Intake of vitamin D and risk of type 2 diabetes in the Nurses Health Study
| . | Total vitamin D intake (IU/day) . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤200 . | 201–400 . | 401–600 . | 601–800 . | > 800 . | P for trend . | |||||
| No. of new cases of diabetes | 1,780 | 1,812 | 832 | 313 | 106 | ||||||
| Follow-up person-years | 603,041 | 553,325 | 271,764 | 107,174 | 45,653 | ||||||
| RR (95% CI) | |||||||||||
| Age adjusted | 1.00 | 0.94 (0.88–1.00) | 0.87 (0.80–0.94) | 0.86 (0.76–0.97) | 0.74 (0.61–0.91) | <0.001 | |||||
| Multivariate without diet* | 1.00 | 0.93 (0.87–0.99) | 0.93 (0.86–1.01) | 0.89 (0.79–1.01) | 0.77 (0.63–0.94) | 0.002 | |||||
| Multivariate with diet† | 1.00 | 0.97 (0.89–1.05) | 0.99 (0.88–1.10) | 0.94 (0.81–1.10) | 0.80 (0.64–1.00) | 0.15 | |||||
| Multivariate with diet + calcium | 1.00 | 1.00 (0.93–1.10) | 1.05 (0.93–1.18) | 1.01 (0.86–1.19) | 0.87 (0.69–1.09) | 0.67 | |||||
| . | Total vitamin D intake (IU/day) . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤200 . | 201–400 . | 401–600 . | 601–800 . | > 800 . | P for trend . | |||||
| No. of new cases of diabetes | 1,780 | 1,812 | 832 | 313 | 106 | ||||||
| Follow-up person-years | 603,041 | 553,325 | 271,764 | 107,174 | 45,653 | ||||||
| RR (95% CI) | |||||||||||
| Age adjusted | 1.00 | 0.94 (0.88–1.00) | 0.87 (0.80–0.94) | 0.86 (0.76–0.97) | 0.74 (0.61–0.91) | <0.001 | |||||
| Multivariate without diet* | 1.00 | 0.93 (0.87–0.99) | 0.93 (0.86–1.01) | 0.89 (0.79–1.01) | 0.77 (0.63–0.94) | 0.002 | |||||
| Multivariate with diet† | 1.00 | 0.97 (0.89–1.05) | 0.99 (0.88–1.10) | 0.94 (0.81–1.10) | 0.80 (0.64–1.00) | 0.15 | |||||
| Multivariate with diet + calcium | 1.00 | 1.00 (0.93–1.10) | 1.05 (0.93–1.18) | 1.01 (0.86–1.19) | 0.87 (0.69–1.09) | 0.67 | |||||
| . | Dietary vitamin D intake (IU/day)‡ . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤100 . | 101–200 . | 201–300 . | 301–400 . | >400 . | P for trend . | |||||
| No. of new cases of diabetes | 829 | 2031 | 1257 | 350 | 80 | ||||||
| Follow-up person-years | 299,091 | 670,048 | 371,830 | 109,938 | 29,595 | ||||||
| RR (95%CI) | |||||||||||
| Age adjusted | 1.00 | 0.92 (0.85–1.00) | 0.98 (0.89–1.07) | 0.95 (0.84–1.08) | 0.91 (0.72–1.14) | 0.80 | |||||
| Multivariate without diet* | 1.00 | 0.86 (0.80–0.94) | 0.89 (0.81–0.97) | 0.82 (0.73–0.94) | 0.81 (0.64–1.01) | 0.01 | |||||
| Multivariate with diet† | 1.00 | 0.90 (0.83–0.98) | 0.98 (0.89–1.08) | 0.93 (0.81–1.01) | 0.91 (0.72–1.16) | 0.86 | |||||
| Multivariate with diet + calcium | 1.00 | 0.94 (0.85–1.03) | 1.06 (0.95–1.18) | 1.02 (0.88–1.19) | 1.00 (0.78–1.29) | 0.25 | |||||
| . | Dietary vitamin D intake (IU/day)‡ . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤100 . | 101–200 . | 201–300 . | 301–400 . | >400 . | P for trend . | |||||
| No. of new cases of diabetes | 829 | 2031 | 1257 | 350 | 80 | ||||||
| Follow-up person-years | 299,091 | 670,048 | 371,830 | 109,938 | 29,595 | ||||||
| RR (95%CI) | |||||||||||
