Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey
Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey
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DOI：
10.2337/diacare.27.12.2813
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发表时间：
2004-12-01
期刊：
影响因子：
16.2
通讯作者：
Bell, C
中科院分区：
文献类型：
--
作者：
Scragg, R;Sowers, M;Bell, C
目的-确定血清25-羟基维生素D(250HD)与糖尿病风险的相关性以及是否因种族而异。研究设计和方法-我们对参加第三次全国健康和营养检查调查(1988-1994)上午检查的参与者的数据进行了分析，第三次全国健康和营养检查调查(1988-1994)是对具有全国代表性的美国人口样本的横断面调查。通过空腹和/或2小时血糖和血清胰岛素测量，从6,228名年龄大于或等于20岁的人(2,766名非西班牙裔白人，1,736名非西班牙裔黑人和1,726名墨西哥裔美国人)获得了反映维生素D状况的250HD血清水平。与最低的250HD(小于或等于43.9nmol/L)相比，在250HD中，最高的维生素D四分位数(250HD大于或等于81.0nmol/L)与最低的250HD(小于或等于43.9nmol/L)相比，糖尿病的种族特定优势比(OR)在250HD的四分位数(非西班牙裔白人的OR为0.25[95%CI 0.11-0.60]，墨西哥裔美国人的OR为0.17[0.08-0.37])中呈剂量依赖关系。这种相反的关联在非西班牙裔黑人中没有观察到。调整混杂因素后，在墨西哥裔美国人(P=0.0024)和非西班牙裔白人(P=0.058)中，胰岛素抵抗的稳态模型评估(LOG，)与血清250HD呈负相关，但与非西班牙裔黑人无关(P=0.93)。结论--这些结果表明，在非西班牙裔白人和墨西哥裔美国人中，维生素D状态与糖尿病之间存在负相关，可能涉及胰岛素抵抗。在非西班牙裔黑人中缺乏反向关联可能反映了对维生素D和/或相关激素(如甲状旁腺激素)的敏感性降低。
OBJECTIVE - To determine the association between serum 25-hydroxyvitamin D (250HD) and diabetes risk and whether it varies by ethnicity.RESEARCH DESIGN AND METHODS - We performed an analysis of data from participants who attended the morning examination of the Third National Health and Nutrition Examination Survey (1988-1994), a cross-sectional survey of a nationally representative sample of the U.S. population. Serum levels of 250HD, which reflect vitamin D status, were available from 6,228 people (2,766 non-Hispanic whites, 1,736 non-Hispanic blacks, and 1,726 Mexican Americans) aged greater than or equal to20 years With fasting and/or 2-h plasma glucose and serum insulin measurements.RESULTS - Adjusting for sex, age, BMI, leisure activity, and quarter of year, ethnicity-specific odds ratios (ORs) for diabetes (fasting glucose greater than or equal to7.0 mmol/l) varied inversely across quartiles of 250HD in a dose-dependent pattern (OR 0.25 [95% CI 0.11-0.60] for non-Hispanic whites and 0.17 [0.08-0.37] for Mexican Americans) in the highest vitamin D quartile (250HD greater than or equal to81.0 nmol/l) compared with the lowest 250HD (less than or equal to43.9 nmol/l). This inverse association was not observed in non-Hispanic blacks. Homeostasis model assessment of insulin resistance (log,) was inversely associated with serum 250HD in Mexican Americans (P = 0.0024) and non-Hispanic whites (P = 0.058) but not non-Hispanic blacks (P = 0.93), adjusting for confounders.CONCLUSIONS - These results show an inverse association between vitamin D status and diabetes, possibly involving insulin resistance, in non-Hispanic whites and Mexican Americans. The lack of an inverse association in non-Hispanic blacks may reflect decreased sensitivity to vitamin D and/or related hormones such as the parathyroid hormone.