Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study.

Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study.
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DOI:
10.1038/ejcn.2013.235
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发表时间:
2014-02
影响因子:
4.7
通讯作者:
--
中科院分区:
医学3区
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前瞻性队列研究表明,血清维生素D水平与2型糖尿病的风险呈负相关。然而,这类研究无法确定维生素D的来源。因此,我们在欧洲癌症与营养前瞻性调查(EPIC)-InterAct研究中检查了膳食维生素D摄入量与2型糖尿病发病率的关系,该研究在包括8个地理差异很大的欧洲异质人群中进行。采用病例队列设计,11245例2型糖尿病病例和代表性亚队列(N= 15798)被纳入分析。2型糖尿病的风险比(HR)和95%置信区间(CIs)采用经潜在混杂因素校正的普伦蒂斯加权Cox回归计算。来自一个子样本(N=2347)的24小时饮食回忆数据被用来校准来自饮食问卷的习惯性摄入数据。中位随访时间为10.8年。饮食中维生素D的摄入量与患2型糖尿病的风险没有显著关联。未校准维生素D摄入量的最高五分位数与最低五分位数的HR和95% ci为1.09 (0.97-1.22),(ptrend=0.17)。在性别特异性分析中未观察到相关性。使用连续校准变量的总合并效应[95% CI]为1.00(0.97-1.03),每增加1 μg/天的膳食维生素D。该观察性研究不支持较高的膳食维生素D摄入量与2型糖尿病发病率之间的关联。这一结果必须根据膳食维生素D对一个人整体维生素D水平的有限贡献来解释。
Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including 8 countries with large geographical variation. Using a case-cohort design, 11,245 incident cases of type 2 diabetes and a representative subcohort (N=15,798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. 24-h diet recall data from a subsample (N=2347) were used to calibrate habitual intake data derived from dietary questionnaires. Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95 % CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22), (ptrend=0.17). No associations were observed in a sex-specific analysis. The overall pooled effect [HR (95% CI)] using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 μg/day dietary vitamin D. This observational study does not support an association between higher dietary vitamin D intake and type-2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.
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