25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey
25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey
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DOI：
10.1038/sj.ki.5002002
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发表时间：
2007-01-01
影响因子：
19.6
通讯作者：
Scragg, R.
中科院分区：
文献类型：
--
作者：
Chonchol, M.;Scragg, R.
先前的研究报告了慢性肾脏病（CKD）患者血清25-羟基维生素D水平降低，尽管CKD患者维生素D状态与胰岛素抵抗（IR）之间的关系尚未在一般人群中进行研究。我们在第三次全国健康和营养检查调查（NHANES III）的14679名参与者中，研究了肾功能（根据血清肌酐估计的肾小球滤过率（eGFR））与血清25-羟基维生素D水平和代谢综合征组分的相关性。在这项分析中，校正后的平均血清25-羟基维生素D仅在eGFR严重降低（15-29 ml/min/1.73 m2）的受试者中显著低于肾功能正常的受试者（61.6 vs 73.3 nmol/l，P = 0.0063）。血清25-羟维生素D（P = 0.0018）和肾功能水平（P = 0.0003）与胰岛素抵抗的稳态模型评估（HOMA-IR）呈负相关，相互独立，调整混杂因素。高25-羟基维生素D水平（481 nmol/l）的参与者HOMA-IR较低。我们得出结论，25-羟基维生素D缺乏症在美国一般人群中并不普遍，肾小球滤过率降低，如先前报道的CKD患者;维生素D和肾功能与IR呈独立的负相关。
Previous research has reported reduced serum 25-hydroxyvitamin D levels in patients with chronic kidney disease (CKD), although the relationship between vitamin D status and insulin resistance (IR) in patients with CKD has not been examined in the general population. We examined the association that kidney function, based on glomerular filtration rate (eGFR) estimated from serum creatinine, has with serum levels of 25-hydroxyvitamin D and components of the metabolic syndrome among 14 679 participants in the Third National Health and Nutrition Examination Survey (NHANES III). In this analysis, adjusted mean serum 25-hydroxyvitamin D was significantly lower only in the participants with a severe (15-29 ml/min/1.73 m(2)) decrease in eGFR compared to those with normal kidney function (61.6 vs 73.3 nmol/l, P = 0.0063). Serum 25-hydroxyvitamnin D (P = 0.0018) and level of kidney function (P = 0.0003) were inversely associated, independent of each other, with homeostasis model assessment of insulin resistance (HOMA-IR), adjusting for confounders. Participants with high 25-hydroxyvitamin D levels (481 nmol/l) had lower HOMA-IR. We conclude that 25-hydroxyvitamin D deficiency is not as prevalent in the US general population with decreased eGFR as previously reported in patients with CKD; and that vitamin D and kidney function have independent inverse associations with IR.