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Archives of Public Health
Published in: Archives of Public Health 1/2024

Open Access 01-12-2024 | Research

Green tea consumption and incidence of cardiovascular disease in type 2 diabetic patients with overweight/obesity: a community-based cohort study

Authors: Bingyue Liu, Shujun Gu, Jin Zhang, Hui Zhou, Jian Su, Sudan Wang, Qian Sun, Zhengyuan Zhou, Jinyi Zhou, Chen Dong

Published in: Archives of Public Health | Issue 1/2024

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Abstract

Background

Green tea has been reported to be potentially protective against the development of cardiovascular disease (CVD). This study aimed to investigate the association between green tea consumption and incident CVD in type 2 diabetes (T2D) patients with overweight/obesity.

Methods

A total of 4756 Chinese overweight/obese T2D patients were recruited and followed up for 6.27 years. Information on green tea consumption was collected at baseline using interviewer-administered questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD according to green tea consumption were estimated using the Cox proportional hazards model.

Results

Compared with non-habitual consumers, participants who consumed > 5 g/day of green tea leaves reduced the risk of CVD by 29% (95%CI: 0.55–0.92), stroke by 30% (95%CI: 0.51–0.95) and coronary heart disease (CHD) by 40% (95%CI: 0.40–0.89). Similarly, participants who consumed green tea for ≥ 40 years reduced the risk of CVD by 31% (95%CI: 0.54–0.88), stroke by 33% (95%CI: 0.50–0.90) and CHD by 39% (95%CI: 0.42–0.88). Among participants with < 5-year history of T2D, > 5 g/day of tea leaves and > 40 years of tea consumption were associated with 59% (95%CI: 0.23–0.72) and 57% (95%CI: 0.26–0.74) reduced risk of stroke, respectively. However, among participants with ≥ 5-year history of T2D, > 5 g/day of tea leaves and > 40 years of tea consumption were associated with a 50% (95%CI: 0.30–0.82) and 46% (95%CI: 0.35–0.85) reduced risk of CHD, respectively.

