Luteolin intake is negatively associated with all-cause and cardiac mortality among patients with type 2 diabetes mellitus

Abstract

Background Luteolin, a common flavonoid in our daily diet, has potent anti-diabetic effects. However, its prognostic impact on type 2 diabetes mellitus (T2DM) is still uncertain. This study aimed to clarify this association. Methods In this prospective cohort study, 2,461 patients with T2DM were included from the National Health and Nutrition Examination Survey. Dietary luteolin intake was estimated by the type and amount of food consumed in a 24-hour dietary recall. All-cause and cardiac mortality were ascertained by National Death Index Mortality data (as of December 31, 2019). The association of luteolin intake with mortality risk was estimated by Cox proportional hazards model. Results The median (interquartile range) luteolin intake was 0.355 (0.130, 0.835) mg/day. During the follow-up (median, 8.4 years), 561 all-cause deaths (including 136 cardiac deaths) were documented. Per-unit increment of luteolin intake (natural logarithm transformed) was found to reduce all-cause mortality by 7.0% (P = 0.024) and cardiac mortality by 22.6% (P = 0.001) in patients with T2DM. An inverse dose-response association was identified between luteolin intake (range: 0.005–9.870 mg/day) and mortality risk. The consistent result was also shown when stratified by age, gender, race, body mass index, HbA1c level, and T2DM duration. Moreover, luteolin intake increment was also shown to be associated with a lower C-reactive protein level at baseline (β =-0.332; 95% CI =-0.541, -0.122). Conclusion The current study confirmed that the dietary luteolin intake increment reduced all-cause mortality (especially cardiac mortality) in patients with T2DM, which may be attributed to the anti-inflammatory property of luteolin. Graphical abstract

The association between flavonoids intake and hypertension in U.S. adults: A cross‐sectional study from The National Health and Nutrition Examination Survey

“…36 Additionally, some studies have reported a lower level of established inflammatory biomarkers, such as C-reactive protein, associated with a higher intake of flavonoids. 37,38 This is consistent with our study, which suggests that total flavonoids intakes increment were associated with lower hs-CRP. Flavonoid compounds possess antioxidant, anti-inflammatory, and anti-thrombotic activities.…”

The association between flavonoids intake and hypertension in U.S. Adults: a cross-sectional study from The National Health and Nutrition Examination Survey

“…In vitro studies have demonstrated that avonoid compounds reduce oxidative damage by scavenging free radicals [25]. Higher avonoid intake has also been associated with lower liver injury markers (AST, ALT) and in ammatory biomarkers such as C-reactive protein [26,27]. Although it remains unclear whether avonoid compounds in the human body can enhance the preventive effects against cardiovascular events through mutual interactions and metabolism of intestinal ora [28], their wide range of pharmacological actions provides compelling evidence for dietary adjustments to prevent hypertension and cardiovascular diseases [29,30].…”