- Jukka T Salonen, academy professor,
- Kristiina Nyyssonen, research associatea,
- Tomi-Pekka Tuomainen, research associatea,
- Pekka H Maenpaa, professorb,
- Heikki Korpela, assistant professorc,
- George A Kaplan, chiefd,
- John Lynch, research scientistd,
- Susan P Helmrich, research scientistd,
- Riitta Salonen, research scientista
- aResearch Institute of Public Health, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland
- bDepartment of Biochemistry and Biotechnology, University of Kuopio
- cDepartment of Community Health and General Practice, University of Kuopio
- dHuman Population Laboratory, California Department of Health Services, Berkeley, California, USA
- Correspondence to: Professor Salonen.
Objective: To investigate whether low vitamin E status is a risk factor for incident non-insulin dependent diabetes mellitus.
Design: Population based follow up study with diabetes assessed at baseline and at four years.
Setting: Eastern Finland.
Subjects: Random sample of 944 men aged 42-60 who had no diabetes at the baseline examination.
Intervention: Oral glucose tolerance test at four year follow up.
Main outcome measures: A man was defined diabetic if he had either (a) a fasting blood glucose concentration >/=6.7 mmol/l, or (b) a blood glucose concentration >/=10.0 mmol/l two hours after a glucose load, or (c) a clinical diagnosis of diabetes with either dietary, oral, or insulin treatment.
Results: 45 men developed diabetes during the follow up period. In a multivariate logistic regression model including the strongest predictors of diabetes, a low lipid standardised plasma vitamin E (below median) concentration was associated with a 3.9-fold (95% confidence interval 1.8-fold to 8.6-fold) risk of incident diabetes. A decrement of 1 µmol/l of uncategorised unstandardised vitamin E concentration was associated with an increment of 22% in the risk of diabetes when allowing for the strongest other risk factors as well as serum low density lipoprotein cholesterol and triglyceride concentrations.
Conclusions: There was a strong independent association between low vitamin E status before follow up and an excess risk of diabetes at four years. This supports the theory that free radical stress has a role in the causation of non-insulin dependent diabetes mellitus.
Funding The Academy of Finland; the Finnish Ministry of Education; and the National Heart, Lung and Blood Institute of the United States (grant HL44199).
Conflict of interest None.