Abstract
BackgroundLower 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.MethodsBaseline 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.ResultsNone 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 > 6.8mg/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.ConclusionLarger 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.
Highlights
Hemoglobin A1c (HbA1c) reflects the percentage of glycated hemoglobin, which results from non-enzymatic attachment of glucose to hemoglobin
None of the investigated nutrients except for carotenoids was significantly associated with changes in hemoglobin A1c (HbA1c) levels after 10 years
Vitamin/Mineral Supplements and Long-Term HbA1c and the MONICA Augsburg studies (MONICA, Monitoring of Trends and Determinants in Cardiovascular Diseases) were initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria
Summary
Hemoglobin A1c (HbA1c) reflects the percentage of glycated hemoglobin, which results from non-enzymatic attachment of glucose to hemoglobin. The increased risk of cardiovascular complications with higher HbA1c levels is evident in those with established diabetes, and in non-diabetic adults [4,5,6,7]. In the latter, HbA1c levels are more strongly associated with coronary heart disease risk than other glycemic measures [8], and all-cause mortality risk increases by 26% with a 1% increase in HbA1c concentration [9]. 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
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