Dietary Phylloquinone and Menaquinones Intakes and Risk of Type 2 Diabetes

Joline W.J. Beulens; Daphne L. van der A; Diederick E. Grobbee; Ivonne Sluijs; Annemieke M.W. Spijkerman; Yvonne T. van der Schouw

doi:10.2337/dc09-2302

Original Research

Dietary Phylloquinone and Menaquinones Intakes and Risk of Type 2 Diabetes

Joline W.J. Beulens, PHD¹,²,
Daphne L. van der A, PHD³,
Diederick E. Grobbee, MD¹,
Ivonne Sluijs, MSC¹,
Annemieke M.W. Spijkerman, PHD² and
Yvonne T. van der Schouw, PHD¹

¹Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands;
²Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, the Netherlands;
³Center for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

Corresponding author: Joline Beulens, j.beulens{at}umcutrecht.nl.

Diabetes Care 2010 Aug; 33(8): 1699-1705. https://doi.org/10.2337/dc09-2302

Article Figures & Tables

Figures

Tables

Download figure
Open in new tab
Download powerpoint
Figure 1
Association between phylloquinone intake and risk of type 2 diabetes modeled continuously using splines; HR (——) with 95% CI in gray.

Tables

Figures

Table 1

Baseline characteristics according to quartiles of energy-adjusted phylloquinone and menaquinones intake of 38,094 Dutch adults

Characteristics	Phylloquinone				Menaquinones
Characteristics	Quartile 1 (low)	Quartile 2	Quartile 3	Quartile 4 (high)	Quartile 1 (low)	Quartile 2	Quartile 3	Quartile 4 (high)
n	9,523	9,524	9,524	9,523	9,486	9,557	9,557	9,494
Phylloquinone (μg)	95.7 ± 24.6	155.8 ± 15.1	213.1 ± 19.1	332.9 ± 82.5	187.1 ± 97.3	200.6 ± 96.8	205.3 ± 99.5	204.5 ± 98.6
Menaquinones (μg)	29.4 ± 14.5	30.3 ± 13.6	30.9 ± 13.3	31.5 ± 13.5	15.4 ± 3.7	24.5 ± 2.2	33.0 ± 2.8	49.1 ± 10.8
Male sex	3,204 (33.6)	2,738 (28.7)	2,191 (23.0)	1,607 (16.9)	3,509 (37.0)	2,585 (27.0)	2,033 (21.3)	1,613 (17.0)
Age (years)	46.3 ± 12.4	48.2 ± 11.8	49.8 ± 11.6	52.2 ± 10.9	44.9 ± 12.9	49.0 ± 11.9	50.5 ± 11.2	52.0 ± 10.2
BMI (kg/m²)	25.3 ± 3.9	25.4 ± 3.9	25.6 ± 3.9	26.1 ± 4.2	25.3 ± 3.9	25.7 ± 4.0	25.8 ± 4.0	25.8 ± 4.1
Waist circumference (cm)	84.7 ± 11.7	84.8 ± 11.4	85.0 ± 11.2	85.7 ± 11.3	84.9 ± 11.7	85.4 ± 11.4	85.2 ± 11.2	84.8 ± 11.4
Current smoker	3,167 (33.3)	2,860 (30.1)	2,754 (29.0)	2,849 (30.0)	3,376 (35.7)	2,979 (31.3)	2,707 (28.4)	2,568 (27.1)
Physically inactive^*	1,079 (11.3)	808 (8.5)	785 (8.2)	829 (8.7)	1,169 (12.3)	871 (9.1)	750 (7.8)	711 (7.5)
Higher education	2,257 (23.7)	2,030 (21.3)	1,955 (20.5)	1,588 (16.7)	1,676 (17.7)	1,770 (18.5)	2,024 (21.2)	2,360 (24.9)
Family history of diabetes	1,570 (16.5)	1,674 (17.6)	1,759 (18.5)	1,860 (19.5)	1,482 (15.6)	1,783 (18.7)	1,851 (19.4)	1,747 (18.4)
Systolic blood pressure (mmHg)	124.3 ± 18.5	125.1 ± 18.1	126.7 ± 19.0	128.1 ± 19.5	123.6 ± 18.0	126.1 ± 18.6	127.0 ± 19.1	127.3 ± 19.3
Diastolic blood pressure (mmHg)	77.4 ± 10.8	77.6 ± 10.4	77.9 ± 10.6	78.2 ± 10.7	77.1 ± 10.4	77.9 ± 10.7	78.0 ± 10.7	78.0 ± 10.7
Hypertension	3,225 (33.9)	3,307 (34.7)	3,605 (37.9)	3,908 (41.0)	3,096 (32.6)	3,592 (37.6)	3,664 (38.3)	3,693 (38.9)
Hyperlipidemia	771 (8.1)	787 (8.3)	748 (7.9)	828 (8.7)	958 (10.1)	836 (8.7)	738 (7.7)	602 (6.3)
Alcohol intake (g/day)^†	5.6 (16.7)	5.7 (15.3)	5.2 (14.3)	4.1 (13.7)	4.3 (15.7)	5.2 (15.4)	5.2 (14.1)	5.7 (14.9)
Diet^‡
Energy intake (kcal/day)	2,060 ± 649	2,103 ± 624	2,071 ± 612	1,984 ± 590	2,087 ± 669	2,064 ± 618	2,043 ± 590	2,024 ± 601
Saturated fat intake (g/day)	31.9 ± 5.9	32.5 ± 5.8	32.8 ± 5.7	33.1 ± 6.1	29.4 ± 5.4	31.7 ± 5.2	33.2 ± 5.1	35.9 ± 5.8
PUFA intake (g/day)	14.5 ± 3.9	14.9 ± 3.7	15.1 ± 3.8	15.3 ± 4.1	15.5 ± 4.2	15.2 ± 3.8	14.9 ± 3.7	14.3 ± 3.7
MUFA intake (g/day)	29.2 ± 5.2	29.5 ± 5.0	29.6 ± 5.1	29.5 ± 5.3	29.0 ± 5.6	29.4 ± 5.1	29.5 ± 4.9	30.0 ± 5.0
Protein intake (g/day)	73.5 ± 11.3	75.0 ± 10.4	76.2 ± 10.5	78.2 ± 11.2	69.0 ± 10.3	74.1 ± 9.4	77.5 ± 9.5	82.3 ± 10.2
Fiber intake (g/day)	21.1 ± 4.6	22.9 ± 4.4	23.9 ± 4.4	25.5 ± 4.7	23.0 ± 5.3	23.4 ± 4.8	23.6 ± 4.5	23.4 ± 4.6
Vitamin C intake (mg/day)	94.2 ± 39.6	107.0 ± 42.9	113.6 ± 44.3	122.8 ± 49.2	101.5 ± 47.2	108.5 ± 44.3	113.0 ± 43.9	114.6 ± 44.8
Vitamin E intake (mg/day)	11.5 ± 3.2	12.0 ± 3.1	12.4 ± 3.1	13.0 ± 3.4	12.6 ± 3.5	12.4 ± 3.3	12.2 ± 3.1	11.7 ± 3.0
Calcium intake (mg/day)	1,003 ± 370	1,050 ± 347	1,079 ± 343	1,130 ± 349	804 ± 296	990 ± 285	1,127 ± 283	1,340 ± 320

