Calcium plus vitamin D supplementation and the risk of incident diabetes in the women's health initiative
Calcium plus vitamin D supplementation and the risk of incident diabetes in the women's health initiative
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DOI：
10.2337/dc07-1829
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发表时间：
2008-04-01
期刊：
影响因子：
16.2
通讯作者：
Weiss, Noel S.
中科院分区：
文献类型：
--
作者：
de Boer, Ian H.;Tinker, Lesley F.;Weiss, Noel S.
目的：实验和皮肤病学研究表明，钙和维生素D可以降低患糖尿病的风险。我们研究了钙加维生素D补充对绝经后妇女药物治疗糖尿病发病率的影响。研究设计和方法-妇女健康倡议钙/维生素D试验随机分配绝经后妇女以双盲方式每天服用1000 Trig元素钙加400IU维生素D3或安慰剂。在基线时没有自我报告糖尿病的33,951名参与者中，我们通过治疗分配确定了服用口服降糖药或胰岛素治疗的糖尿病的新诊断。在一组参与者中检查了干预对空腹血糖、胰岛素和胰岛素抵抗测量的影响。结果：在7年的中位随访期内，有2,291名女性新诊断为糖尿病。与钙/维生素D治疗相关的糖尿病发病风险比为1.01(95%可信区间0.94-1。10)基于治疗意向。这一无效结果在亚组分析、解释不依从性的疗效分析和检查实验室测量变化的分析中是可靠的。结论在这项随机安慰剂对照试验中，钙加维生素D3补充剂在7年的随访期内不能降低发生糖尿病的风险。可能需要更高剂量的维生素D来影响糖尿病风险，和/或在非随机研究中观察到的钙和维生素D摄入量与葡萄糖代谢改善之间的关联可能是混杂或含有这些营养物质的食物的其他成分的结果。
OBJECTIVE - Experimental and epiderniologic studies suggest that calcium and vitamin D may reduce the risk of developing diabetes. We examined the effect of calcium plus vitamin D supplementation on the incidence of drug-treated diabetes in postmenopausal women.RESEARCH DESIGN AND METHODS- The Women's Health Initiative Calcium/Vitamin D Trial randomly assigned postmenopausal women to receive 1,000 Trig elemental calcium plus 400 IU of vitamin D3 daily, or placebo, in a double-blind fashion. Among 33,951 participants without self-reported diabetes at baseline, we ascertained by treatment assignment new diagnoses of diabetes treated with oral hypoglycemic agents or insulin. Effects of the intervention on fasting measurements of glucose, insulin, and insulin resistance were examined among a subset of participants.RESULTS - Over a median follow-up time of 7 years, 2,291 women were newly diagnosed with diabetes. The hazard ratio for incident diabetes associated with calcium/vitamin D treatment was 1.01 (95% Cl 0.94-1. 10) based on intention to treat. This null result was robust in subgroup analyses, efficacy analyses accounting for nonadherence, and analyses examining change in laboratory measurements.CONCLUSIONS - Calcium plus vitamin D3 supplementation did not reduce the risk of developing diabetes over 7 years of follow-up in this randomized placebo-controlled trial. Higher doses of vitamin D may be required to affect diabetes risk, and/or associations of calcium and vitamin D intake with improved glucose metabolism observed in nonrandomized studies may be the result of confounding or of other components of foods containing these nutrients.