Associations of Biomarker-Calibrated Intake of Total Sugars With the Risk of Type 2 Diabetes and Cardiovascular Disease in the Women's Health Initiative Observational Study.
Associations of Biomarker-Calibrated Intake of Total Sugars With the Risk of Type 2 Diabetes and Cardiovascular Disease in the Women's Health Initiative Observational Study.
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女性健康倡议观察性研究中生物标志物校准的总糖摄入量与 2 型糖尿病和心血管疾病风险的关联。
DOI：
10.1093/aje/kwy115
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发表时间：
2018
影响因子：
5
通讯作者：
P
中科院分区：
文献类型：
--
作者：
Tasevska,Natasha;Pettinger,Mary;Kipnis,Victor;Midthune,Douglas;Tinker,LesleyF;Potischman,Nancy;Neuhouser,MarianL;Beasley,JeannetteM;VanHorn,Linda;Howard,BarbaraV;Liu,Simin;Manson,JoAnnE;Shikany,JamesM;Thomson,CynthiaA;P
流行病学研究发现总糖(TS)摄入量与心血管疾病(CVD)或2型糖尿病(T2D)风险之间存在不一致的结果，部分原因可能是自我报告摄入量的测量错误。使用基于TS的预测生物标记物和能量的恢复生物标记物开发的回归校正方程，我们在参加妇女健康倡议观察性研究的82,254名绝经后妇女中，检查了饮食校正前后TS与T2D和心血管疾病风险的关系。经过长达16年的跟踪(1993-2010年)，确定了6621例T2D和5802例心血管事件。在多变量能量替代中，校正TS每增加20%，T2D的危险比为0.94(95%可信区间：0.77，1.15)；在能量分配模型中，T2D的危险比为1.00(95%可信区间：0.85，1.18)。能量替代的多变量风险比为0.97(95%CI：0.87，1.09)，能量分配模型的多变量风险比为0.91(95%CI：0.80，1.04)。在多变量能量替代和能量分配模型中，未校准的TS与T2D和总心血管疾病风险在统计学上呈显著负相关。我们的校准分析缺乏确凿的结果可能是由于TS的校准方程的解释能力较低，这可能导致风险估计的不完全衰减。
The inconsistent findings from epidemiologic studies relating total sugars (TS) consumption to cardiovascular disease (CVD) or type 2 diabetes (T2D) risk may be partly due to measurement error in self-reported intake. Using regression calibration equations developed based on the predictive biomarker for TS and recovery biomarker for energy, we examined the association of TS with T2D and CVD risk, before and after dietary calibration, in 82,254 postmenopausal women participating in the Women’s Health Initiative Observational Study. After up to 16 years of follow-up (1993–2010), 6,621 T2D and 5,802 CVD incident cases were identified. The hazard ratio for T2D per 20% increase in calibrated TS was 0.94 (95% confidence interval (CI): 0.77, 1.15) in multivariable energy substitution, and 1.00 (95% CI: 0.85, 1.18) in energy partition models. Multivariable hazard ratios for total CVD were 0.97 (95% CI: 0.87, 1.09) from energy substitution, and 0.91 (95% CI: 0.80, 1.04) from energy partition models. Uncalibrated TS generated a statistically significant inverse association with T2D and total CVD risk in multivariable energy substitution and energy partition models. The lack of conclusive findings from our calibrated analyses may be due to the low explanatory power of the calibration equations for TS, which could have led to incomplete deattenuation of the risk estimates.