Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely Prospective Study 1990-2000.
Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely Prospective Study 1990-2000.
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DOI：
10.2337/db08-0593
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发表时间：
2008-10
期刊：
影响因子：
7.7
通讯作者：
Wareham NJ
中科院分区：
文献类型：
--
作者：
Forouhi NG;Luan J;Cooper A;Boucher BJ;Wareham NJ
累积的流行病学证据表明，维生素D缺乏症可能与2型糖尿病和相关代谢风险有关。然而，使用生物标志物血清25-羟基维生素D [25（OH）D]的前瞻性数据有限，因此在本研究中进行了检查。研究设计和方法-在基于人群的伊利研究中，共有524名随机选择的非糖尿病男性和女性，基线年龄40-69岁，测量血清25（OH）D和IGF-1，血糖状态（口服葡萄糖耐量），脂质，胰岛素，人体测量，在基线和10年随访时测量血压和推导代谢综合征风险（代谢综合征Z评分）。MTS-年龄校正的基线平均血清25（OH）D在男性（64.5 nmol/l [95% CI 61.2-67.9]）中高于女性（57.2 nmol/l [54.4，60.0]），并随季节变化（夏末最高）。基线25（OH）D与10年高血糖风险呈负相关（空腹血糖：β =-0.0023，P = 0.019; 2小时血糖：β =-0.0097，P = 0.006）、胰岛素抵抗（空腹胰岛素β = −0.1467，P = 0.010;胰岛素抵抗的稳态模型评估[HOMA-IR]：β =-0.0059，P = 0.005）和代谢综合征z评分（β =-0.0016，P = 0.048），校正年龄、性别、吸烟、BMI、季节和每个代谢结果变量的基线值后。在进一步调整IGF-1、甲状旁腺激素、钙、体力活动和社会阶层后，与2小时血糖、胰岛素和HOMA-IR的相关性仍然显著。结论：这项前瞻性研究报告了基线血清25（OH）D与未来的胰岛素抵抗和胰岛素抵抗之间的负相关性。这些关联对于理解糖代谢异常的病因学具有潜在的重要性，并且需要在更大的、专门设计的前瞻性研究和补充剂的随机对照试验中进行调查。
OBJECTIVE—Accumulating epidemiological evidence suggests that hypovitaminosis D may be associated with type 2 diabetes and related metabolic risks. However, prospective data using the biomarker serum 25-hydroxyvitamin D [25(OH)D] are limited and therefore examined in the present study. RESEARCH DESIGN AND METHODS—A total of 524 randomly selected nondiabetic men and women, aged 40–69 years at baseline, with measurements for serum 25(OH)D and IGF-1 in the population-based Ely Study, had glycemic status (oral glucose tolerance), lipids, insulin, anthropometry, and blood pressure measured and metabolic syndrome risk (metabolic syndrome z score) derived at baseline and at 10 years of follow-up. RESULTS—Age-adjusted baseline mean serum 25(OH)D was greater in men (64.5 nmol/l [95% CI 61.2–67.9]) than women (57.2 nmol/l [54.4,60.0]) and varied with season (highest late summer). Baseline 25(OH)D was associated inversely with 10-year risk of hyperglycemia (fasting glucose: β = −0.0023, P = 0.019; 2-h glucose: β = −0.0097, P = 0.006), insulin resistance (fasting insulin β = −0.1467, P = 0.010; homeostasis model assessment of insulin resistance [HOMA-IR]: β = −0.0059, P = 0.005), and metabolic syndrome z score (β = −0.0016, P = 0.048) after adjustment for age, sex, smoking, BMI, season, and baseline value of each metabolic outcome variable. Associations with 2-h glucose, insulin, and HOMA-IR remained significant after further adjustment for IGF-1, parathyroid hormone, calcium, physical activity, and social class. CONCLUSIONS—This prospective study reports inverse associations between baseline serum 25(OH)D and future glycemia and insulin resistance. These associations are potentially important in understanding the etiology of abnormal glucose metabolism and warrant investigation in larger, specifically designed prospective studies and randomized controlled trials of supplementation.