| Peer-Reviewed

Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis

Received: 2 February 2021     Accepted: 15 February 2021     Published: 4 March 2021
Views:       Downloads:
Abstract

Background: Dietary Calcium and vitamin D intake may have effects on the onset risk of type 2 diabetes mellitus (T2DM), whereas the results of existing studies are inconsistent. We performed a meta-analysis of prospective studies to evaluate the association between dietary calcium orvitamin D intakeand the onset risk of T2DM. Methods: We searched PubMed, Web of Science, and Embase for relevant studies published through 5 Jan 2021. The relative risks (RRs) with 95% confidence intervals (CIs) of T2DM in relation to dietary calcium and vitamin D intake were pooled with a fix or random-effects model. Results: 22 cohort studies were included in this meta-analysis, which comprising 31027 cases and 448578 participants. We found dietary calcium (RR: 0.84; 95% CI: 0.76–0.93) rather than dietary vitamin D (RR: 1.00; 95% CI: 0.92–1.08) reduced the onset risk of T2DM. Subgroup analysis showed the efficacy of dietary calcium intake is only in Asian, women and older population. Dose-response analysis revealed that each 300 mg/day increase in dietary calcium intake reduces the risk of T2DM by 8%. However, the increasing dietary vitamin D intake does not affect the risk of T2DM. Conclusions: Dietary calcium intake reduces the onset risk of T2DM but dietary vitamin D has no effect.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 1)
DOI 10.11648/j.ijde.20210601.17
Page(s) 36-45
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Calcium, Vitamin D, Type 2 Diabetes Mellitus, Meta-analysis

