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Tatulashvili S, Gusto G, Cosson E, Balkau B, Gourdy P, Bonnet F, Bihan H, Fagherazzi G. Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22-year follow-up of 83 799 women from the E3N cohort study. J Diabetes 2021; 13:330-338. [PMID: 33145935 DOI: 10.1111/1753-0407.13129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/12/2020] [Accepted: 11/01/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In many populations the incidence of type 2 diabetes is higher in men than in women. This may be explained by exposure to female gonadal hormones, but so far, there is no consensus on their role over the life course in type 2 diabetes etiology. METHODS Data are from 83 799 French women from the E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale) cohort study, followed for 22 years. Multivariable Cox models including classical risk factors were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between gonadal hormonal factors and incident type 2 diabetes. RESULTS Older age at menarche, more menstrual cycles, older age at menopause, longer duration of exposure to gonadal hormones and breastfeeding were inversely associated with incident type 2 diabetes cases (n = 4806). While a longer duration of menstrual cycles (HR = 1.23 [95% CI: 1.07-1.41] comparing ≥32 vs ≤24 days) and use of contraceptive pills (HR = 1.33 [1.25-1.42]) were associated with a greater risk of type 2 diabetes. CONCLUSIONS In women, a longer exposure to endogenous gonadal hormones with a later menopause as well as breastfeeding were associated with a lower risk of developing type 2 diabetes, independently of classical diabetes risk factors. In contrast, the use of contraceptive agents was associated with incident diabetes, but the influence of each type of contraception and of exposure duration remain to be investigated.
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Affiliation(s)
- Sopio Tatulashvili
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
| | - Gaelle Gusto
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
| | - Emmanuel Cosson
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Beverley Balkau
- Clinical Epidemiology, Université Paris-Saclay, UVSQ, Inserm u1018, CESP, Villejuif, France
| | - Pierre Gourdy
- Diabetology Department, CHU Toulouse, Institute of Metabolic and Cardiovascular Diseases (I2MC, UMR1048 Inserm/UPS), University of Toulouse, Toulouse, France
| | - Fabrice Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Endocrinology, Diabetology and Nutrition, CHU Rennes, Université de Rennes 1, Rennes, France
| | - Hélène Bihan
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Guy Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
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Laouali N, Berrandou T, A. Rothwell J, Shah S, El Fatouhi D, Romana Mancini F, Boutron-Ruault MC, Fagherazzi G. Profiles of Polyphenol Intake and Type 2 Diabetes Risk in 60,586 Women Followed for 20 Years: Results from the E3N Cohort Study. Nutrients 2020; 12:nu12071934. [PMID: 32610657 PMCID: PMC7400616 DOI: 10.3390/nu12071934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Most studies on dietary polyphenol intake and type 2 diabetes (T2D) risk have focused on total or specific subclasses of polyphenols. Since polyphenols are often consumed simultaneously, the joint effect of an intake of multiple subclasses should be explored. We aimed to identify profiles of the dietary polyphenol subclasses intake associated with T2D. A total of 60,586 women from the Etude Epidémiologique auprès de femmes de l'Education Nationale (E3N) cohort study were followed for 20 years between 1993 and 2014. T2D cases were identified and validated. The individual energy-adjusted daily intakes of 15 subclasses of polyphenols were estimated at baseline using a food frequency questionnaire and the PhenolExplorer database. We used Bayesian profile regression to perform the clustering of the covariates by identifying exposure profiles of polyphenol intakes and, simultaneously, link these to T2D risk by using multivariable Cox regression models. We validated 2740 incident T2D cases during follow-up, and identified 15 distinct clusters with different intake profiles and T2D risk. When compared to the largest cluster (n = 6298 women), higher risks of T2D were observed in three of those clusters, which were composed of women with low or medium intakes of anthocyanins, dihydroflavonols, catechins, flavonols, hydroxybenzoic acids, lignans, and stilbenes. One cluster (n = 4243), characterized by higher intakes of these polyphenol subclasses, exhibited lower T2D risk when compared to the reference cluster. These results highlight the importance of a varied diet of polyphenol-rich foods such as nuts, fruits, and vegetables to prevent T2D risk.
