More Coffee May Up Metabolic Syndrome Risk in Type 1 Diabetes

Marlene Busko

March 07, 2018

In a snapshot cross-sectional analysis of study participants with type 1 diabetes in Finland, drinking three or more cups of filtered coffee a day was associated with increased odds of having metabolic syndrome, in contrast to previous findings in the general population.

The article, by B Stutz of the University of Helsinki, Finland, and colleagues, based on data from the Finnish Diabetic Nephropathy (FinnDiane) study, was published online February 1 in Nutrition, Metabolism & Cardiovascular Diseases.

"In contrast to the previous observations in other populations, coffee consumption was associated with higher odds of [metabolic syndrome] in the current study" in people with type 1 diabetes, the researchers report.

Among these individuals with type 1 diabetes, those who drank moderate or high amounts of coffee had a significantly increased risk of metabolic syndrome compared with those who did not drink coffee, after adjusting for multiple variables.

Those who drank any amount of coffee were more likely to have hypertension.

The reasons for these findings remain to be determined and more study is also needed to see how coffee consumption might affect health outcomes in people with type 1 diabetes, the researchers conclude.

Association Mainly Driven by Hypertension

In the general population, regular coffee drinkers have been reported to have a lower risk of developing metabolic syndrome, and thus a lower risk of cardiovascular disease and early mortality.

However, it has not been clear whether patients with type 1 diabetes who are regular coffee drinkers would also have a lower risk of metabolic syndrome.

To investigate this, researchers examined 1040 participants from the FinnDiane study who had type 1 diabetes — defined as diabetes onset before age 35 years and permanent insulin therapy within a year of diagnosis — and complete data from a diet questionnaire along with information on metabolic syndrome criteria.   

Metabolic syndrome was defined as having three of the following five criteria: waist circumference ≥ 94 cm in men and ≥ 80 cm in women; triglycerides ≥ 1.7 mmol/L or on lipid-lowering medication; high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L in men and < 1.3 mmol/L in women, or on medication to increase HDL-C; blood pressure ≥ 130/85 mmHg or use of antihypertensive medication; and fasting blood glucose ≥ 110 mg/dL.

Participants were classed as having the following coffee consumption levels:

  • None: < 1 cup/day, 134 participants (13%)

  • Low: 1–2 cups/day, 230 participants (22%)

  • Moderate: 3–4 cups/day, 371 participants (36%)

  • High: ≥ 5 cups/day, 305 participants (29%)

Of the 906 coffee drinkers, 825 (91%) drank filtered coffee, so researchers pooled data for the different types of coffee.

On average, individuals who did not drink coffee were 40 years old and had diabetes for 21 years, whereas coffee drinkers were older (mean age 46 to 49 years) and had diabetes longer (mean duration 27 to 30 years).

There were more current smokers in the group that had a high consumption of coffee (22%) than in the groups that drank less (up to 12%) or no coffee (3%).

There were also more men in the group who drank 5 or more cups of coffee a day (60%) than in the groups that drank less or no coffee (32% to 45%).

Coffee drinkers were more likely to be taking antihypertensive or lipid-lowering medications than nondrinkers. 

The prevalence of metabolic syndrome increased stepwise from 51% to 64% to 65% to 70% among people whose coffee consumption was none, low, moderate, or high, respectively.

Compared with noncoffee drinkers, those who drank 3 or 4 cups a day had a 1.8-fold increased risk of having metabolic syndrome, and those who drank 5 or more cups a day had a 2.1-fold increased risk (P < .05 for both), after adjusting for age, sex, total calories, alcohol, physical activity, and smoking.  

Similarly, compared with noncoffee drinkers, those who drank 1 or more cups of coffee a day had a 2.2- to 2.8-fold increased risk of hypertension, after adjusting for multiple variables (P < .05).  

"The association between coffee consumption and [metabolic syndrome] seems to be mainly driven by the blood pressure component," Stutz and colleagues observe.

The study was supported by grants from Folkhälsan Research Foundation; Wilhelm and Else Stockmann Foundation; Academy of Finland; Novo Nordisk Foundation; Signe, and Ane Gyllenberg Foundation; Helsinki University Central Hospital Research Funds; Päivikki and Sakari Sohlberg Foundation; and Diabetes Wellness Finland. Per-Henrik Groop, MD, PhD, has received research grants from Eli Lilly and Roche, is an advisory board member for AbbVie, AstraZeneca, Boehringer Ingelheim, Cebix, Eli Lilly, Janssen, MSD, Medscape, Novartis, Novo Nordisk, and Sanofi. He has received lecture fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Elo Water, Genzyme, MSD, Novartis, Novo Nordisk, and Sanofi. The other authors have reported no relevant financial relationships.

Nutr Metab Cardiovasc Dis. February 1, 2018. Abstract

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