Plasma and dietary vitamin E in relation to incidence of type 2 diabetes - The Insulin Resistance and Atherosclerosis Study (IRAS)
Plasma and dietary vitamin E in relation to incidence of type 2 diabetes - The Insulin Resistance and Atherosclerosis Study (IRAS)
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DOI：
10.2337/diacare.25.12.2172
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发表时间：
2002-12-01
期刊：
影响因子：
16.2
通讯作者：
Bell, RA
中科院分区：
文献类型：
--
作者：
Mayer-Davis, EJ;Costacou, T;Bell, RA
研究设计与方法：胰岛素抵抗动脉粥样硬化研究(IRAS)包括895名基线水平的非糖尿病成年人(包括303名糖耐量受损[IGT])，其中148人在5年的随访中根据世界卫生组织(WHO)的标准发展为2型糖尿病。在基线时，通过有效的食物频率访谈评估膳食维生素E，通过补充剂标签确认常用补充剂的使用，并测量血浆α-生育酚。结果：在不服用补充剂的人中，报告的维生素E(mgα-生育酚当量[α-TE])的平均摄入量在保持非糖尿病的人(n-490)和患有糖尿病的人(n=87)之间没有差异(分别为10.5+/-5.5和9.5+/-4.8[平均+/-SD]，NS)。在调整了人口统计学变量、肥胖、体力活动和其他营养素后，与最低摄入量(1-4α-TE)相比，最高摄入量(大于或等于20 mgα-TE)与最低摄入量(1-4α-TE)的相关性仍然不显著(优势比[OR]0.80，95%CI 0.13-5.06)。然而，α-生育酚的血浆浓度在调整潜在混杂因素前后都显示出显著的保护作用(调整后的OR为0.12，95%CI为0.02-0.68，最高五分位数与最低五分位数比较；总体趋势检验，P<；0.01)。在报告习惯使用维生素E补充剂的人中(基线前一年至少每月一次；259人保持非糖尿病，59人发展为糖尿病)，没有观察到报告的维生素E摄入量或α-生育酚血浆浓度的保护作用。结论-维生素E的保护作用可能存在于食物可获得的摄入量范围内。在使用高剂量补充剂的研究中，这种影响可能没有被发现，因为它似乎没有额外的保护益处。
OBJECTIVE - To evaluate the association of vitamin E with incidence of type 2 diabetes and to do so separately among individuals who did and those who did not report regular use of vitamin supplementation.RESEARCH DESIGN AND METHODS - The Insulin Resistance Atherosclerosis Study (IRAS) included 895 nondiabetic adults at baseline (including 303 with impaired glucose tolerance [IGT]), 148 of whom developed type 2 diabetes according to World Health Organization (WHO) criteria during the 5-year follow-up. At baseline, dietary vitamin E was estimated by a validated food frequency interview, usual supplement use was confirmed by supplement label, and plasma alpha-tocopherol was measured. Analyses were conducted separately for individuals who did (n = 318) and did not (n = 577) use vitamin E supplements.RESULTS - Among supplement nonusers, reported mean intake of vitamin E (mg alpha-tocopherol equivalents [alpha-TE]) did not differ between those who remained nondiabetic (n - 490) and those who developed diabetes (n = 87) (10.5 +/- 5.5 vs. 9.5 +/- 4.8 [means +/- SD], respectively, NS). After adjustment for demographic variables, obesity, physical activity, and other nutrients, the association remained nonsignificant (odds ratio [OR] 0.80, 95% Cl 0.13-5.06) for the highest level of intake (greater than or equal to20 mg alpha-TE) compared with the lowest level (1-4 alpha-TE). However, results or plasma concentration of alpha-tocopherol showed a significant protective effect both before and after adjustment for potential confounders (adjusted OR 0.12, 95% CI 0.02-0.68, for the highest quintile vs. the lowest quintile; overall test for trend, P < 0.01). Among individuals who reported habitual use of vitamin E supplements (at least once per month in the year before baseline; 259 remained nondiabetic and 59 developed diabetes), no protective effect was observed for either reported intake of vitamin E or plasma concentration of α-tocopherolCONCLUSIONS - A protective effect of vitamin E may exist within the range of intake available from food. This effect may go undetected within studies of high-dose supplement use, which appears to hold no additional protective benefit.