References
[1] Federation ID. IDF diabetes atlas 9th edition 2019, https://www.diabetesatlas.org/en/sections/worldwide-toll-of-diabetes.html; 2019 [accessed 10 December 2019].
[2] Lee DH, Yang M, Giovannucci EL, Sun Q, Chavarro JE. Mushroom consumption, biomarkers, and risk of cardiovascular disease and type 2 diabetes: a prospective cohort study of US women and men. AmJ Clin Nutr. 2019; 110 (3): 666-74.
[3] Wang X, Wu W, Zheng W, Fang X, Chen L, Rink L, et al. Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2019; 110 (1): 76-90.
[4] Pozzan T, Rizzuto R, Volpe P, Meldolesi J. Molecular and cellular physiology of intracellular calcium stores. Physiol Rev. 1994; 74 (3): 595-636.
[5] Milner RD, Hales CN. The role of calcium and magnesium in insulin secretion from rabbit pancreas studied in vitro. Diabetologia. 1967; 3 (1): 47-9.
[6] Wright DC, Hucker KA, Holloszy JO, Han DH. Ca2+ and AMPK both mediate stimulation of glucose transport by muscle contractions. Diabetes. 2004; 53 (2): 330-5.
[7] Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357 (3): 266-81.
[8] Berridge MJ. Vitamin D deficiency and diabetes. Biochem J. 2017; 474 (8): 1321-32.
[9] Dong JY, Qin LQ. Dietary calcium intake and risk of type 2 diabetes: possible confounding by magnesium. Eur J Clin Nutr. 2012; 66 (3): 408-10.
[10] Zhao LM, Tian XQ, Ge JP, Xu YC. Vitamin D intake and type 2 diabetes risk: a meta-analysis of prospective cohort studies. Afr Health Sci. 2013; 13 (4): 1130-8.
[11] Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama. 2000; 283 (15): 2008-12.
[12] Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses, http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp; 1999 [accessed 13 December 2019].
[13] Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 2011; 343: d5928.
[14] Fang X, Wei J, He X, An P, Wang H, Jiang L, et al. Landscape of dietary factors associated with risk of gastric cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. Eur J Cancer. 2015; 51 (18): 2820-32.
[15] Higgins JP, Thompson SG. Controlling the risk of spurious findings from meta-regression. Stat Med. 2004; 23 (11): 1663-82.
[16] Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical research ed) 1997; 315 (7109): 629-34.
[17] Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics1994; 50 (4): 1088-101.
[18] Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol. 1992; 135 (11): 1301-9.
[19] Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data. Stata J. 2006; 6: 40-57.
[20] Harrell FE, Jr., Lee KL, Pollock BG. Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst. 1988; 80 (15): 1198-202.
[21] Colditz GA, Manson JE, Stampfer MJ, Rosner B, Willett WC, Speizer FE: Diet and risk of clinical diabetes in women. Am J Clin Nutr. 1992; 55 (5): 1018-23.
[22] Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimmet PZ, et al. Serum 25-hydroxyvitamin D, calcium intake, and risk of type 2 diabetes after 5 years: results from a national, population-based prospective study (the Australian Diabetes, Obesity and Lifestyle study). Diabetes care. 2011; 34 (5): 1133-8.
[23] Kim KN, Oh SY, Hong YC. Associations of serum calcium levels and dietary calcium intake with incident type 2 diabetes over 10years: the Korean Genome and Epidemiology Study (KoGES). Diabetol Metab Syndr. 2018; 10: 50.
[24] Kirii K, Mizoue T, Iso H, Takahashi Y, Kato M, Inoue M, et al. Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort. Diabetologia. 2009; 52 (12): 2542-50.
[25] Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes care 2005; 28 (12): 2926-32.
[26] Oh JM, Woo HW, Kim MK, Lee Y-H, Shin DH, Shin M-H, et al. Dietary total, animal, vegetable calcium and type 2 diabetes incidence among Korean adults: The Korean Multi-Rural Communities Cohort (MRCohort). Nutr Metab Cardiovasc Dis. 2017; 27 (12): 1152-64.
[27] Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes care 2006; 29 (3): 650-6.
[28] Talaei M, Pan A, Yuan JM, Koh WP: Dairy intake and risk of type 2 diabetes. Clin Nutr. 2018; 37 (2): 712-8.
[29] van Dam RM, Hu FB, Rosenberg L, Krishnan S, Palmer JR. Dietary calcium and magnesium, major food sources, and risk of type 2 diabetes in U.S. black women. Diabetes care 2006; 29 (10): 2238-43.
[30] Villegas R, Gao YT, Dai Q, Yang G, Cai H, Li H, et al. Dietary calcium and magnesium intakes and the risk of type 2 diabetes: the Shanghai Women's Health Study. Am J Clin Nutr. 2009; 89 (4): 1059-67.
[31] Wu F, Juonala M, Pahkala K, Buscot M, Sabin MA, Pitkänen N, et al. Youth and Long-Term Dietary Calcium Intake With Risk of Impaired Glucose Metabolism and Type 2 Diabetes in Adulthood. J Clin Endocrinol Metab. 2019; 104 (6): 2067-74.
[32] Osorio-Yáñez C, Qiu C, Gelaye B, Enquobahrie DA, Williams MA. Risk of gestational diabetes mellitus in relation to maternal dietary calcium intake. Public Health Nutr. 2017; 20 (6): 1082-9.
[33] Abbas S, Linseisen J, Rohrmann S, Beulens JWJ, Buijsse B, Amiano P, et al. Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study. Eur J Clin Nutr. 2014; 68 (2): 196-202.
[34] Bao W, Song Y, Bertrand KA, Tobias DK, Olsen SF, Chavarro JE, et al. Prepregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus: A prospective cohort study. J Diabetes. 2018; 10 (5): 373-9.
[35] Eshak ES, Iso H, Muraki I, Tamakoshi A. Fat-soluble vitamins from diet in relation to risk of type 2 diabetes mellitus in Japanese population. Br J Nutr. 2018: 1-18.
[36] Fang AP, Li KJ, Shi HY, He JJ, Li H. Habitual dietary calcium intakes and calcium metabolism in healthy adults Chinese: a systematic review and meta-analysis. Asia Pac J Clin Nutr. 2016; 25 (4): 776-84.
[37] Brot C, Jorgensen NR, Sorensen OH. The influence of smoking on vitamin D status and calcium metabolism. Eur J Clin Nutr. 1999; 53 (12): 920-6.
[38] Conde FA, Aronson WJ. Risk factors for male osteoporosis. Urol Oncol. 2003; 21 (5): 380-3.
[39] Resnick NM, Greenspan SL. 'Senile' osteoporosis reconsidered. Jama. 1989; 261 (7): 1025-9.
[40] Gunta SS, Thadhani RI, Mak RH. The effect ofvitamin D status on risk factors for cardiovasculardisease. Nat Rev Nephrol. 2013; 9 (6): 337-47.
[41] LucasA, WolfM. Vitamin D and Health Outcomes: Then Came the Randomized Clinical Trials. Jama. 2019.
Cite This Article
  • APA Style

    Lingling Li, Qianwen Li, Junhao Wang, Hao Wang, Yongjuan Xin, et al. (2021). Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis. International Journal of Diabetes and Endocrinology, 6(1), 36-45. https://doi.org/10.11648/j.ijde.20210601.17