| Age adjusted | 1.00 | 0.92 (0.85–1.00) | 0.98 (0.89–1.07) | 0.95 (0.84–1.08) | 0.91 (0.72–1.14) | 0.80 | |||||
| Multivariate without diet* | 1.00 | 0.86 (0.80–0.94) | 0.89 (0.81–0.97) | 0.82 (0.73–0.94) | 0.81 (0.64–1.01) | 0.01 | |||||
| Multivariate with diet† | 1.00 | 0.90 (0.83–0.98) | 0.98 (0.89–1.08) | 0.93 (0.81–1.01) | 0.91 (0.72–1.16) | 0.86 | |||||
| Multivariate with diet + calcium | 1.00 | 0.94 (0.85–1.03) | 1.06 (0.95–1.18) | 1.02 (0.88–1.19) | 1.00 (0.78–1.29) | 0.25 | |||||
| . | Supplemental vitamin D intake (IU/day)§ . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤100 . | 101–200 . | 201–300 . | 301–400 . | >400 . | P for trend . | |||||
| No. of new cases of diabetes | 2,956 | 678 | 497 | 347 | 365 | ||||||
| Follow-up person-years | 947,379 | 206,980 | 155,352 | 125,792 | 145,455 | ||||||
| RR (95% CI) | |||||||||||
| Age adjusted | 1.00 | 0.87 (0.80–0.95) | 0.88 (0.80–0.97) | 0.81 (0.72–0.90) | 0.79 (0.71–0.88) | <0.001 | |||||
| Multivariate without diet* | 1.00 | 0.92 (0.84–1.00) | 0.97 (0.89–1.07) | 0.90 (0.81–1.01) | 0.88 (0.79–0.98) | 0.007 | |||||
| Multivariate without diet† | 1.00 | 0.91 (83–1.00) | 0.96 (0.85–1.07) | 0.88 (0.76–1.00) | 0.84 (0.73–0.97) | 0.01 | |||||
| Multivariate with diet + calcium | 1.00 | 0.92 (0.84–1.01) | 0.97 (0.87–1.09) | 0.90 (0.78–1.03) | 0.87 (0.75–1.00) | 0.04 | |||||
| . | Supplemental vitamin D intake (IU/day)§ . | . | . | . | . | . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| . | ≤100 . | 101–200 . | 201–300 . | 301–400 . | >400 . | P for trend . | |||||
| No. of new cases of diabetes | 2,956 | 678 | 497 | 347 | 365 | ||||||
| Follow-up person-years | 947,379 | 206,980 | 155,352 | 125,792 | 145,455 | ||||||
| RR (95% CI) | |||||||||||
| Age adjusted | 1.00 | 0.87 (0.80–0.95) | 0.88 (0.80–0.97) | 0.81 (0.72–0.90) | 0.79 (0.71–0.88) | <0.001 | |||||
| Multivariate without diet* | 1.00 | 0.92 (0.84–1.00) | 0.97 (0.89–1.07) | 0.90 (0.81–1.01) | 0.88 (0.79–0.98) | 0.007 | |||||
| Multivariate without diet† | 1.00 | 0.91 (83–1.00) | 0.96 (0.85–1.07) | 0.88 (0.76–1.00) | 0.84 (0.73–0.97) | 0.01 | |||||
| Multivariate with diet + calcium | 1.00 | 0.92 (0.84–1.01) | 0.97 (0.87–1.09) | 0.90 (0.78–1.03) | 0.87 (0.75–1.00) | 0.04 | |||||
RR adjusted for age, BMI, hypertension, family history of diabetes, smoking, physical activity, caffeine, alcohol, and state of residence (southern states [California, Florida, and Texas] or northern states [Connecticut, Maryland, Massachusetts, Michigan, New Jersey, New York, Ohio, and Pennsylvania]).
RR adjusted for everything in footnote ∗ plus type of fat (saturated, polyunsaturated, or trans), cereal fiber, glycemic load, magnesium, and retinol.
Women who were specific vitamin D supplement users were excluded at baseline and during follow-up (2,058 at baseline, 8,745 during follow-up). The entire analysis for supplemental vitamin D was also adjusted for multivitamin use (yes or no).
The entire analysis was adjusted for multivitamin use (yes or no) and dietary vitamin D intake.