Associations of Biomarker-Calibrated Intake of Total Sugars With the Risk of Type 2 Diabetes and Cardiovascular Disease in the Women’s Health Initiative Observational Study

Abstract The inconsistent findings from epidemiologic studies relating total sugars (TS) consumption to cardiovascular disease (CVD) or type 2 diabetes (T2D) risk may be partly due to measurement error in self-reported intake. Using regression calibration equations developed based on the predictive...

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Bibliographic Details
Published in:American journal of epidemiology 2018-10, Vol.187 (10), p.2126-2135
Main Authors: Tasevska, Natasha, Pettinger, Mary, Kipnis, Victor, Midthune, Douglas, Tinker, Lesley F, Potischman, Nancy, Neuhouser, Marian L, Beasley, Jeannette M, Van Horn, Linda, Howard, Barbara V, Liu, Simin, Manson, JoAnn E, Shikany, James M, Thomson, Cynthia A, Prentice, Ross L
Format: Article
Language:English
Subjects:
Aged
Biomarkers
Biomarkers - analysis
Calibration
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Confidence intervals
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - etiology
Diet
Diet - adverse effects
Diet Surveys - methods
Diet Surveys - statistics & numerical data
Dietary Sugars - analysis
Energy
Energy Intake
Energy recovery
Epidemiology
Error analysis
Female
Health hazards
Health risk assessment
Health risks
Heart diseases
Humans
Incidence
Mathematical models
Middle Aged
Multivariate Analysis
Observational studies
Original Contributions
Partitions
Post-menopause
Postmenopause
Proportional Hazards Models
Prospective Studies
Regression Analysis
Risk
Risk Assessment
Statistical analysis
Substitutes
Sugar
United States - epidemiology
Women's Health
Womens health
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Summary:Abstract The inconsistent findings from epidemiologic studies relating total sugars (TS) consumption to cardiovascular disease (CVD) or type 2 diabetes (T2D) risk may be partly due to measurement error in self-reported intake. Using regression calibration equations developed based on the predictive biomarker for TS and recovery biomarker for energy, we examined the association of TS with T2D and CVD risk, before and after dietary calibration, in 82,254 postmenopausal women participating in the Women’s Health Initiative Observational Study. After up to 16 years of follow-up (1993–2010), 6,621 T2D and 5,802 CVD incident cases were identified. The hazard ratio for T2D per 20% increase in calibrated TS was 0.94 (95% confidence interval (CI): 0.77, 1.15) in multivariable energy substitution, and 1.00 (95% CI: 0.85, 1.18) in energy partition models. Multivariable hazard ratios for total CVD were 0.97 (95% CI: 0.87, 1.09) from energy substitution, and 0.91 (95% CI: 0.80, 1.04) from energy partition models. Uncalibrated TS generated a statistically significant inverse association with T2D and total CVD risk in multivariable energy substitution and energy partition models. The lack of conclusive findings from our calibrated analyses may be due to the low explanatory power of the calibration equations for TS, which could have led to incomplete deattenuation of the risk estimates.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwy115