneficial effects may involve both improved insulin sensitivity and enhanced insulin response.

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