Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.
Department of Cardiology, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.
BMJ Open Diabetes Res Care. 2020 Oct;8(1). doi: 10.1136/bmjdrc-2020-001423.
Previous studies in mostly Western populations have yielded conflicting findings on the association of vitamin B with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B-diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.
This report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.
At baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B measurements, we found a positive association between an increase in vitamin B and an increase in FBG.
In this large Chinese population of patients with hypertension mostly sufficient with vitamin B, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B and its longitudinal trajectory in order to better elucidate the role of vitamin B in the development of diabetes. Such findings would have important clinical and public health implications.
之前在主要为西方人群进行的研究中，维生素 B 与糖尿病风险之间的关联存在相互矛盾的结果，部分原因是研究设计和人群特征存在差异。本研究通过横断面和纵向分析，旨在研究中国高血压成年人中维生素 B 与糖尿病之间的关系。
本报告共纳入了来自中国脑卒中一级预防试验的 16699 名参与者，这些参与者具有相关的基线和随访数据。糖尿病的定义为医生诊断的糖尿病、使用降血糖药物或空腹血糖（FBG）≥7.0mmol/L。新发糖尿病的定义为随访期间出现任何新发糖尿病病例或出口访视时 FBG≥7.0mmol/L。
基线时，有 1872 名（11.2%）患者患有糖尿病；不足 1.5%的患者存在临床维生素 B 缺乏症（<148.0pmol/L）。在中位随访时间 4.5 年期间，有 1589 例（10.7%）发生新发糖尿病。横断面分析显示，基线维生素 B 水平与 FBG 水平（β=0.18，95%CI 0.15 至 0.21）和糖尿病（OR=1.16，95%CI 1.10 至 1.21）呈正相关。然而，纵向分析显示基线维生素 B 与新发糖尿病或 FBG 水平变化之间无关联。在样本的一个亚组（n=4366）中，同时具有基线和出口维生素 B 测量值，我们发现维生素 B 增加与 FBG 增加呈正相关。
在这项以中国高血压患者为对象的大型研究中，大多数患者的维生素 B 水平充足，平行的横断面和纵向分析为之前研究中的相互矛盾的结果提供了新的见解，这些结果强调了未来研究需要考虑基线维生素 B 及其纵向轨迹，以更好地阐明维生素 B 在糖尿病发展中的作用。这些发现将具有重要的临床和公共卫生意义。
