Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, P.R. China.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, P.R. China.
J Clin Endocrinol Metab. 2022 Sep 28;107(10):e4106-e4114. doi: 10.1210/clinem/dgac439.
Epidemiologic evidence regarding the role of dietary vitamin A in the development of diabetes is limited and inconsistent. This study was to explore the association between vitamin A intake and diabetes risk in Chinese adults.
A prospective cohort study was conducted among 17 111 adults (8537 men and 8577 women) who participated in the China Health and Nutrition Survey between 1989 and 2015. Dietary intakes were assessed by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Diabetes was determined by self-reported diagnosis, diabetes medication use, or additional criterion in 2009 of fasting blood glucose or hemoglobin A1c. We analyzed the association of vitamin A intake (total, β-carotene, retinol) with diabetes risk using Cox proportional hazards models.
A total of 519 men and 531 women developed diabetes during a median of 11 years of follow-up. Higher dietary total vitamin A intakes were associated with a lower risk of diabetes in both men (quintile 5 [Q5] vs Q1: hazard ratio [HR] = 0.69, 95% CI, 0.49-0.97, P-trend = 0.079) and women (Q5 vs Q1: HR = 0.63; 95% CI, 0.45-0.89; P-trend = 0.039). An inverse relation with diabetes risk was observed for dietary intakes of β-carotene (Q5 vs Q1: HR = 0.71; 95% CI, 0.52-0.97) and retinol (Q5 vs Q1: HR = 0.58; 95% CI, 0.39-0.85) among men, but not women. Dose-response analyses showed the association of dietary intakes of total vitamin A, β-carotene, and retinol with diabetes risk in men was L-shaped (P-nonlinearity = 0.043), reverse J-shaped (P-nonlinearity = 0.001), and linear, respectively.
Our findings suggest that adequate intake of vitamin A may help protecting against diabetes, especially for men.
有关膳食维生素 A 在糖尿病发展中的作用的流行病学证据有限且不一致。本研究旨在探讨中国成年人维生素 A 摄入量与糖尿病风险之间的关系。
对 1989 年至 2015 年间参加中国健康与营养调查的 17111 名成年人（男性 8537 名，女性 8577 名）进行了一项前瞻性队列研究。膳食摄入量通过 3 次连续的 24 小时膳食回忆和家庭食物库存结合评估。糖尿病通过自我报告的诊断、糖尿病药物使用或 2009 年空腹血糖或糖化血红蛋白的附加标准确定。我们使用 Cox 比例风险模型分析了维生素 A 摄入量（总摄入量、β-胡萝卜素、视黄醇）与糖尿病风险的关系。
在中位随访 11 年期间，共有 519 名男性和 531 名女性发生糖尿病。较高的膳食总维生素 A 摄入量与男性（五分位 5 [Q5]与五分位 1 [Q1]：风险比 [HR] = 0.69，95%置信区间，0.49-0.97，P 趋势 = 0.079）和女性（Q5 与 Q1：HR = 0.63；95%置信区间，0.45-0.89；P 趋势 = 0.039）患糖尿病的风险降低相关。男性的膳食 β-胡萝卜素（Q5 与 Q1：HR = 0.71；95%置信区间，0.52-0.97）和视黄醇（Q5 与 Q1：HR = 0.58；95%置信区间，0.39-0.85）摄入量与糖尿病风险呈负相关，但女性则无。剂量反应分析显示，男性膳食总维生素 A、β-胡萝卜素和视黄醇摄入量与糖尿病风险的关系呈 L 型（P 非线性 = 0.043）、反 J 型（P 非线性 = 0.001）和线性。
我们的研究结果表明，足够的维生素 A 摄入可能有助于预防糖尿病，尤其是男性。