Data are means ± SD or n (%) unless otherwise indicated. P_trend < 0.001 except for waist circumference over menaquinones categories. MUFA, monounsaturated fat; PUFA, polyunsaturated fat.
↵*Inactive according to the Cambridge physical activity index.
↵†Median (interquartile range).
↵‡All nutrients are energy adjusted except energy intake.

Table 2

Energy-adjusted phylloquinone and menaquinones intake and risk of type 2 diabetes among 38.094 Dutch men and women

	Quartile 1	Quartile 2	Quartile 3	Quartile 4	P_trend value	Per 50 μg
Phylloquinone
Intake (μg/day)	100.1	155.7	211.4	308.1
Age-, sex-, waist-adjusted	1.0	0.89 (0.73–1.08)	0.95 (0.79–1.14)	0.89 (0.74–1.07)	0.35	1.00 (0.97–1.03) P = 0.92
Multivariate adjusted^*	1.0	0.89 (0.74–1.09)	0.94 (0.78–1.14)	0.88 (0.73–1.06)	0.26	0.99 (0.96–1.02) P = 0.65
Multivariate adjusted^†	1.0	0.87 (0.71–1.06)	0.90 (0.74–1.09)	0.81 (0.66–0.99)	0.08	0.98 (0.95–1.02) P = 0.31
Menaquinones
Intake (μg/day)	16.0	24.5	32.9	46.1		Per 10 μg
Age-, sex-, waist-adjusted	1.0	1.03 (0.85–1.25)	0.95 (0.78–1.15)	0.86 (0.71–1.05)	0.07	0.95 (0.91–1.01) P = 0.060
Multivariate adjusted^*	1.0	1.04 (0.86–1.26)	0.97 (0.80–1.17)	0.88 (0.73–1.08)	0.13	0.96 (0.91–1.02) P = 0.12
Multivariate adjusted^†	1.0	0.99 (0.82–1.21)	0.89 (0.72–1.10)	0.80 (0.62–1.02)	0.04	0.93 (0.87–1.00) P = 0.038

Data are HRs (95% CI).
↵*Adjusted for age, sex, waist circumference, smoking status, physical activity, hypertension, education, alcohol consumption, and total energy intake.
↵†Adjusted for confounders in footnote * and energy-adjusted intake of saturated, polyunsaturated, and monounsaturated fat, protein, fiber, calcium, vitamin C, and vitamin E.