Conclusions

Green tea consumption is associated with reduced risk of CVD, stroke, and CHD in overweight/obese T2D patients.
Appendix
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Literature
1.
Nguyen HD, Oh H, Hoang NHM, Kim MS. Association between heavy metals, high-sensitivity C-reaction protein and 10-year risk of cardiovascular diseases among adult Korean population. Sci Rep. 2021;11(1):14664.PubMedPubMedCentralCrossRefADS
2.
3.
4.
Lin CC, Li CI, Liu CS, Lin WY, Lin CH, Chiang JI, Yang SY, Li TC. Obesity paradox in associations between body mass index and diabetes-related hospitalization and mortality in patients with type 2 diabetes: retrospective cohort studies. Diabetes Metab. 2019;45(6):564–72.PubMedCrossRef
5.
Kong L, Qi Y, Ye C, Wang Y, Zhao Z, Li M, Wang S, Lin H, Xu Y, Xu M. Diabesity phenotype and the risks of cardiovascular disease and subclinical atherosclerosis: a prospective cohort study. Obes (Silver Spring). 2022;30(8):1681–90.CrossRef
6.
Soh AZ, Pan A, Chee CBE, Wang YT, Yuan JM, Koh WP. Tea drinking and its association with active tuberculosis incidence among middle-aged and Elderly adults: the Singapore Chinese Health Study. Nutrients 2017, 9(6).
7.
Chieng D, Kistler PM. Coffee and tea on cardiovascular disease (CVD) prevention. Trends Cardiovasc Med; 2021.
8.
Mineharu Y, Koizumi A, Wada Y, Iso H, Watanabe Y, Date C, Yamamoto A, Kikuchi S, Inaba Y, Toyoshima H, et al. Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women. J Epidemiol Community Health. 2011;65(3):230–40.PubMedCrossRef
9.
Pang J, Zhang Z, Zheng TZ, Bassig BA, Mao C, Liu X, Zhu Y, Shi K, Ge J, Yang YJ, et al. Green tea consumption and risk of cardiovascular and ischemic related diseases: a meta-analysis. Int J Cardiol. 2016;202:967–74.PubMedCrossRef
10.
Zhao LG, Li HL, Sun JW, Yang Y, Ma X, Shu XO, Zheng W, Xiang YB. Green tea consumption and cause-specific mortality: results from two prospective cohort studies in China. J Epidemiol. 2017;27(1):36–41.PubMedCrossRef
11.
Nie J, Yu C, Guo Y, Pei P, Chen L, Pang Y, Du H, Yang L, Chen Y, Yan S, et al. Tea consumption and long-term risk of type 2 diabetes and diabetic complications: a cohort study of 0.5 million Chinese adults. Am J Clin Nutr. 2021;114(1):194–202.PubMedPubMedCentralCrossRef
12.
Chen L, Sun X, Zheng L. No causal effect of tea consumption on cardiovascular diseases: a two-sample mendelian randomization study. Front Cardiovasc Med. 2022;9:870972.PubMedPubMedCentralCrossRef
13.
Liu X, Xu W, Cai H, Gao YT, Li H, Ji BT, Shu X, Wang T, Gerszten RE, Zheng W, et al. Green tea consumption and risk of type 2 diabetes in Chinese adults: the Shanghai women’s Health Study and the Shanghai men’s Health Study. Int J Epidemiol. 2018;47(6):1887–96.PubMedPubMedCentralCrossRef
14.
Shen C, Wen J, Pan X, Su J, Du W, Pan E, Zhang Q, Zhang N, Sheng H, Liu C, et al. Age at menarche and age at natural menopause as predictors of glycemic control in type 2 diabetic patients. J Diabetes Complications. 2018;32(7):623–9.PubMedCrossRef
15.
Miao DD, Pan EC, Zhang Q, Sun ZM, Qin Y, Wu M. Development and validation of a Model for Predicting Diabetic Nephropathy in Chinese people. Biomed Environ Sci. 2017;30(2):106–12.PubMed
16.
Chen Y, Yang J, Su J, Qin Y, Shen C, Li Y, Lu S, Pan E, Gao Y, Miao D, et al. Physical activity, sedentary time and their associations with clustered metabolic risk among people with type 2 diabetes in Jiangsu province: a cross-sectional study. BMJ Open. 2019;9(8):e027906.PubMedPubMedCentralCrossRef
17.
Li M, Wu M, Qin Y, Zhou J, Su J, Pan E, Zhang Q, Zhang N, Sheng H, Dong J, et al. ACTB Variants Confer the Genetic Susceptibility to Diabetic kidney disease in a Han Chinese Population. Front Genet. 2019;10:663.PubMedPubMedCentralCrossRef
18.
2. Classification and diagnosis of diabetes: standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):15–s33.
19.
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147–167.PubMedPubMedCentralCrossRef
20.
Chen C, Zhao W, Yang X, Chen J, Li K, Zhao L, Yao C, Zhao X, Li G, Jia W. Criteria of weight for adults. Health industrial standard of the People’s Republic of China China’s State Family Planning Commission; 2013.
21.
Boyko EJ, Ahroni JH, Stensel VL, Smith DG, Davignon DR, Pecoraro RE. Predictors of transcutaneous oxygen tension in the lower limbs of diabetic subjects. Diabet Med. 1996;13(6):549–54.PubMedCrossRef
22.
Deng W, Dong X, Zhang Y, Jiang Y, Lu D, Wu Q, Liang Z, Yang G, Chen B. Transcutaneous oxygen pressure (TcPO2): a novel diagnostic tool for peripheral neuropathy in type 2 diabetes patients. Diabetes Res Clin Pract. 2014;105(3):336–43.PubMedCrossRef
23.
Kubicek-Sutherland JZ, Vu DM, Mendez HM, Jakhar S, Mukundan H. Detection of lipid and amphiphilic biomarkers for Disease Diagnostics. Biosens (Basel) 2017, 7(3).
24.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.PubMedCrossRef
25.
Villena Gonzales W, Mobashsher AT, Abbosh A. The progress of glucose Monitoring-A review of Invasive to minimally and non-invasive techniques, devices and sensors. Sens (Basel) 2019, 19(4).
26.
Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470–5.PubMedCrossRef
27.
Dong Y, Wang X, Zhang L, Chen Z, Zheng C, Wang J, Kang Y, Shao L, Tian Y, Wang Z. High-sensitivity C reactive protein and risk of cardiovascular disease in China-CVD study. J Epidemiol Community Health. 2019;73(2):188–92.PubMedCrossRef
