Plasma 25-hydroxyvitamin D concentration and risk of type 2 diabetes and pre-diabetes: 12-year cohort study
Plasma 25-hydroxyvitamin D concentration and risk of type 2 diabetes and pre-diabetes: 12-year cohort study
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DOI：
10.1371/journal.pone.0193070
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发表时间：
2018-04-19
期刊：
影响因子：
3.7
通讯作者：
Barrett-Connor, Elizabeth
中科院分区：
文献类型：
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作者：
Park, Sue K.;Garland, Cedric F.;Barrett-Connor, Elizabeth
背景据报道，血浆25-羟基维生素D水平越高，患2型糖尿病的风险越低。然而，到目前为止，结果是喜忧参半的，没有基于队列的适当数据可用于正常范围的高端，高于约32 ng/ml或80nmol/L。方法我们对1997-1999年访问美国国立卫生研究院脂肪研究中心诊所期间已知没有糖尿病或糖尿病前期的903名成年人进行了队列研究。血浆25(OH)D在1977-1979年间的第8次访问中测定。平均年龄74岁。访问还包括空腹血糖和口服葡萄糖耐量测试。结果糖尿病患者47例，糖尿病前期患者337例。较高的25(OH)D浓度(30 ng/ml)与较低的危险比(HR)相关：30~39 ng/ml或75~98nmol/L：HR=0.31，95%CI=0.14~0.70；40~49 ng/ml或100~122nmol/L：HR=0.29，CI=0.12~0.68；所有的HR都与30 ng/ml或75nmol/L的浓度进行了比较。25(OH)D浓度与患糖尿病的风险之间存在反比的剂量-反应梯度，其趋势为0.005。25(OH)D浓度每增加10 ng/mL或25nmol/L，HR为0.64，CI=0.48~0.86。25(OH)D浓度与糖尿病前期风险呈较弱的负相关，趋势不明显。结论高水平的25(OH)D是否可以预防2型糖尿病或糖尿病前期向糖尿病的转化，有待进一步研究。
BackgroundIt has been reported that higher plasma 25-hydroxyvitamin D is associated with lower risk of type 2 diabetes. However the results to date have been mixed and no adequate data based on a cohort are available for the high end of the normal range, above approximately 32 ng/ml or 80 nmol/L.MethodsWe performed a cohort study of 903 adults who were known to be free of diabetes or prediabetes during a 1997-1999 visit to a NIH Lipid Research Centers clinic. Plasma 25(OH) D was measured at Visit 8 in 1977-1979. The mean age was 74 years. The visit also included fasting plasma glucose and oral glucose tolerance testing. Follow-up continued through 2009.ResultsThere were 47 cases of diabetes and 337 cases of pre-diabetes. Higher 25(OH) D concentrations (> 30 ng/ml) were associated with lower hazard ratios (HR) for diabetes: 30-39 ng/ml or 75-98 nmol/L: HR = 0.31, 95% CI = 0.14-0.70; for 40-49 ng/ml or 100-122 nmol/L: HR = 0.29, CI = 0.12-0.68; for > 50 ng/ml or 125 nmol/L: HR = 0.19, CI = 0.06-0.56. All HRs are compared to < 30 ng/ml or 75 nmol/L. There was an inverse dose-response gradient between 25(OH) D concentration and risk of diabetes with a p for trend of 0.005. Each 10 ng/mL or 25 nmol/L higher 25(OH) D concentration was associated with a HR of 0.64, CI = 0.48-0.86. 25(OH) D concentrations were more weakly inversely associated with pre-diabetes risk, and the trend was not significant.ConclusionFurther research is needed on whether high 25(OH) D might prevent type 2 diabetes or transition of prediabetes to diabetes.