Table 2.
Associations between gluten intake and type 2 diabetes
| Cohort/model | Gluten (g/day) |
ptrend | ||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | ||
| NHS | ||||||
| Median intake, g/day (range) | 2.61(0.01, 3.21) |
3.67(3.22, 4.07) | 4.47(4.08, 4.87) | 5.34(4.88, 5.91) | 6.80(5.92, 23.59) | |
| Cases/person-years | 1619/330,21 1 |
1570/330,322 | 1394/330,222 | 1290/330,782 | 1215/330,914 | |
| Model 1 | 1 | 0.98 (0.91, 1.05) | 0.88 (0.82, 0.94) | 0.81 (0.75, 0.87) | 0.76 (0.70, 0.82) | <0.001 |
| Model 2 | 1 | 0.95 (0.89, 1.02) | 0.87 (0.81, 0.93) | 0.83 (0.77, 0.89) | 0.83 (0.76, 0.89) | <0.001 |
| Model 3 | 1 | 0.95 (0.88, 1.02) | 0.86 (0.80, 0.93) | 0.83 (0.77, 0.89) | 0.83 (0.77, 0.90) | <0.001 |
| Model 4 | 1 | 0.97 (0.90, 1.05) | 0.90 (0.83, 0.98) | 0.87 (0.80, 0.95) | 0.90 (0.81, 0.99) | 0.008 |
| NHSII | ||||||
| Median intake, g/day (range) | 3.62(0.01, 4.34) |
4.89(4.35, 5.37) | 5.87(5.38, 6.38) | 6.97(6.39, 7.69) | 8.83(7.70, 27.03) | |
| Cases/person-years | 1679/357,12 5 |
1168/357,596 | 997/358,121 | 830/357,727 | 786/357,611 | |
| Model 1 | 1 | 0.71 (0.66, 0.77) | 0.62 (0.57, 0.67) | 0.52 (0.47, 0.56) | 0.49 (0.45, 0.53) | <0.001 |
| Model 2 | 1 | 0.86 (0.80, 0.93) | 0.82 (0.75, 0.89) | 0.73 (0.67, 0.80) | 0.74 (0.68, 0.81) | <0.001 |
| Model 3 | 1 | 0.87 (0.81, 0.94) | 0.84 (0.77, 0.91) | 0.75 (0.69, 0.82) | 0.77 (0.71, 0.84) | <0.001 |
| Model 4 | 1 | 0.89 (0.82, 0.97) | 0.88 (0.80, 0.96) | 0.81 (0.73, 0.89) | 0.84 (0.75, 0.94) | <0.001 |
| HPFS | ||||||
| Median intake, g/day (range) | 3.49(0.01, 4.30) |
4.93(4.31, 5.48) | 6.03(5.49, 6.60) | 7.25(6.61, 8.05) | 9.35(8.06, 33.46) | |
| Cases/person-years | 904/159,813 | 730/160,276 | 668/160,392 | 575/160,293 | 522/160,334 | |
| Model 1 | 1 | 0.82 (0.74, 0.90) | 0.76 (0.69, 0.84) | 0.65 (0.58, 0.72) | 0.59 (0.53, 0.66) | <0.001 |
| Model 2 | 1 | 0.86 (0.78, 0.95) | 0.84 (0.75, 0.93) | 0.76 (0.68, 0.84) | 0.76 (0.68, 0.85) | <0.001 |
| Model 3 | 1 | 0.86 (0.78, 0.95) | 0.84 (0.76, 0.93) | 0.77 (0.69, 0.85) | 0.79 (0.71, 0.88) | <0.001 |
| Model 4 | 1 | 0.87 (0.79, 0.97) | 0.87 (0.78, 0.98) | 0.82 (0.72, 0.93) | 0.88 (0.76, 1.02) | 0.05 |
| Pooled | ||||||
| Model 1 | 1 | 0.84 (0.80, 0.88) | 0.75 (0.71, 0.78) | 0.66 (0.62, 0.69) | 0.62 (0.59, 0.65) | <0.001 |
| Model 2 | 1 | 0.89 (0.85, 0.93) | 0.83 (0.80, 0.88) | 0.77 (0.73, 0.81) | 0.78 (0.74, 0.82) | <0.001 |
| Model 3 | 1 | 0.89 (0.85, 0.93) | 0.84 (0.80, 0.88) | 0.78 (0.74, 0.82) | 0.80 (0.76, 0.84) | <0.001 |
| Model 4 | 1 | 0.91 (0.87, 0.96) | 0.88 (0.83, 0.93) | 0.83 (0.78, 0.88) | 0.87 (0.81, 0.93) | <0.001 |
HRs and 95% CIs for the association between quintiles of gluten intake and type 2 diabetes were calculated using Cox proportional hazards models Model 1, adjusted for age
Model 2, further adjusted for ethnicity (white, African-American, Asian, and other ethnicity), family history of diabetes (yes/no), smoking status (never, former, current [1–14, 15–24, or ≥ 25 cigarettes/day], or missing), alcohol intake (g/day: 0, 0.1–4.9, 5.0–14.9, and ≥ 15.0 in women, 0, 0.1–4.9, 5.0–29.9, and ≥ 30.0 in men, or missing), physical activity (<3, 3.0–8.9, 9.0–17.9, 18.0–26.9, ≥ 27.0 METs, or missing), menopausal status and postmenopausal hormone use (pre-menopause, postmenopause [never, former, or current hormone use], or missing, for women), oral contraceptive use (yes, no, or missing, for NHSII), multivitamin use (yes/no), BMI (<23.0, 23.0–24.9, 25.0–29.9, 30.0–34.9, ≥ 35.0 kg/m2, or missing), and total energy intake based on model 1
Model 3, further adjusted for AHEI (in quintiles), folic acid intake (in quintiles) and magnesium intake (in quintiles), based on model 2
Model 4, further adjusted for cereal fibre intake based on model 3