28.
29.
Glance LG, Osler TM, Mukamel DB, Meredith W, Dick AW. Impact of statistical approaches for handling missing data on trauma center quality. Ann Surg. 2009;249(1):143–8.PubMedCrossRef
30.
Robins JM, Hernán MA, Brumback B. Marginal structural models and causal inference in epidemiology. Epidemiology. 2000;11(5):550–60.PubMedCrossRef
31.
Hernán MA, Hernández-Díaz S, Werler MM, Mitchell AA. Causal knowledge as a prerequisite for confounding evaluation: an application to birth defects epidemiology. Am J Epidemiol. 2002;155(2):176–84.PubMedCrossRef
32.
VanderWeele TJ, Ding P. Sensitivity analysis in Observational Research: introducing the E-Value. Ann Intern Med. 2017;167(4):268–74.PubMedCrossRef
33.
Haneuse S, VanderWeele TJ, Arterburn D. Using the E-Value to assess the potential effect of unmeasured confounding in Observational studies. JAMA. 2019;321(6):602–3.PubMedCrossRef
34.
Li R, Li X, Wu H, Yang Z, Fei L, Zhu J. Theaflavin attenuates cerebral ischemia/reperfusion injury by abolishing miRNA–128–3p–mediated Nrf2 inhibition and reducing oxidative stress. Mol Med Rep. 2019;20(6):4893–904.PubMedPubMedCentral
35.
Lorenz M, Rauhut F, Hofer C, Gwosc S, Müller E, Praeger D, Zimmermann BF, Wernecke KD, Baumann G, Stangl K, et al. Tea-induced improvement of endothelial function in humans: no role for epigallocatechin gallate (EGCG). Sci Rep. 2017;7(1):2279.PubMedPubMedCentralCrossRefADS
36.
Gaeini Z, Bahadoran Z, Mirmiran P, Azizi F. Tea, coffee, caffeine intake and the risk of cardio-metabolic outcomes: findings from a population with low coffee and high tea consumption. Nutr Metab (Lond). 2019;16:28.PubMedCrossRef
37.
Kuriyama S, Shimazu T, Ohmori K, Kikuchi N, Nakaya N, Nishino Y, Tsubono Y, Tsuji I. Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: the Ohsaki study. JAMA. 2006;296(10):1255–65.PubMedCrossRef
38.
Kokubo Y, Iso H, Saito I, Yamagishi K, Yatsuya H, Ishihara J, Inoue M, Tsugane S. The impact of green tea and coffee consumption on the reduced risk of stroke incidence in Japanese population: the Japan public health center-based study cohort. Stroke. 2013;44(5):1369–74.PubMedCrossRef
39.
Rehman T, Rajaa S, Kumar G, Jayalakshmy R. Prevalence and factors influencing diabesity among persons with type 2 diabetes Mellitus in Urban Puducherry: a cross-sectional Analytical Study. Indian J Community Med. 2020;45(3):315–9.PubMedPubMedCentralCrossRef
40.
Bovet P, Romain S, Shamlaye C, Mendis S, Darioli R, Riesen W, Tappy L, Paccaud F. Divergent fifteen-year trends in traditional and cardiometabolic risk factors of cardiovascular diseases in the Seychelles. Cardiovasc Diabetol. 2009;8:34.PubMedPubMedCentralCrossRef
41.
Sesso HD, Paffenbarger RS Jr., Oguma Y, Lee IM. Lack of association between tea and cardiovascular disease in college alumni. Int J Epidemiol. 2003;32(4):527–33.PubMedCrossRef
42.
Soerensen M, Nygaard M, Dato S, Stevnsner T, Bohr VA, Christensen K, Christiansen L. Association study of FOXO3A SNPs and aging phenotypes in Danish oldest-old individuals. Aging Cell. 2015;14(1):60–6.PubMedCrossRef
43.
Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol. 2018;17(1):83.PubMedPubMedCentralCrossRef
44.
Eastwood SV, Tillin T, Sattar N, Forouhi NG, Hughes AD, Chaturvedi N. Associations between prediabetes, by three different diagnostic criteria, and incident CVD differ in South asians and europeans. Diabetes Care. 2015;38(12):2325–32.PubMedCrossRef
45.
Kim KJ, Kwon TY, Yu S, Seo JA, Kim NH, Choi KM, Baik SH, Choi DS, Kim SG, Park Y, et al. Ten-Year Mortality trends for adults with and without diabetes Mellitus in South Korea, 2003 to 2013. Diabetes Metab J. 2018;42(5):394–401.PubMedPubMedCentralCrossRef
46.
Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.PubMedCrossRef
47.
Xu Y, Bi Y, Li M, Wang T, Sun K, Xu M, Lu J, Yu Y, Li X, Lai S, et al. Significant coronary stenosis in asymptomatic Chinese with different glycemic status. Diabetes Care. 2013;36(6):1687–94.PubMedPubMedCentralCrossRef
48.
Fox CS, Sullivan L, D’Agostino RB, Sr., Wilson PW. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004;27(3):704–8.PubMedCrossRef
49.
Liu J, Liu S, Zhou H, Hanson T, Yang L, Chen Z, Zhou M. Association of green tea consumption with mortality from all-cause, cardiovascular disease and cancer in a Chinese cohort of 165,000 adult men. Eur J Epidemiol. 2016;31(9):853–65.PubMedPubMedCentralCrossRef
50.
Qiu L, Sautter J, Gu D. Associations between frequency of tea consumption and health and mortality: evidence from old Chinese. Br J Nutr. 2012;108(9):1686–97.PubMedCrossRef
51.
Shin S, Lee JE, Loftfield E, Shu XO, Abe SK, Rahman MS, Saito E, Islam MR, Tsugane S, Sawada N, et al. Coffee and tea consumption and mortality from all causes, cardiovascular disease and cancer: a pooled analysis of prospective studies from the Asia Cohort Consortium. Int J Epidemiol. 2022;51(2):626–40.PubMedCrossRef
Metadata
Title
Green tea consumption and incidence of cardiovascular disease in type 2 diabetic patients with overweight/obesity: a community-based cohort study
Authors
Bingyue Liu
Shujun Gu
Jin Zhang
Hui Zhou
Jian Su
Sudan Wang
Qian Sun
Zhengyuan Zhou
Jinyi Zhou
Chen Dong
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2024
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-024-01242-3

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