Arnlöv J, Zethelius B, Risérus U, Basu S, Berne C, Vessby B, Alfthan G, Helmersson J
Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala Science Park, Uppsala, Sweden.
Diabetologia. 2009 Jan;52(1):97-105. doi: 10.1007/s00125-008-1189-3. Epub 2008 Nov 5.
AIMS/HYPOTHESIS: To investigate the association of serum concentrations and dietary intake of beta-carotene and alpha-tocopherol with type 2 diabetes incidence.
Serum beta-carotene, alpha-tocopherol, lifestyle factors (BMI, physical activity and smoking) and metabolic factors (insulin sensitivity [homeostasis model assessment], acute insulin response and impaired fasting glucose) were analysed in 846 50-year-old non-diabetic Swedish men (participants in the Uppsala Longitudinal Study of Adult Men). Diabetes was identified in 245 participants at reinvestigations after 10, 20 and 27 years. At the 20 year reinvestigation, dietary intake of beta-carotene and alpha-tocopherol, insulin sensitivity (euglycaemic-hyperinsulinaemic clamp) and insulin secretion (early insulin response in OGTT) were determined.
The highest tertile of serum beta-carotene at age 50 (>0.335 mumol/l) was associated with 59% lower risk of diabetes during follow-up compared with the lowest tertile (<0.210 mumol/l) after adjustment for lifestyle and metabolic factors (p < 0.01). The highest tertile of lipid-corrected serum alpha-tocopherol at age 50 (>3.67 mumol/mmol) was associated with 46% lower risk of diabetes compared with the lowest tertile (<3.25 mumol/mmol) independently of metabolic factors (p < 0.05). Moreover, lower serum beta-carotene and alpha-tocopherol concentrations were independently associated with impaired insulin sensitivity (p < 0.001), but not with early insulin response, in a subsample of non-diabetic individuals 20 years later. Dietary intake of beta-carotene and alpha-tocopherol independently predicted type 2 diabetes during 7 years of follow-up.
CONCLUSIONS/INTERPRETATION: Serum concentrations and dietary intakes of beta-carotene and alpha-tocopherol independently predicted insulin resistance and type 2 diabetes incidence during 27 years of follow-up in a community-based study of men. This result supports the importance of impaired antioxidant status for the development of insulin resistance and type 2 diabetes.
目的/假设：研究血清中β-胡萝卜素和α-生育酚的浓度及膳食摄入量与2型糖尿病发病率之间的关联。
对846名50岁的非糖尿病瑞典男性（乌普萨拉成年男性纵向研究的参与者）的血清β-胡萝卜素、α-生育酚、生活方式因素（体重指数、身体活动和吸烟）以及代谢因素（胰岛素敏感性[稳态模型评估]、急性胰岛素反应和空腹血糖受损）进行了分析。在10年、20年和27年后的复查中，有245名参与者被确诊患有糖尿病。在20年复查时，测定了β-胡萝卜素和α-生育酚的膳食摄入量、胰岛素敏感性（正常血糖-高胰岛素钳夹法）以及胰岛素分泌（口服葡萄糖耐量试验中的早期胰岛素反应）。
在对生活方式和代谢因素进行调整后，50岁时血清β-胡萝卜素最高三分位数（>0.335μmol/l）的参与者在随访期间患糖尿病的风险比最低三分位数（<0.210μmol/l）的参与者低59%（p<0.01）。50岁时经脂质校正的血清α-生育酚最高三分位数（>3.67μmol/mmol）的参与者患糖尿病的风险比最低三分位数（<3.25μmol/mmol）的参与者低46%，且与代谢因素无关（p<0.05）。此外，在20年后的非糖尿病个体子样本中，较低的血清β-胡萝卜素和α-生育酚浓度与胰岛素敏感性受损独立相关（p<0.001），但与早期胰岛素反应无关。在7年的随访期间，β-胡萝卜素和α-生育酚的膳食摄入量可独立预测2型糖尿病。
结论/解读：在一项基于社区的男性研究中，血清中β-胡萝卜素和α-生育酚的浓度及膳食摄入量在27年的随访期间可独立预测胰岛素抵抗和2型糖尿病的发病率。这一结果支持了抗氧化状态受损在胰岛素抵抗和2型糖尿病发生发展中的重要性。
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