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Plasma Vitamin C and Type 2 Diabetes: Genome-Wide Association Study and Mendelian Randomization Analysis in European Populations.

Accepted version
Peer-reviewed

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Authors

Luan, Jian'an 
Sofianopoulou, Eleni 
Imamura, Fumiaki 
Stewart, Isobel D 

Abstract

OBJECTIVE: Higher plasma vitamin C levels are associated with lower type 2 diabetes risk, but whether this association is causal is uncertain. To investigate this, we studied the association of genetically predicted plasma vitamin C with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted genome-wide association studies of plasma vitamin C among 52,018 individuals of European ancestry to discover novel genetic variants. We performed Mendelian randomization analyses to estimate the association of genetically predicted differences in plasma vitamin C with type 2 diabetes in up to 80,983 case participants and 842,909 noncase participants. We compared this estimate with the observational association between plasma vitamin C and incident type 2 diabetes, including 8,133 case participants and 11,073 noncase participants. RESULTS: We identified 11 genomic regions associated with plasma vitamin C (P < 5 × 10-8), with the strongest signal at SLC23A1, and 10 novel genetic loci including SLC23A3, CHPT1, BCAS3, SNRPF, RER1, MAF, GSTA5, RGS14, AKT1, and FADS1. Plasma vitamin C was inversely associated with type 2 diabetes (hazard ratio per SD 0.88; 95% CI 0.82, 0.94), but there was no association between genetically predicted plasma vitamin C (excluding FADS1 variant due to its apparent pleiotropic effect) and type 2 diabetes (1.03; 95% CI 0.96, 1.10). CONCLUSIONS: These findings indicate discordance between biochemically measured and genetically predicted plasma vitamin C levels in the association with type 2 diabetes among European populations. The null Mendelian randomization findings provide no strong evidence to suggest the use of vitamin C supplementation for type 2 diabetes prevention.

Description

Keywords

Ascorbic Acid, Delta-5 Fatty Acid Desaturase, Diabetes Mellitus, Type 2, Genome-Wide Association Study, Humans, Mendelian Randomization Analysis, Polymorphism, Single Nucleotide, Risk Factors

Journal Title

Diabetes Care

Conference Name

Journal ISSN

0149-5992
1935-5548

Volume Title

44

Publisher

American Diabetes Association

Rights

All rights reserved
Sponsorship
European Commission (602068)
Medical Research Council (MC_UU_12015/5)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Medical Research Council (MC_UU_12015/1)
European Commission (279233)
British Heart Foundation (None)
MRC (MC_UU_00006/2)
MRC (MC_UU_00006/1)
Medical Research Council (G0800270)
European Research Council (268834)
Medical Research Council (MR/L003120/1)
MRC (MC_UU_00006/3)
National Institute for Health and Care Research (IS-BRC-1215-20014)
European Commission Horizon 2020 (H2020) Marie Sk?odowska-Curie actions (701708)
Medical Research Council (G0800270/1)
The InterAct project was funded by the EU FP6 programme (grant number LSHM_CT_2006_037197). In addition, InterAct investigators acknowledge funding from the following agencies: Medical Research Council Epidemiology Unit MC_UU_12015/1 and MC_UU_12015/5 [NJW, JZ, FI, NGF], and NIHR Biomedical Research Center Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014) [NJW, NGF]. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The Spanish National cohort is supported by Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain). Biomarker measurements for vitamin C were funded by the MRC Cambridge Initiative (RG71466, SJAH/004) and the EPIC-CVD project which is supported by the European Union Framework 7 (HEALTH-F2-2012-279233), European Research Council (268834), UK Medical Research Council (G0800270 and MR/L003120/1), British Heart Foundation (SP/09/002 and RG/08/014 and RG13/13/30194) and the UK National Institute for Health Research [Cambridge Biomedical Research Center at the Cambridge University Hospitals NHS Foundation Trust]. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This work was supported by Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome. This research has been conducted using the UK Biobank Resource (application number 44448). Dr Ju-Sheng Zheng was additionally supported by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 701708, the National Natural Science Foundation of China (81903316) and Zhejiang Ten-thousand Talents Program (2019R52039)