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

Natasha Tasevska, Mary Pettinger, Victor Kipnis, Douglas Midthune, Lesley F. Tinker, Nancy Potischman, Marian L. Neuhouser, Jeannette M. Beasley, Linda Van Horn, Barbara V. Howard, Simin Liu, Joann E. Manson, James M. Shikany, Cynthia Thomson, Ross L. Prentice

Research output: Contribution to journalArticle

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2126-2135
Number of pages10
JournalAmerican Journal of Epidemiology
Volume187
Issue number10
DOIs
StatePublished - Oct 1 2018

Keywords

  • calibration
  • cardiovascular disease
  • diabetes
  • diet
  • measurement error
  • total sugars
  • Women's Health Initiative

ASJC Scopus subject areas

  • Epidemiology

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    Tasevska, N., Pettinger, M., Kipnis, V., Midthune, D., Tinker, L. F., Potischman, N., Neuhouser, M. L., Beasley, J. M., Van Horn, L., Howard, B. V., Liu, S., Manson, J. E., Shikany, J. M., Thomson, C., & Prentice, R. L. (2018). 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. American Journal of Epidemiology, 187(10), 2126-2135. https://doi.org/10.1093/aje/kwy115