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Affiliation(s)
- Nasser Laouali
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
- Correspondence: ; Tel.: +33-1-42-11-63-73
| | - Takiy Berrandou
- Cardiovascular Research Center, University of Paris, UMR 970 Inserm, 75015 Paris, France;
| | - Joseph A. Rothwell
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
| | - Sanam Shah
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
| | - Douae El Fatouhi
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
| | - Francesca Romana Mancini
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
| | - Guy Fagherazzi
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, 94800 Villejuif CEDEX, France; (J.A.R.); (S.S.); (D.E.F.); (F.R.M.); (M.-C.B.-R.); (G.F.)
- Faculty of Medicine, Paris-South Paris Saclay University, 94800 Villejuif, France
- Digital Epidemiology Hub, Department of Population Health, Luxembourg Institute of Health (LIH), 1445 Strassen, Luxembourg
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Mancini FR, Cano-Sancho G, Mohamed O, Cervenka I, Omichessan H, Marchand P, Boutron-Ruault MC, Arveux P, Severi G, Antignac JP, Kvaskoff M. Plasma concentration of brominated flame retardants and postmenopausal breast cancer risk: a nested case-control study in the French E3N cohort. Environ Health 2020; 19:54. [PMID: 32434563 PMCID: PMC7238573 DOI: 10.1186/s12940-020-00607-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/11/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Brominated flame retardants (BFRs) are lipophilic substances with endocrine-disrupting properties. To date, only few investigations, mainly retrospective case-control studies, have explored the link between internal levels of BFRs and the risk of breast cancer, leading to conflicting results. We investigated the associations between plasma concentrations of two main groups of BFRs, PBDEs (pentabromodiphenyl ethers) and PBBs (polybrominated biphenyls), and the risk of breast cancer in a nested case-control study. METHODS A total of 197 incident breast cancer cases and 197 controls with a blood sample collected in 1994-1999 were included. Plasma levels of PBDE congeners (BDE-28, BDE-47, BDE-99, BDE-100, BDE153, BDE-154) and of PBB-153 were measured by gas chromatography coupled to high-resolution mass spectrometry. Conditional logistic regression models, adjusted for potential confounders, were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Women were aged 56 years on average at blood draw. All cases, except for one, were diagnosed after menopause, with an average age at diagnosis of 68 years. Overall, we found no evidence of an association between plasma levels of PBDEs and PBB-153 and postmenopausal breast cancer risk (log-concentrations of BFRs yielding non-statistically significant ORs of 0.87 to 1.07). The analysis showed a non-linear inverse association for BDE-100 and BDE-153 and postmenopausal breast cancer risk; nevertheless, these findings were statistically significant only when the exposure was modeled as ng/L plasma (third vs. first quintile: OR = 0.42, 95%CI = 0.19-0.93 and OR = 0.42, 95%CI = 0.18-0.98, respectively) and not when modeled as ng/gr of lipids (OR = 0.58, 95%CI = 0.27-1.25 and OR = 0.53, 95%CI = 0.25-1.17). These results were unchanged in stratified analyses by tumor hormone receptor expression or body mass index. CONCLUSIONS Our results suggest no clear association between internal levels of PBDEs and PBB-153 and the risk of breast cancer in postmenopausal women. However, these findings need to be carefully interpreted, taking into account limitations due to the limited number of women included in the study, the lack of information concerning genetic susceptibility of cases, and the unavailability of exposure assessment during critical windows of susceptibility for breast cancer. More studies are warranted to further investigate the relationships between PBDE and PBB exposure and breast cancer risk.
