期刊
BMJ-BRITISH MEDICAL JOURNAL
卷 370, 期 -, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmj.m2194
关键词
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资金
- EU FP6 programme [LSHM_CT_2006_037197]
- MRC Cambridge Initiative [RG71466, SJAH/004]
- UK Medical Research Council [MR/M012190/1]
- British Heart Foundation [RG/13/13/30194, RG/18/13/33946]
- European Commission [HEALTH-F2-2012-279233]
- European Research Council
- National Institute for Health Research (NIHR)
- (Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust) - National Institute for Health Research
- Medical Research Council Epidemiology Unit [MC_UU_12015/1, MC_UU_12015/5]
- NIHR Biomedical Research Centre Cambridge [IS-BRC-1215-20014]
- Westlake University [YSYY0209]
- European Union [701708]
- Cancer Research UK
- Swedish Research Council
- Novo Nordisk
- Swedish Diabetes Association
- Swedish Heart-Lung Foundation
- Medical Research Council UK
- German Cancer Aid
- German Cancer Research Center (DKFZ)
- German Federal Ministry of Education and Research (BMBF)
- Danish Cancer Society
- Compagnia di San Paolo
- regional government of Asturias
- Vasterboten County Council
- Imperial College Biomedical Research Centre
- Dutch Ministry of Public Health, Welfare and Sports, Netherlands Cancer Registry, LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Health Research Fund (FIS) -Instituto de Salud Carlos III (ISCIII)
- Catalan Institute of Oncology (ICO) (Spain)
- InterAct project
- EPIC-CVD project
- MRC [MC_UU_12015/5, MC_UU_00006/1, MC_UU_12015/1, MC_UU_00006/3] Funding Source: UKRI
- Marie Curie Actions (MSCA) [701708] Funding Source: Marie Curie Actions (MSCA)
OBJECTIVE To investigate the association of plasma vitamin C and carotenoids, as indicators of fruit and vegetable intake, with the risk of type 2 diabetes. DESIGN Prospective case-cohort study. SETTING Populations from eight European countries. PARTICIPANTS 9754 participants with incident type 2 diabetes, and a subcohort of 13 662 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort of 340 234 participants: EPIC-InterAct case-cohort study. MAIN OUTCOME MEASURE Incident type 2 diabetes. RESULTS In a multivariable adjusted model, higher plasma vitamin C was associated with a lower risk of developing type 2 diabetes (hazard ratio per standard deviation 0.82, 95% confidence interval 0.76 to 0.89). A similar inverse association was shown for total carotenoids (hazard ratio per standard deviation 0.75, 0.68 to 0.82). A composite biomarker score (split into five equal groups), comprising vitamin C and individual carotenoids, was inversely associated with type 2 diabetes with hazard ratios 0.77, 0.66, 0.59, and 0.50 for groups 2-5 compared with group 1 (the lowest group). Self-reported median fruit and vegetable intake was 274 g/day, 396 g/day, and 508 g/day for participants in categories defined by groups 1, 3, and 5 of the composite biomarker score, respectively. One standard deviation difference in the composite biomarker score, equivalent to a 66 (95% confidence interval 61 to 71) g/day difference in total fruit and vegetable intake, was associated with a hazard ratio of 0.75 (0.67 to 0.83). This would be equivalent to an absolute risk reduction of 0.95 per 1000 person years of follow-up if achieved across an entire population with the characteristics of the eight European countries included in this analysis. CONCLUSIONS These findings indicate an inverse association between plasma vitamin C, carotenoids, and their composite biomarker score, and incident type 2 diabetes in different European countries. These biomarkers are objective indicators of fruit and vegetable consumption, and suggest that diets rich in even modestly higher fruit and vegetable consumption could help to prevent development of type 2 diabetes.
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