Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries

被引：86

作者：

Zheng, Ju-Sheng ^{[1
,2
]}

Sharp, Stephen J. ^{[1
]}

Imamura, Fumiaki ^{[1
]}

Chowdhury, Rajiv ^{[3
]}

Gundersen, Thomas E. ^{[4
]}

Steur, Marinka ^{[1
]}

Sluijs, Ivonne ^{[5
]}

Schouw, Yvonne T. van der ^{[5
]}

Agudo, Antonio ^{[6
]}

Aune, Dagfinn ^{[7
,8
,9
]}

Barricarte, Aurelio ^{[10
]}

Boeing, Heiner ^{[11
]}

Chirlaque, Maria -Dolores ^{[12
,13
]}

Dorronsoro, Miren ^{[14
]}

Freisling, Heinz ^{[15
]}

El-Fatouhi, Douae ^{[16
]}

Franks, Paul W. ^{[17
]}

Fagherazzi, Guy ^{[16
,18
]}

Grioni, Sara ^{[19
]}

Gunter, Marc J. ^{[15
]}

Kyro, Cecilie ^{[20
]}

Katzke, Verena ^{[21
]}

Kuhn, Tilman ^{[21
]}

Khaw, Kay-Tee ^{[22
]}

Laouali, Nasser ^{[16
]}

Masala, Giovanna ^{[23
]}

Nilsson, Peter M. ^{[17
]}

Overvad, Kim ^{[24
,25
]}

Panico, Salvatore ^{[26
]}

Papier, Keren ^{[27
]}

Quiros, J. Ramon ^{[28
]}

Rolandsson, Olov ^{[29
]}

Redondo-Sanchez, Daniel ^{[13
,30
,31
]}

Ricceri, Fulvio ^{[32
,33
]}

Schulze, Matthias B. ^{[34
,35
,36
]}

Spijkerman, Annemieke M. W. ^{[37
]}

Tjonneland, Anne ^{[20
]}

Tong, Tammy Y. N. ^{[27
]}

Tumino, Rosario ^{[38
]}

Weiderpass, Elisabete ^{[15
]}

John, Danesh ^{[3
,39
,40
,41
]}

Butterworth, Adam S. ^{[3
,39
]}

Riboli, Elio ^{[7
]}

Forouhi, Nita G. ^{[1
]}

Wareham, Nicholas J. ^{[1
]}

机构：

[1] Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge Biomed Campus, Cambridge CB2 0QQ, England

[2] Westlake Univ, Key Lab Growth Regulat & Translat Res Zhejiang Pr, Sch Life Sci, Hangzhou, Peoples R China

[3] Univ Cambridge, Dept Publ Hlth & Primary Care, MRC BHF Cardiovasc Epidemiol Unit, Cambridge, England

[4] Vitas AS, Oslo, Norway

[5] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[6] Bellvitge Biomed Res Inst, Grp Res Nutr & Canc, Canc Epidemiol Res Programme, Catalan Inst Oncol,Unit Nutr & Canc, Barcelona, Spain

[7] Imperial Coll London, Sch Publ Hlth, London, England

[8] Bjorknes Univ Coll, Dept Nutr, Oslo, Norway

[9] Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Oslo, Norway

[10] Navarra Publ Hlth Inst, Pamplona, Spain

[11] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany

[12] Murcia Univ, IMIB Arrixaca, Reg Hlth Council, Dept Epidemiol, Murcia, Spain

[13] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain

[14] Publ Hlth Div Gipuzkoa, San Sebastian, Spain

[15] Int Agcy Res Canc, Lyon, France

[16] Paris Sud Paris Saclay Univ, Ctr Res Epidemiol & Populat Hlth, Inst Gustave Roussy, INSERM,UMR 1018, Villejuif, France

[17] Lund Univ, Dept Clin Sci, Malmo, Sweden

[18] Luxembourg Inst Hlth LIH, Dept Populat Hlth, Strassen, Luxembourg

[19] Epidemiol & Prevent Unit, Milan, Italy

[20] Danish Canc Soc, Res Ctr, Copenhagen, Denmark

[21] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[22] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England

[23] Inst Canc Res Prevent & Clin Network, Canc Risk Factors & Life Style Epidemiol Unit, Florence, Italy

[24] Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark

[25] Aalborg Univ Hosp, Dept Cardiol, Aarhus, Denmark

[26] Univ Naples Federico II, Dept Clin Med & Surg, Naples, Italy

[27] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

[28] Publ Hlth Directorate, Asturias, Spain

[29] Umea Univ, Dept Publ Hlth & Clin Med, Family Med, Umea, Sweden

[30] Andalusian Sch Publ Hlth, Granada, Spain

[31] Inst Biosanitary Res Granada, Granada, Spain

[32] Univ Turin, Dept Clin & Biol Sci, Turin, Italy

[33] Reg Hlth Serv ASL TO3, Unit Epidemiol, Turin, Italy

[34] German Inst Human Nutr Potsdam Rehbrucke, Dept Mol Epidemiol, Nuthetal, Germany

[35] German Ctr Diabet Res, Neuherberg, Germany

[36] Univ Potsdam, Inst Nutr Sci, Potsdam, Germany

[37] Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands

[38] Azienda Sanit Prov, Canc Registry & Histopathol Dept, Ragusa, Italy

[39] Univ Cambridge, NIHR Blood & Transplant Res Unit Donor Hlth & Gen, Dept Publ Hlth & Primary Care, Cambridge, England

[40] Addenbrookes Hosp, Div Cardiovasc Med, British Heart Fdn, Cambridge Ctr Excellence, Cambridge, England

[41] Wellcome Trust Sanger Inst, Dept Human Genet, Cambridge, England

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2020年 / 370卷

基金：

英国医学研究理事会; 欧洲研究理事会; 瑞典研究理事会;

关键词：

BETA-CAROTENE SUPPLEMENTATION; VITAMIN-C; CARDIOVASCULAR-DISEASE; LEVEL CORRELATIONS; GUT MICROBIOTA; CANCER; RISK; METAANALYSIS; MELLITUS; HEALTH;

D O I：

10.1136/bmj.m2194

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：14

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