Top

BMC Endocrine Disorders

Published in:

Open Access 01-12-2018 | Research article

Higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis: data from Southwest China

Authors: Danting Li, Haoche Wei, Hongmei Xue, Jieyi Zhang, Mengxue Chen, Yunhui Gong, Guo Cheng

Published in: BMC Endocrine Disorders | Issue 1/2018

Abstract

Background

Recent epidemiological studies have suggested inverse associations between vitamin D status and metabolic diseases including type 2 diabetes (T2DM). The aim of this study was to examine whether a higher serum 25-hydroxyvitamin D (25(OH)D) was associated with a more favorable glucose homeostasis among adults without diabetes in Southwest China.

Methods

Serum 25(OH)D concentration was measured in a cross-sectional sample of 1514 adults without diabetes aged 25–65 years recruited from Southwest China. Indices describing glucose homeostasis included fasting plasma glucose (FPG), fasting insulin, glycated hemoglobin (HbA_1c), the homeostatic model assessment 2-insulin resistance (HOMA2-IR) and odds of pre-diabetes. Data were analyzed by multivariable-adjusted regression models.

Results

The average serum 25(OH)D was 22.66 ng/ml, and percentages of vitamin D deficiency [25(OH)D < 20 ng/ml], insufficiency [20 ≤ 25(OH)D ≤ 30 ng/ml] were 47.6 and 32.2%, respectively. Serum 25(OH)D was inversely associated with fasting insulin (P = 0.0007), HbA_1c (P = 0.0001) and HOMA2-IR (P = 0.0007), but not with FPG, after adjusting for age, gender, monthly personal income, smoking status, energy intake, moderate-to-vigorous physical activity (MVPA) and waist circumference (WC). Compared with the lowest 25(OH)D tertile, the odds ratio for pre-diabetes in the highest tertile was 0.68 (95%CI: 0.47-0.99) after adjustment for cofounders. In the following stratified analyses according to weight status, we only observed this inverse association between serum 25(OH)D and pre-diabetes in overweight or obese adults (n = 629, P = 0.047), but not in their counterparts with BMI < 24 kg/m².

Conclusions

Our results advocate that a higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis among adults without diabetes in Southwest China. Further studies are warranted to determine the role of vitamin D in glucose homeostasis.

Available only for authorised users

Pan X-R, Liu J, Yang W-Y, Li G-W. Prevalence of diabetes and its risk factors in China, 1994. Diabetes Care. 1997;20(11):1664–9.CrossRefPubMed

Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310(9):948–59.CrossRefPubMed

American Diabetes A. Classification and diagnosis of diabetes. Diabetes Care. 2016;39(Suppl 1):S13–22.

van der Rhee H, Coebergh JW, de Vries E. Sunlight, vitamin D and the prevention of cancer: a systematic review of epidemiological studies. Eur J Cancer Prev. 2009;18(6):458–75.CrossRefPubMed

Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296(23):2832–8.CrossRefPubMed

Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503–11.CrossRefPubMed

Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yakout SM, Aljohani NJ, et al. Lower vitamin D status is more common among Saudi adults with diabetes mellitus type 1 than in non-diabetics. BMC Public Health. 2014;14(1):1–5.CrossRef

Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third national health and nutrition examination survey. Diabetes Care. 2004;27(12):134–9.CrossRef

Pittas AG, Sun Q, Manson JE, Dawson-Hughes B, Hu FB. Plasma 25-hydroxyvitamin D concentration and risk of incident type 2 diabetes in women. Diabetes Care. 2010;33(9):2021–3.CrossRefPubMedPubMedCentral

10.

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81.CrossRefPubMed

11.

Zhen D, Liu L, Guan C, Zhao N, Tang X. High prevalence of vitamin D deficiency among middle-aged and elderly individuals in northwestern China: its relationship to osteoporosis and lifestyle factors. Bone. 2015;71:1–6.CrossRefPubMed

12.

Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, et al. Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr. 2009;139(2):329–34.CrossRefPubMedPubMedCentral

13.

Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely prospective study 1990-2000. Diabetes. 2008;57(10):2619–25.CrossRefPubMedPubMedCentral

14.

Ford ES, Zhao G, Tsai J, Li C. Associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA1c among adolescents in the United States. Diabetes Care. 2011;34(3):646–8.CrossRefPubMedPubMedCentral

15.

Chiu KC, Chu A, Go VLW, Saad MF. Hypovitaminosis D is associated with insulin resistance and dysfunction. Amer J Clin Nutr. 2004;79(5):820–5.CrossRefPubMed

16.

Scragg R, Holdaway I, Singh V, et al. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus [J]. Diabetes Res Clin Pract. 1995;27(3):181–8.CrossRefPubMed

17.

Zhang J, Ye J, Guo G, et al. Vitamin D status is negatively correlated with insulin resistance in Chinese type 2 diabetes:[J]. Int J Endocrinol. 2016;2016(5):1–7.

18.

Lin D, Wang C, Ma H, et al. The study of serum vitamin D and insulin resistance in Chinese populations with normal glucose tolerance [J]. Int J Endocrinol. 2014;2014(2014):870235.

19.

Guo C, Xue H, Jiao L, et al. Relevance of the dietary glycemic index, glycemic load and genetic predisposition for the glucose homeostasis of Chinese adults without diabetes [J]. Sci Rep. 2017;7(1):400.CrossRef

20.

Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73–8.CrossRefPubMed

21.

Wallace TM, Levy JC, Matthew DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.CrossRefPubMed

22.

Group CSCaHR. Reports on the physical fitness and health research of chinese school students. Beijing: Higher Education Press; 2010.

23.

Working Group on Obesity in China. Guidelines for prevention and control of overweight and obesity in Chinese adults. Acta Nutrimenta Sinica. 2004;26(1):1–4.

