Vitamins C, E, and β-Carotene and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 101540874 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2156-5376 (Electronic) Linking ISSN: 21618313 NLM ISO Abbreviation: Adv Nutr Subsets: MEDLINE
    • Publication Information:
      Publication: 2023- : [New York, NY] : Elsevier
      Original Publication: Bethesda, MD : American Society for Nutrition
    • Subject Terms:
      Diabetes Mellitus, Type 2*/prevention & control ; Diabetes Mellitus, Type 2*/blood ; beta Carotene*/administration & dosage ; beta Carotene*/pharmacology ; beta Carotene*/blood ; Ascorbic Acid*/administration & dosage ; Ascorbic Acid*/pharmacology ; Vitamin E*/administration & dosage ; Vitamin E*/pharmacology ; Antioxidants*/administration & dosage ; Dietary Supplements*; Humans ; Insulin Resistance ; Diet ; Risk Factors ; Male ; Female ; Middle Aged ; Adult ; Aged
    • Abstract:
      A systematic review and meta-analysis was conducted to assess the relationship between the common dietary antioxidants vitamin C, vitamin E, and β-carotene and type 2 diabetes (T2D) and related traits. MEDLINE, Embase, and the Cochrane Library were searched for relevant publications up until May 2023. Studies were eligible if they had a cohort, case-control, or randomized controlled trial (RCT) design and examined dietary intake, supplementation, or circulating levels of these antioxidants as exposure, and insulin resistance, β-cell function, or T2D incidence as outcomes. Summary relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI) were estimated using random-effects models. The certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluations framework. Among 6190 screened records, 25 prospective observational studies and 15 RCTs were eligible. Inverse associations were found between dietary and circulating antioxidants and T2D (observational studies). The lowest risk was seen at intakes of 70 mg/d of vitamin C (RR: 0.76; CI: 0.61, 0.95), 12 mg/d of vitamin E (RR: 0.72; CI: 0.61, 0.86), and 4 mg/d of β-carotene (RR: 0.78; CI: 0.65, 0.94). Supplementation with vitamin E (RR: 1.01; CI: 0.93, 1.10) or β-carotene (RR: 0.98; CI: 0.90, 1.07) did not have a protective effect on T2D (RCTs), and data on vitamin C supplementation was limited. Regarding insulin resistance, higher dietary vitamin C (RR: 0.85; CI: 0.74, 0.98) and vitamin E supplementation (MD: -0.35; CI: -0.65, -0.06) were associated with a reduced risk. The certainty of evidence was high for the associations between T2D and dietary vitamin E and β-carotene, and low to moderate for other associations. In conclusion, moderate intakes of vitamins C, E, and β-carotene may lower risk of T2D by reducing insulin resistance. Lack of protection with supplementation in RCTs suggests that adequate rather than high intakes may play a role in T2D prevention. This systematic review and meta-analysis was registered in PROSPERO with registration number CRD42022343482.
      (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: antioxidants; insulin resistance; meta-analysis; systematic review; type 2 diabetes; vitamin C; vitamin E; β-carotene
    • Publication Date:
      Date Created: 20240317 Date Completed: 20240517 Latest Revision: 20240628
    • Publication Date:
      20240628
    • Accession Number:
      PMC11002795
    • Accession Number:
      10.1016/j.advnut.2024.100211
    • Accession Number:
      38493875