    Copy | Download

    ACS Style

    Lingling Li; Qianwen Li; Junhao Wang; Hao Wang; Yongjuan Xin, et al. Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis. Int. J. Diabetes Endocrinol. 2021, 6(1), 36-45. doi: 10.11648/j.ijde.20210601.17

    Copy | Download

    AMA Style

    Lingling Li, Qianwen Li, Junhao Wang, Hao Wang, Yongjuan Xin, et al. Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis. Int J Diabetes Endocrinol. 2021;6(1):36-45. doi: 10.11648/j.ijde.20210601.17

    Copy | Download

  • @article{10.11648/j.ijde.20210601.17,
      author = {Lingling Li and Qianwen Li and Junhao Wang and Hao Wang and Yongjuan Xin and Shenshen Zhang and Ying Cao and Mengyao Zhou and Wenjie Yang},
      title = {Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {1},
      pages = {36-45},
      doi = {10.11648/j.ijde.20210601.17},
      url = {https://doi.org/10.11648/j.ijde.20210601.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210601.17},
      abstract = {Background: Dietary Calcium and vitamin D intake may have effects on the onset risk of type 2 diabetes mellitus (T2DM), whereas the results of existing studies are inconsistent. We performed a meta-analysis of prospective studies to evaluate the association between dietary calcium orvitamin D intakeand the onset risk of T2DM. Methods: We searched PubMed, Web of Science, and Embase for relevant studies published through 5 Jan 2021. The relative risks (RRs) with 95% confidence intervals (CIs) of T2DM in relation to dietary calcium and vitamin D intake were pooled with a fix or random-effects model. Results: 22 cohort studies were included in this meta-analysis, which comprising 31027 cases and 448578 participants. We found dietary calcium (RR: 0.84; 95% CI: 0.76–0.93) rather than dietary vitamin D (RR: 1.00; 95% CI: 0.92–1.08) reduced the onset risk of T2DM. Subgroup analysis showed the efficacy of dietary calcium intake is only in Asian, women and older population. Dose-response analysis revealed that each 300 mg/day increase in dietary calcium intake reduces the risk of T2DM by 8%. However, the increasing dietary vitamin D intake does not affect the risk of T2DM. Conclusions: Dietary calcium intake reduces the onset risk of T2DM but dietary vitamin D has no effect.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Dietary Calcium or Vitamin D Intake and Type 2 Diabetes Mellitus Incidence: A Dose-Response Meta-analysis
    AU  - Lingling Li
    AU  - Qianwen Li
    AU  - Junhao Wang
    AU  - Hao Wang
    AU  - Yongjuan Xin
    AU  - Shenshen Zhang
    AU  - Ying Cao
    AU  - Mengyao Zhou
    AU  - Wenjie Yang
    Y1  - 2021/03/04
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijde.20210601.17
    DO  - 10.11648/j.ijde.20210601.17
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 36
    EP  - 45
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210601.17
    AB  - Background: Dietary Calcium and vitamin D intake may have effects on the onset risk of type 2 diabetes mellitus (T2DM), whereas the results of existing studies are inconsistent. We performed a meta-analysis of prospective studies to evaluate the association between dietary calcium orvitamin D intakeand the onset risk of T2DM. Methods: We searched PubMed, Web of Science, and Embase for relevant studies published through 5 Jan 2021. The relative risks (RRs) with 95% confidence intervals (CIs) of T2DM in relation to dietary calcium and vitamin D intake were pooled with a fix or random-effects model. Results: 22 cohort studies were included in this meta-analysis, which comprising 31027 cases and 448578 participants. We found dietary calcium (RR: 0.84; 95% CI: 0.76–0.93) rather than dietary vitamin D (RR: 1.00; 95% CI: 0.92–1.08) reduced the onset risk of T2DM. Subgroup analysis showed the efficacy of dietary calcium intake is only in Asian, women and older population. Dose-response analysis revealed that each 300 mg/day increase in dietary calcium intake reduces the risk of T2DM by 8%. However, the increasing dietary vitamin D intake does not affect the risk of T2DM. Conclusions: Dietary calcium intake reduces the onset risk of T2DM but dietary vitamin D has no effect.
    VL  - 6
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • School of Education and Child Development, Drury University, Springfield, Missouri, USA

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Precision Nutrition Innovation Center, Department of Nutrition, College of Public Health, Zhengzhou University, Zhengzhou, China

  • Sections