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Affiliation(s)
- Francesca Romana Mancini
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | | | - Oceane Mohamed
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Iris Cervenka
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Hanane Omichessan
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | | | | | - Patrick Arveux
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
- Breast and Gynaecologic Cancer Registry of Côte d’Or, Georges-François Leclerc Cancer Centre, UNICANCER, Dijon, France
| | - Gianluca Severi
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
- Departement of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | | | - Marina Kvaskoff
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
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Mancini FR, Cano-Sancho G, Gambaretti J, Marchand P, Boutron-Ruault MC, Severi G, Arveux P, Antignac JP, Kvaskoff M. Perfluorinated alkylated substances serum concentration and breast cancer risk: Evidence from a nested case-control study in the French E3N cohort. Int J Cancer 2019; 146:917-928. [PMID: 31008526 DOI: 10.1002/ijc.32357] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/01/2019] [Accepted: 04/11/2019] [Indexed: 11/10/2022]
Abstract
Endocrine-disrupting chemicals are proposed to increase breast cancer (BC) incidence. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), two perfluorinated alkylated substances (PFASs), are suspected to be ubiquitously present in the blood of human population worldwide. We investigated the associations between serum concentrations of these substances and BC risk. Etude Epidémiologique auprès de femmes de l'Education Nationale is a cohort of 98,995 French women born in 1925-1950 and followed up since 1990. We sampled 194 BC cases and 194 controls from women with available blood samples. Serum concentrations of PFASs were measured by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Adjusted conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). All statistical tests were two sided. While PFASs concentrations were not associated with BC risk overall, we found positively linear associations between PFOS concentrations and the risk of ER+ (3rd quartile: OR = 2.22 [CI = 1.05-4.69]; 4th quartile: OR = 2.33 [CI = 1.11-4.90]); Ptrend = 0.04) and PR+ tumors (3rd quartile: OR = 2.47 [CI = 1.07-5.65]; 4th quartile: OR = 2.76 [CI = 1.21-6.30]; Ptrend = 0.02). When considering receptor-negative tumors, only the 2nd quartile of PFOS was associated with risk (ER-: OR = 15.40 [CI = 1.84-129.19]; PR-: OR = 3.47 [CI = 1.29-9.15]). While there was no association between PFOA and receptor-positive BC risk, the 2nd quartile of PFOA was positively associated with the risk of receptor-negative tumors (ER-: OR = 7.73 [CI = 1.46-41.08]; PR-: OR = 3.44 [CI = 1.30-9.10]). PFAS circulating levels were differentially associated with BC risk. While PFOS concentration was linearly associated with receptor-positive tumors, only low concentrations of PFOS and PFOA were associated with receptor-negative tumors. Our findings highlight the importance of considering exposure to PFASs as a potential risk factor for BC.
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Affiliation(s)
- Francesca Romana Mancini
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | | | - Juliette Gambaretti
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | | | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Patrick Arveux
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France.,Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre, UNICANCER, Dijon, France
| | | | - Marina Kvaskoff
- CESP, Fac. de médecine, Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
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Lafourcade A, His M, Baglietto L, Boutron-Ruault MC, Dossus L, Rondeau V. Factors associated with breast cancer recurrences or mortality and dynamic prediction of death using history of cancer recurrences: the French E3N cohort. BMC Cancer 2018; 18:171. [PMID: 29426294 PMCID: PMC5807734 DOI: 10.1186/s12885-018-4076-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In addition to tumor characteristics and lifestyle factors, cancer relapses are often related to the risk of death but have not been jointly studied. We investigate the prognostic factors of recurrent events and death after a diagnosis of breast cancer and predict individual deaths including a history of recurrences. METHODS The E3N (Etude Epidémiologique auprès de Femmes de la Mutuelle Générale de l'Education Nationale) study is a prospective cohort study that was initiated in 1990 to investigate factors associated with the most common types of cancer. Overall survival and three types of recurrent events were considered: locoregional recurrence, metastasis, and second primary breast cancer. Recurrent events and death were analyzed using a joint frailty model. RESULTS The analysis included 4926 women from the E3N cohort diagnosed with a first primary invasive breast cancer between June 1990 and June 2008; during the follow-up, 1334 cases had a recurrence (median time of follow-up is 7.2 years) and 469 women died. Cases with high grade, large tumor size, axillary nodal involvement, and negative estrogen and progesterone receptors had a higher risk of recurrence or death. Furthermore, smoking increased the risk of relapse. For cases with a medium risk profile in terms of tumor characteristics and lifestyle factors, the probability of dying between 5 and 10 years after diagnosis was 6, 20 and 36% for 0, 1 or 2 recurrences within the first 5 years after diagnosis, respectively. CONCLUSIONS Our study showed the importance of considering baseline lifestyle characteristics and history of relapses to dynamically predict the risk of death in breast cancer cases. Medical experience coupled with an estimate of a patient's survival probability that considers all available information for this patient would enable physicians to make better informed decisions regarding their actions and thus improve clinical output.
