Dietary Vitamin C Intake Reduces the Risk of Type 2 Diabetes in Chinese Adults: HOMA-IR and T-AOC as Potential Mediators

Abstract

Despite growing interest in the protective role that dietary antioxidant vitamins may have in the development of type 2 diabetes (T2D), little epidemiological evidence is available in non-Western populations especially about the possible mediators underlying in this role. The present study aimed to investigate the association of vitamin C and vitamin E intakes with T2D risk in Chinese adults and examine the potential mediators. 178 incident T2D cases among 3483 participants in the Harbin People Health Study (HPHS), and 522 newly diagnosed T2D among 7595 participants in the Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases (HDNNCDS) were studied. In the multivariable-adjusted logistics regression model, the relative risks (RRs) were 1.00, 0.75, and 0.76 (Ptrend = 0.003) across tertiles of vitamin C intake in the HDNNCDS, and this association was validated in the HPHS with RRs of 1.00, 0.47, and 0.46 (Ptrend = 0.002). The RRs were 1.00, 0.72, and 0.76 (Ptrend = 0.039) when T2D diagnosed by haemoglobin A1c in the HDNNCDS. The mediation analysis discovered that insulin resistance (indicated by homeostasis model assessment) and oxidative stress (indicated by plasma total antioxidative capacity) partly mediated this association. But no association was evident between vitamin E intake and T2D. In conclusion, our research adds further support to the role of vitamin C intake in reducing the development of T2D in the broader population studied. The results also suggested that this association was partly mediated by inhibiting or ameliorating oxidative stress and insulin resistance.

Micronutrient dietary patterns associated with type 2 diabetes mellitus among women of the E3N‐EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study

“…32 Moreover the third pattern had high loadings for vitamin B 12 and retinol, which are both highly concentrated in foods of animal origin, and in particular in the liver. This pattern was characterized by a negative loading of vitamin C, which is known to be a marker of a diet rich in fruit and vegetables, which have previously been associated with a reduced risk of T2DM.…”

“…This pattern was characterized by a negative loading of vitamin C, which is known to be a marker of a diet rich in fruit and vegetables, which have previously been associated with a reduced risk of T2DM. 32 Moreover the third pattern had high loadings for vitamin B 12 and retinol, which are both highly concentrated in foods of animal origin, and in particular in the liver. 30 The recommended intake for vitamin B 12 is 2.4 μg/day, whereas that for retinol is 700 μg/day; 23 in women above Q4 of the third pattern, the intake of vitamin B 12 and retinol was fiveand threefold higher, respectively.…”

Dietary manganese and type 2 diabetes mellitus: two prospective cohort studies in China

“…Two prospective study cohorts were recruited in Harbin, the capital and largest city of Heilongjiang province in north China, to investigate the impacts of diet and nutrition on chronic non-communicable diseases. They were the Harbin People's Health Study (HPHS) [20,21] and the Harbin Cohort Study on Diet, Nutrition and Chronic Noncommunicable Diseases (HDNNCDS) (registered at http:// www.chictr.org.cn/showproj.aspx?proj=6833 as ChiCTR-ECH-12002721) [22]. Participants in the HPHS and the HDNNCDS were recruited in 2008 and 2010, and the first follow-up surveys were conducted in 2012 and 2015-2016, with an average of 4.2 and 5.3 years follow-up, respectively.…”

Fat-soluble vitamins from diet in relation to risk of type 2 diabetes mellitus in Japanese population

“…However, recent studies have shown that micronutrients are also involved (4,5) . It has been found that fat-soluble vitamins with antioxidant effects, such as vitamins A and E, may have protective effects against oxidative stress-driven pathogenesis and complications of chronic diseases including type 2 diabetes (5)(6)(7)(8)(9) . Moreover, interests have also been shown (5,(10)(11)(12)(13)(14) in the possible roles of the other two fat-soluble vitamins, vitamins K and D.…”