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Intake of Vitamin and Mineral Supplements and Longitudinal Association with HbA1c Levels in the General Non-Diabetic Population--Results from the MONICA/KORA S3/F3 Study.

Schwab S, Zierer A, Heier M, Fischer B, Huth C, Baumert J, Meisinger C, Peters A, Thorand B - PLoS ONE (2015)

Bottom Line: Follow-up data were derived from 2774 participants in the follow-up survey named "Cooperative Health Research in the Region of Augsburg" (KORA) F3 (2004/05).For carotenoids, analyses were stratified by smoking status.An inverse association was observed in those who never smoked but not in (former) smokers.

View Article: PubMed Central - PubMed

Affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.

ABSTRACT

Background: Lower levels of hemoglobin A1c (HbA1c) are associated with a decreased risk of cardiovascular complications in diabetic and non-diabetic individuals. The aim of the study was to longitudinally investigate the association between the use of 11 vitamins and minerals (vitamins E, C, D, B1, folic acid, carotenoids, calcium, magnesium, zinc, iron, and selenium) and change in HbA1c levels over 10 years in non-diabetic individuals drawn from the general population.

Methods: Baseline data were available from 4447 subjects included in the population-based "Monitoring of Trends and Determinants in Cardiovascular Diseases" (MONICA) Augsburg S3 survey (1994/95). Follow-up data were derived from 2774 participants in the follow-up survey named "Cooperative Health Research in the Region of Augsburg" (KORA) F3 (2004/05). Vitamin/mineral intake from supplements and medications was assessed in a personal interview, where participants were asked to bring product packages of preparations that had been ingested during the last 7 days prior to the examination. Associations between regular vitamin/mineral intake amounts and HbA1c levels measured at baseline and follow-up were investigated using generalized estimating equation models. For carotenoids, analyses were stratified by smoking status.

Results: None of the investigated nutrients except for carotenoids was significantly associated with changes in HbA1c levels after 10 years. Regular intake of carotenoids from supplements and medications in amounts > 6.8 mg/d (upper tertile) was associated with an absolute -0.26% (95% CI: -0.43 to -0.08) lower increase in HbA1c levels compared with no intake of carotenoids. An inverse association was observed in those who never smoked but not in (former) smokers.

Conclusion: Larger prospective and intervention studies in non-diabetic/non-smoking individuals are needed to confirm the results and to assess whether the observed associations between carotenoid intake and change in HbA1c levels are causal. If our results are confirmed, high carotenoid intake could be one strategy for the prevention of cardiovascular complications in non-diabetic people.

No MeSH data available.


Related in: MedlinePlus

Longitudinal association between regular carotenoid intake amount from supplements and medications in tertiles and levels of HbA1c over 10 years (1994/95 to 2004/05).nTotal population = 4447, nnever smokers = 1959, n(former) smokers = 2498; 10 people who stated they were never smokers at baseline but smokers at follow-up were partly used for both strata for the appropriate time point; HbA1c beta estimates (βx) result from fully adjusted generalized estimating equation models and refer to interaction terms with time (represents the difference in change in HbA1c levels compared with those with no intake of carotenoids, see βx in Table 3 for total population); cut-off point for tertiles 1 and 2: 1.9 mg/d; for tertiles 2 and 3: 6.8 mg/d.
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pone.0139244.g001: Longitudinal association between regular carotenoid intake amount from supplements and medications in tertiles and levels of HbA1c over 10 years (1994/95 to 2004/05).nTotal population = 4447, nnever smokers = 1959, n(former) smokers = 2498; 10 people who stated they were never smokers at baseline but smokers at follow-up were partly used for both strata for the appropriate time point; HbA1c beta estimates (βx) result from fully adjusted generalized estimating equation models and refer to interaction terms with time (represents the difference in change in HbA1c levels compared with those with no intake of carotenoids, see βx in Table 3 for total population); cut-off point for tertiles 1 and 2: 1.9 mg/d; for tertiles 2 and 3: 6.8 mg/d.

Mentions: In the smoking status-stratified analyses of carotenoid intake and HbA1c levels, the results for current and former smokers were pooled together, as they did not differ substantially (data not shown). A longitudinal inverse association of the upper carotenoid tertile with HbA1c level was significant in participants who never smoked (βx = –0.43% (95% CI: –0.63 to –0.24), p < 0.0001), but not in current or former smokers (βx = –0.11% (95% CI: –0.39 to 0.17), p = 0.451) (see Fig 1). Never smokers with carotenoid intakes in the upper tertile had higher baseline HbA1c values than never smokers with no intake of carotenoids (β0 = 0.33 (95% CI: 0.18 to 0.48), p < 0.0001).