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Affiliation(s)
- Alexandre Lafourcade
- Research Center Inserm, U1219 Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Mathilde His
- CESP Generations and Health Team, Paris-Saclay University, Paris-Sud Univ, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laura Baglietto
- CESP Generations and Health Team, Paris-Saclay University, Paris-Sud Univ, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP Generations and Health Team, Paris-Saclay University, Paris-Sud Univ, UVSQ, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Virginie Rondeau
- Research Center Inserm, U1219 Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Biostatistic Team, INSERM U1219, University of Bordeaux, 146 rue Léo Saignat, CS 61292, F-33076 Bordeaux Cedex, France
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Mancini FR, Affret A, Dow C, Balkau B, Bonnet F, Boutron-Ruault MC, Fagherazzi G. Dietary antioxidant capacity and risk of type 2 diabetes in the large prospective E3N-EPIC cohort. Diabetologia 2018; 61:308-316. [PMID: 29119242 DOI: 10.1007/s00125-017-4489-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/28/2017] [Indexed: 01/04/2023]
Abstract
AIMS/HYPOTHESIS Recent evidence suggests that oxidative stress may contribute to the pathogenesis of type 2 diabetes. The diet, and especially fruit and vegetables, contains a variety of compounds with antioxidant activity, which may have cumulative/synergistic antioxidant effects. The total antioxidant capacity, an index derived from dietary intake, is a single estimate of antioxidant capacity from all dietary antioxidants. The main aim of this study was to investigate the relationship between total antioxidant capacity and risk of type 2 diabetes. METHODS Among 64,223 women (mean age 52 ± 7 years) from the French E3N-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, 1751 women had validated type 2 diabetes during 15 years of follow-up. The total antioxidant capacity was estimated with the ferric ion-reducing antioxidant power (FRAP) method. Adjusted Cox proportional hazards regression models were used to calculate HRs and 95% CIs for the associations between total antioxidant capacity and type 2 diabetes risk, adjusted for potential confounders. RESULTS In multivariable models, higher levels of total antioxidant capacity were associated with a lower risk of type 2 diabetes. Compared with women in the lowest quintile, women in the third, fourth and fifth quintiles for total antioxidant capacity had HRs of 0.74 (95% CI 0.63, 0.86), 0.70 (95% CI 0.59, 0.83) and 0.73 (95% CI 0.60, 0.89), respectively. The inverse association between total antioxidant capacity and risk of type 2 diabetes was linear up to values of 15 mmol/day, after which the effect reached a plateau. CONCLUSIONS/INTERPRETATION Our findings suggest that the total antioxidant capacity may play an important role in reducing the risk of type 2 diabetes in middle-aged women. More studies are warranted to better understand the biological mechanisms underlying this inverse association.
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Affiliation(s)
- Francesca Romana Mancini
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Aurélie Affret
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Courtney Dow
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Beverley Balkau
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Renal and cardiovascular Epidemiology' Team, University Versailles, Saint Quentin, University Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
- CHU Rennes, Université de Rennes 1, Department of Endocrinology, Diabetology and Nutrition, Rennes, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
| | - Guy Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
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