UCLA

Oxidative stress and chronic subclinical inflammation are implicated in the pathology of type 2 diabetes (T2D). Consumption of vitamins and nutrients may dampen the harmful oxidative stress, which normally perpetuates inflammation. Reduction of inflammation may delay or reduce the risk of type 2 diabetes. However current research has not been able to confirm the nutrient-inflammation inverse association. Further, postmenopausal women have a different T2D risk and average C-reactive protein (CRP) concentrations than premenopausal women or men of a similar age.

Moderate alcohol consumption is another dietary factor which has been associated with a reduced type 2 diabetes risk. Limited evidence also suggests alcohol consumption maybe associated with some sex hormones. Additionally, sex hormones have been associated with type 2 diabetes risk. However, sex hormones as mediators of the alcohol-type 2 diabetes association have not been established.

The overall objectives of this dissertation were to examine the role of certain dietary factors (vitamins, nutrients, and alcohol) and inflammation or sex hormones in the pathology of type 2 diabetes in postmenopausal women.

Three separate study designs, using 3 distinct datasets, were selected to evaluate the objectives of this dissertation. A cross-sectional study was employed to assess vitamins, nutrients, inflammation and T2D risk with data from the NHANES survey, a stratified, multistage probability sample of the civilian noninstitutionalized U.S. population in 2003-2006. Cross-sectional data from a nested, matched case-control study within the Women's Health Initiative-Observational Study (WHI-OS) were used to examine the separate relations of dietary or supplemental nutrients to biomarkers of inflammation. Prospective data from a matched, nested case-control study within the Women's Health Study (WHS) were used to examine whether circulating concentrations of sex hormones were associated with alcohol intake or mediated the alcohol-T2D association.

Nutrient concentrations measured in NHANES were different in postmenopausal women than in premenopausal women, but were similar to men. The nutrients were not associated with reduced inflammation and T2D risk in postmenopausal women. WHI-OS data results indicate that dietary vitamin C, beta-carotene, and alpha-carotene as well as supplemental vitamin E and beta-carotene are modestly inversely associated with concentrations of systemic inflammatory biomarkers among postmenopausal women. The WHS cross-sectional analysis showed positive associations between alcohol intake and endogenous estradiol concentrations. Prospective WHS data suggested that baseline concentrations of estradiol and SHBG might influence the alcohol-T2D association in postmenopausal women.