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Carbohydrates, glycemic index and diabetes mellitus

The evaluation of inflammatory and oxidative stress biomarkers on coffee–diabetes association: results from the 10-year follow-up of the ATTICA Study (2002–2012)



The purpose of this work was to investigate the association between coffee drinking and diabetes development and potential mediation by oxidative stress and inflammatory biomarkers.


In 2001–2002, a random sample of 1514 men (18–87 years old) and 1528 women (18–89 years old) were selected to participate in the ATTICA study (Athens metropolitan area, Greece). A validated food-frequency questionnaire was used to assess coffee drinking (abstention, casual, habitual) and other lifestyle and dietary factors. Evaluation of oxidative stress and inflammatory markers was also performed. During 2011–2012, the 10-year follow-up of the ATTICA study was carried out. The outcome of interest in this work was incidence of type 2 diabetes, defined according to American Diabetes Association criteria.


During follow-up, 191 incident cases of diabetes were documented (incidence 13.4% in men and 12.4% in women). After various adjustments, individuals who consumed 250 ml of coffee (≈1.5cup) had 54% lower odds of developing diabetes (95% confidence interval: 0.24, 0.90), as compared with abstainers. A dose-response linear trend between coffee drinking and diabetes incidence was also observed (P for trend=0.017). When controlling for several oxidative stress and inflammatory biomarkers, the inverse association between habitual coffee drinking and diabetes was found to be mediated by serum amyloid-A levels.


This work highlights the significance of long-term habitual coffee drinking against diabetes onset. The anti-inflammatory effect of several coffee components may be responsible for this protection.

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We thank the ATTICA study group of investigators Yannis Skoumas, Natassa Katinioti, Labros Papadimitriou, Constantina Masoura, Spiros Vellas, Yannis Lentzas, Manolis Kambaxis, Konstadina Palliou, Vassiliki Metaxa, Agathi Ntzouvani, Dimitris Mpougatsas, Nikolaos Skourlis, Christina Papanikolaou, Georgia-Maria Kouli, Aimilia Christou, Adella Zana, Maria Ntertimani, Aikaterini Kalogeropoulou, Evangelia Pitaraki, Alexandros Laskaris, Mihail Hatzigeorgiou and Athanasios Grekas for their assistance in the initial physical examination and follow-up evaluation; Efi Tsetsekou for her assistance in psychological evaluation; as well as the laboratory team Carmen Vassiliadou and George Dedoussis (genetic analysis), Marina Toutouza-Giotsa, Constadina Tselika and Sia Poulopoulou (biochemical analysis) and Maria Toutouza for the database management.

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Correspondence to D B Panagiotakos.

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Koloverou, E., Panagiotakos, D., Pitsavos, C. et al. The evaluation of inflammatory and oxidative stress biomarkers on coffee–diabetes association: results from the 10-year follow-up of the ATTICA Study (2002–2012). Eur J Clin Nutr 69, 1220–1225 (2015).

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