Associations of folate intake with all-cause and cause-specific mortality among individuals with diabetes

Background and aimsThe evidence regarding folate intake and mortality risk among patients with type 2 diabetes (T2D) remains unclear. This study aimed to investigate the association of folate intake with the risk of mortality among individuals with T2D. MethodsA total of 9,196 participants with T2D from the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 1999-2014 were included. The data of survival were obtained by the cohort database linked with the national death index up to 31 December 2015. The Cox proportional hazard model was used to evaluate the relationship between dietary folate with all-cause and cause-specific mortality. ResultsAmong patients with T2D, dietary folate intake was negatively correlated with all-cause mortality, cardiovascular mortality, and cancer mortality in men, and for women with all-cause mortality and cardiovascular mortality. The multivariate adjustment hazard ratio (HR) (95% CIs) for men of highest vs. lowest quartile was 0.77 (0.66-0.90), 0.61 (0.45-0.83), and 0.70 (0.49-0.99) for all-cause, cardiovascular, and cancer mortality, respectively. Among women, the multivariate adjustment HR (95% CIs) of highest vs. lowest quartile was 0.77 (0.64-0.92), 0.52 (0.33-0.83), and 0.78 (0.50-1.22) for all-cause, cardiovascular, and cancer mortality, respectively. ConclusionHigher dietary intake of folate was significantly associated with lower all-cause and cardiovascular mortality. This cohort study suggested that increasing the dietary folate intake may reduce mortality risk among U.S. adults with T2D.

Automated summary

This study found that higher dietary folate intake was associated with lower all-cause and cardiovascular mortality among individuals with type 2 diabetes. The association was observed in both men and women, with stronger associations seen in men. Increasing folate intake in the diet may reduce mortality risk in US adults with type 2 diabetes.