Intake of Vitamin and Mineral Supplements and Longitudinal Association with HbA1c Levels in the General Non-Diabetic Population--Results from the MONICA/KORA S3/F3 Study.

Schwab S, Zierer A, Heier M, Fischer B, Huth C, Baumert J, Meisinger C, Peters A, Thorand B - PLoS ONE (2015)

Longitudinal association between regular carotenoid intake amount from supplements and medications in tertiles and levels of HbA1c over 10 years (1994/95 to 2004/05).nTotal population = 4447, nnever smokers = 1959, n(former) smokers = 2498; 10 people who stated they were never smokers at baseline but smokers at follow-up were partly used for both strata for the appropriate time point; HbA1c beta estimates (βx) result from fully adjusted generalized estimating equation models and refer to interaction terms with time (represents the difference in change in HbA1c levels compared with those with no intake of carotenoids, see βx in Table 3 for total population); cut-off point for tertiles 1 and 2: 1.9 mg/d; for tertiles 2 and 3: 6.8 mg/d.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608810&req=5

pone.0139244.g001: Longitudinal association between regular carotenoid intake amount from supplements and medications in tertiles and levels of HbA1c over 10 years (1994/95 to 2004/05).nTotal population = 4447, nnever smokers = 1959, n(former) smokers = 2498; 10 people who stated they were never smokers at baseline but smokers at follow-up were partly used for both strata for the appropriate time point; HbA1c beta estimates (βx) result from fully adjusted generalized estimating equation models and refer to interaction terms with time (represents the difference in change in HbA1c levels compared with those with no intake of carotenoids, see βx in Table 3 for total population); cut-off point for tertiles 1 and 2: 1.9 mg/d; for tertiles 2 and 3: 6.8 mg/d.
Mentions: In the smoking status-stratified analyses of carotenoid intake and HbA1c levels, the results for current and former smokers were pooled together, as they did not differ substantially (data not shown). A longitudinal inverse association of the upper carotenoid tertile with HbA1c level was significant in participants who never smoked (βx = –0.43% (95% CI: –0.63 to –0.24), p < 0.0001), but not in current or former smokers (βx = –0.11% (95% CI: –0.39 to 0.17), p = 0.451) (see Fig 1). Never smokers with carotenoid intakes in the upper tertile had higher baseline HbA1c values than never smokers with no intake of carotenoids (β0 = 0.33 (95% CI: 0.18 to 0.48), p < 0.0001).

Bottom Line: Follow-up data were derived from 2774 participants in the follow-up survey named "Cooperative Health Research in the Region of Augsburg" (KORA) F3 (2004/05).For carotenoids, analyses were stratified by smoking status.An inverse association was observed in those who never smoked but not in (former) smokers.

View Article: PubMed Central - PubMed

Affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.

ABSTRACT

Background: Lower levels of hemoglobin A1c (HbA1c) are associated with a decreased risk of cardiovascular complications in diabetic and non-diabetic individuals. The aim of the study was to longitudinally investigate the association between the use of 11 vitamins and minerals (vitamins E, C, D, B1, folic acid, carotenoids, calcium, magnesium, zinc, iron, and selenium) and change in HbA1c levels over 10 years in non-diabetic individuals drawn from the general population.

Methods: Baseline data were available from 4447 subjects included in the population-based "Monitoring of Trends and Determinants in Cardiovascular Diseases" (MONICA) Augsburg S3 survey (1994/95). Follow-up data were derived from 2774 participants in the follow-up survey named "Cooperative Health Research in the Region of Augsburg" (KORA) F3 (2004/05). Vitamin/mineral intake from supplements and medications was assessed in a personal interview, where participants were asked to bring product packages of preparations that had been ingested during the last 7 days prior to the examination. Associations between regular vitamin/mineral intake amounts and HbA1c levels measured at baseline and follow-up were investigated using generalized estimating equation models. For carotenoids, analyses were stratified by smoking status.

Results: None of the investigated nutrients except for carotenoids was significantly associated with changes in HbA1c levels after 10 years. Regular intake of carotenoids from supplements and medications in amounts > 6.8 mg/d (upper tertile) was associated with an absolute -0.26% (95% CI: -0.43 to -0.08) lower increase in HbA1c levels compared with no intake of carotenoids. An inverse association was observed in those who never smoked but not in (former) smokers.

Conclusion: Larger prospective and intervention studies in non-diabetic/non-smoking individuals are needed to confirm the results and to assess whether the observed associations between carotenoid intake and change in HbA1c levels are causal. If our results are confirmed, high carotenoid intake could be one strategy for the prevention of cardiovascular complications in non-diabetic people.

No MeSH data available.


Related in: MedlinePlus