Fruit Consumption Is Associated with Lower Carotid Intima-Media Thickness and C-Reactive Protein Levels in Patients with Type 2 Diabetes Mellitus

Abstract

Preliminary evidence in support of fruit intake for the prevention of cardiovascular disease in patients with type 2 diabetes mellitus (T2DM) is still limited. The objective of this study was to evaluate the association between fruit consumption and cardiovascular risk factors such as carotid intima-media thickness (CIMT) and high-sensitive C-reactive protein (hsCRP) in patients with T2DM. In this cross-sectional study, 407 patients with T2DM were recruited from August 2007 to December 2009. Dietary assessment based on 3-day 24-hour recall interviews, hsCRP levels, and CIMT were examined. Participants were categorized into three tertiles based on fruit intake. Comparisons of the participants' clinical characteristics among the three categories were performed using either one-way analysis of variance or analysis of covariance. In patients with type 2 diabetes with CIMT ≥1 mm, the intake of fruit was lower (P=0.001), whereas the serum hsCRP level was higher (P<0.001) compared with patients showing CIMT <1 mm. Results of the multivariable logistic regression analysis showed that the odds ratios of CIMT and hsCRP were 8% and 31% lower, respectively, in participants in the top tertile compared with those in the lowest tertile (P=0.018 and P<0.001, respectively) after adjustment for potential confounders. Hence, a reduction in hsCRP concentration and CIMT were found to be associated with an increase in fruit intake. Sufficient daily intake of fruits should, therefore, be considered as an important component of a medical nutritional therapy strategy for the prevention of cardiovascular diseases in patients with T2DM.