LAUSR

The Chinese dietary structure is different from Western and Mediterranean diets. This study aimed to assess the association of dietary calcium, serum 25-hydroxyvitamin D (25OHD), and other macronutrients with type 2 diabetes (T2D) in Chinese patients. This case-control study enrolled 605 patients (males, 337; females, 268) with T2D and 724 healthy subjects (males, 405; females, 319) at Sir Run Run Shaw Hospital from February to April 2014. Dietary calcium, total energy, fat to energy ratio, glucose administration, 2-h postprandial blood glucose, serum total cholesterol and high density lipoprotein (HDL)-cholesterol, and serum 25OHD level were assessed. Logistic regression was used to assess the associations of various parameters with T2D. Total energy, fat, and the fat-to-energy ratio were significantly higher in healthy male and female controls than in T2D patients (p<0.05). In addition, significant differences were obtained between the T2D and control groups in glucose management, 2-h postprandial blood glucose, serum total cholesterol, and HDL-cholesterol (all p<0.05). Interestingly, statistically significant inverse associations of dietary calcium and total energy intake with the risk of T2D were obtained in women; binary logistic regression analysis showed diet calcium and serum 25OHD were protecting factors against T2D (OR=0.40, p=0.034; OR=0.50, p=0.019). Dietary calcium and serum 25OHD may independently protect Chinese women from T2D. These findings highlight the importance of vitamin D and calcium in daily diet or supplement in the early period of T2D, meanwhile indicators associated with bone metabolism should be assessed in clinical nutrition. It is possible that dietary education and guidance should be implemented based clinical bone metabolism data.