Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes

<i>Background and Objectives</i>. Optimal nutrition for type 2 diabetes (T2DM) aims to improve glycemic control by promoting weight loss and reducing adipose tissue, consequently improving cardiovascular health. Dietary alterations can influence adipose tissue metabolism and potentially...

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Main Authors: Kati Kärberg, Alastair Forbes, Margus Lember
Format: Article
Language:English
Published: MDPI AG 2024-03-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/60/3/438
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author Kati Kärberg
Alastair Forbes
Margus Lember
author_facet Kati Kärberg
Alastair Forbes
Margus Lember
author_sort Kati Kärberg
collection DOAJ
description <i>Background and Objectives</i>. Optimal nutrition for type 2 diabetes (T2DM) aims to improve glycemic control by promoting weight loss and reducing adipose tissue, consequently improving cardiovascular health. Dietary alterations can influence adipose tissue metabolism and potentially impact adipocytokines like visfatin, thereby affecting atherosclerosis development. This study aimed to investigate dietary habits and adherence to recommendations among individuals with T2DM and to examine how dietary adherence influences the association between visfatin and subclinical atherosclerosis. <i>Materials and Methods</i>: This cross-sectional multicenter study involved 216 adults (30–70 years) with T2DM, assessing dietary habits, adherence to recommendations (carbohydrates, fats, protein, fiber, saturated fatty acid, polyunsaturated and monounsaturated fatty acid (PUFA and MUFA) and salt), and the association between visfatin and subclinical atherosclerosis. Participants completed 24 h dietary recalls; dietary misreporting was assessed using the Goldberg cut-off method. Carotid intima–media thickness (IMT) and plaque occurrence were evaluated with ultrasound, while visfatin levels were measured using Luminex’s xMAP technology. <i>Results</i>: Three of the eight recommendations were followed in 31% of subjects, two in 26%, and four in 20%, with the highest adherence to MUFA and protein intake. Significant correlations between IMT and visfatin were observed in individuals with specific dietary patterns. The association between IMT and visfatin persisted when PUFA and MUFA intake aligned with recommendations. PUFA intake ≤ 10% and MUFA ≤ 20% of total energy significantly correlated with carotid artery IMT (<i>p</i> = 0.010 and <i>p</i> = 0.006, respectively). Visfatin’s associations with IMT remained significant (<i>p</i> = 0.006) after adjusting for common risk factors, medication use, and dietary nonadherence. No association was observed with carotid artery plaque. <i>Conclusions</i>: Dietary compliance was limited, as only 31% adhered even to three of eight recommendations. A common dietary pattern characterized by low carbohydrate and fiber but high fat, total fat, saturated fat, and salt intake was identified. This pattern amplifies the statistical association between visfatin and subclinical atherosclerosis.
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spelling doaj.art-bd51f467b0e84a9dad791543dde5f2e92024-03-27T13:53:38ZengMDPI AGMedicina1010-660X1648-91442024-03-0160343810.3390/medicina60030438Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 DiabetesKati Kärberg0Alastair Forbes1Margus Lember2Institute of Clinical Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, EstoniaInstitute of Clinical Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, EstoniaInstitute of Clinical Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, Estonia<i>Background and Objectives</i>. Optimal nutrition for type 2 diabetes (T2DM) aims to improve glycemic control by promoting weight loss and reducing adipose tissue, consequently improving cardiovascular health. Dietary alterations can influence adipose tissue metabolism and potentially impact adipocytokines like visfatin, thereby affecting atherosclerosis development. This study aimed to investigate dietary habits and adherence to recommendations among individuals with T2DM and to examine how dietary adherence influences the association between visfatin and subclinical atherosclerosis. <i>Materials and Methods</i>: This cross-sectional multicenter study involved 216 adults (30–70 years) with T2DM, assessing dietary habits, adherence to recommendations (carbohydrates, fats, protein, fiber, saturated fatty acid, polyunsaturated and monounsaturated fatty acid (PUFA and MUFA) and salt), and the association between visfatin and subclinical atherosclerosis. Participants completed 24 h dietary recalls; dietary misreporting was assessed using the Goldberg cut-off method. Carotid intima–media thickness (IMT) and plaque occurrence were evaluated with ultrasound, while visfatin levels were measured using Luminex’s xMAP technology. <i>Results</i>: Three of the eight recommendations were followed in 31% of subjects, two in 26%, and four in 20%, with the highest adherence to MUFA and protein intake. Significant correlations between IMT and visfatin were observed in individuals with specific dietary patterns. The association between IMT and visfatin persisted when PUFA and MUFA intake aligned with recommendations. PUFA intake ≤ 10% and MUFA ≤ 20% of total energy significantly correlated with carotid artery IMT (<i>p</i> = 0.010 and <i>p</i> = 0.006, respectively). Visfatin’s associations with IMT remained significant (<i>p</i> = 0.006) after adjusting for common risk factors, medication use, and dietary nonadherence. No association was observed with carotid artery plaque. <i>Conclusions</i>: Dietary compliance was limited, as only 31% adhered even to three of eight recommendations. A common dietary pattern characterized by low carbohydrate and fiber but high fat, total fat, saturated fat, and salt intake was identified. This pattern amplifies the statistical association between visfatin and subclinical atherosclerosis.https://www.mdpi.com/1648-9144/60/3/438atherosclerosisvisfatinintima–media thicknesstype 2 diabetes mellitusdietary patternsnutrients
spellingShingle Kati Kärberg
Alastair Forbes
Margus Lember
Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
Medicina
atherosclerosis
visfatin
intima–media thickness
type 2 diabetes mellitus
dietary patterns
nutrients
title Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
title_full Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
title_fullStr Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
title_full_unstemmed Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
title_short Unlocking the Dietary Puzzle: How Macronutrient Intake Shapes the Relationship between Visfatin and Atherosclerosis in Type 2 Diabetes
title_sort unlocking the dietary puzzle how macronutrient intake shapes the relationship between visfatin and atherosclerosis in type 2 diabetes
topic atherosclerosis
visfatin
intima–media thickness
type 2 diabetes mellitus
dietary patterns
nutrients
url https://www.mdpi.com/1648-9144/60/3/438
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