24.

Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379(9833):2279–90.CrossRefPubMedPubMedCentral

25.

Elias P, Birch M. SOC2010: revision of the standard occupational classification. Labour Gaz. 2010;4(7):48–55.

26.

Statistical Bureau of Sichuan, NBS Survey Officie in Sichuan. SiChuan statistical yearbook. Beijing: China Statistic Press; 2015.

27.

Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.CrossRefPubMed

28.

Yuexin Y, Guangya W, Xingchang P. China food conposition: Peking University Medical Press; 2009.

29.

Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of tests of β-cell function across a range of glucose tolerance from normal to diabetes. Diabetes. 1999;48:1779–86.CrossRefPubMed

30.

Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of insulin sensitivity tests across a range, of glucose tolerance from normal to diabetes. Diabetologia. 1999;42(6):678–87.CrossRefPubMed

31.

Tai K, Need AG, Horowitz M, Chapman IM. Vitamin D, glucose, insulin, and insulin sensitivity. Nutrition. 2008;24(3):279–85.CrossRefPubMed

32.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92(6):2017–29.CrossRefPubMedPubMedCentral

33.

Reis JP, von Muhlen D, Miller ER 3rd. Relation of 25-hydroxyvitamin D and parathyroid hormone levels with metabolic syndrome among US adults. Eur J Endocrinol. 2008;159(1):41–8.CrossRefPubMed

34.

Hypponen E, Boucher BJ, Berry DJ, Power C. 25-hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British birth cohort. Diabetes. 2008;57(2):298–305.CrossRefPubMed

35.

Lee DM, Rutter MK, O'Neill TW, Boonen S, Vanderschueren D, Bouillon R, et al. Vitamin D, parathyroid hormone and the metabolic syndrome in middle-aged and older European men. Eur J Endocrinol. 2009;161(6):947–54.CrossRefPubMed

36.

Kositsawat J, Freeman VL, Gerber BS, Geraci S. Association of A1C levels with vitamin D status in U.S. adults: data from the national health and nutrition examination survey. Diabetes Care. 2010;33(6):1236–8.CrossRefPubMedPubMedCentral

37.

Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity. Diabetes Care. 2006;29(10):2244–6.CrossRefPubMed

38.

Shankar A, Sabanayagam C, Kalidindi S. Serum 25-Hydroxyvitamin D levels and prediabetes among subjects free of diabetes. Diabetes Care. 2011;34(5):1114–9.CrossRefPubMedPubMedCentral

39.

Gupta AK, Brashear MM, Johnson WD. Prediabetes and prehypertension in healthy adults are associated with low vitamin D levels. Diabetes Care. 2011;34(3):658–60.CrossRefPubMedPubMedCentral

40.

Zhang FF, Hooti SA, Rao A, Jahmah NA, Saltzman E, Ausman LM. Low level of serum vitamin D is associated with elevated fasting glucose and prediabetes in Kuwait adults. FASEB J. 2013;27(1):lb376.CrossRef

41.

Gonzalez L, Ramos-Trautmann G, Diaz-Luquis GM, Perez CM, Palacios C. Vitamin D status is inversely associated with obesity in a clinic-based sample in Puerto Rico. Nutr Res. 2015;35(4):287–93.CrossRefPubMedPubMedCentral

42.

Zhang Y, Zhang X, Wang F, Zhang W, Wang C, Yu C, et al. The relationship between obesity indices and serum vitamin D levels in Chinese adults from urban settings. Asia Pac J Clin Nutr. 2016;25(2):333–9.PubMed

43.

Giorelli GV, Matos LN, Saado A, Soibelman VL, Dias CB. No association between 25-hydroxyvitamin D levels and prediabetes in Brazilian patients. A cross-sectional study. Sao Paulo Med J. 2015;133(2):73–7.CrossRefPubMed

44.

Knowler WC, Bar-rett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.CrossRefPubMed

45.

American Diabetes A. Standards of medical care in diabetes--2010. Diabetes Care. 2010;33(Suppl 1):S11–61.CrossRef

46.

Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H, et al. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care. 2009;32(7):1278–83.CrossRefPubMedPubMedCentral

47.

Schleicher RL, Sternberg MR, Lacher DA, Sempos CT, Looker AC, Durazo-Arvizu RA, et al. The vitamin D status of the US population from 1988 to 2010 using standardized serum concentrations of 25-hydroxyvitamin D shows recent modest increases. Amer J Clin Nutr. 2016;104(2):454–61.CrossRefPubMedPubMedCentral

48.

Pi-Sunyer F, Becker D, Bouchard C, Carleton R, Colditz G. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998;158(17):1855–67.CrossRef

Title: Higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis: data from Southwest China
Authors: Danting Li
Haoche Wei
Hongmei Xue
Jieyi Zhang
Mengxue Chen
Yunhui Gong
Guo Cheng
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Endocrine Disorders / Issue 1/2018
Electronic ISSN: 1472-6823
DOI: https://doi.org/10.1186/s12902-018-0252-4

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis: data from Southwest China

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Investigation and management of moderate to severe inpatient hyponatraemia in an Australian tertiary hospital

Prevalence of metabolic syndrome in Saudi Arabia - a cross sectional study

Reintroducing testosterone in the db/db mouse partially restores normal glucose metabolism and insulin resistance in a leptin-independent manner

Determining the joint effect of obesity and diabetes on functional disability at 3-months and on all-cause mortality at 1-year following an ischemic stroke

Treatment with PBI-4050 in patients with Alström syndrome: study protocol for a phase 2, single-Centre, single-arm, open-label trial

Complicated Gitelman syndrome and autoimmune thyroid disease: a case report with a new homozygous mutation in the SLC12A3 gene and literature review

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page