Abstract
OBJECTIVES: This study aimed to analyze the associations between dietary polyamine intake and incident T2DM. METHODS: This prospective analysis included 168,137 participants from the UK Biobank who did not have T2DM at baseline. Dietary polyamines were calculated based on portion sizes of food items and a nutrient database. Incident T2DM was defined by hospital admissions with ICD10 codes E11-E14. Cox proportional hazard regression models and restricted cubic splines were used to examine the associations between dietary polyamine intake and incident T2DM. RESULTS: During a median follow-up of 11.2 years (IQR, 11.8-13.2), 4422 (2.6%) participants developed T2DM. The average (SD) daily dietary intake was 10.5 (11.8) mg/day for spermidine, 4.3 (2.1) mg/day for spermine, and 12.7 (6.9) mg/day for putrescine. Compared to quintile 1, the multivariable-adjusted hazard ratios (95% CI) for quintiles 2-5 of dietary spermidine were 0.87 (0.79 to 0.96), 0.87 (0.79 to 0.96), 0.91 (0.82 to 0.99), and 0.96 (0.88 to 1.06); for dietary spermine, they were 1.01 (0.91 to 1.11), 1.03 (0.93 to 1.13), 1.07 (0.97 to 1.18), and 1.11 (1.01 to 1.23); and for dietary putrescine, they were 0.84 (0.76 to 0.92), 0.83 (0.79 to 0.91), 0.82 (0.74 to 0.90), and 0.87 (0.80 to 0.96). CONCLUSIONS: Higher dietary spermidine and putrescine were associated with a lower risk of T2DM, while higher dietary spermine appeared to be associated with a higher risk of T2DM. These findings suggest optimal levels of dietary polyamine intake and indicate that polyamines may be promising targets for nutritional interventions in the prevention and management of T2DM.