Inverse Association between Vitamin D Status and Diabetes in a Clinic Based Sample of Hispanic Adults in Puerto Rico
DOI:
https://doi.org/10.17140/DROJ-1-102Keywords:
Vitamin D status, 25(OH)D levels, Diabetes, Glucose parametersAbstract
Background: Vitamin D deficiency is a public health problem around the world. Diabetes has been associated with vitamin D deficiency. We aimed to examine the association between the vitamin D status and diabetes in a clinic based sample of Hispanic adults in Puerto Rico. Methods: Demographics and laboratory test results for serum 25(OH)D, Fasting Blood Glucose (FBG), and Haemoglobin A1C (HbA1c) were extracted from medical records. Vitamin D status was classified as deficient (<12 ng/ml); inadequate (12-20 ng/ml); insufficient (21-29 ng/ ml) and optimal (≥30 ng/ml) using serum 25(OH)D levels.
Results: A total of 716 records were included in the analyses. Most were females (63.3%), with mean age of 54.1±14.9 y, mean BMI 30.1±6.3 kg/m2 and mean serum 25(OH)D levels of 24.3±8.6 ng/ml. Most were classified as diabetics (41.1%). Those with diabetes had lower 25(OH)D levels compared to pre-diabetic and normal glucose status (p<0.05). Serum 25(OH) D levels were inversely correlated to FBG and HbA1c in the total sample and in men (p<0.05). After adjusting for age, gender, BMI and seasonality, there was a greater risk of diabetes, but not prediabetes, in those with serum 25(OH)D levels <30 ng/ml. This risk increased from 1.8 times in those with vitamin D insufficiency to 4.2 times in those with vitamin D deficiency (<12 ng/ml). Conclusion: Diabetes risk significantly increased as serum 25(OH)D levels decreased in this group of Hispanic adults, underscoring the importance of routinely screening high risk individuals for vitamin D deficiency and offer supplementation to normalize serum levels.
References
Barnes PM, Ward BW, Freeman G, Schiller JS. Early release of selected estimates based on data from the January-March 2011. National Health Interview Survey. National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/nhis. htm. Accessed 2013.
Daviglus ML, Talavera GA, Aviles-Santa ML, et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among hispanic/latino individuals of diverse backgrounds in the united states. JAMA. 2012; 308(17): 1775-1784. doi: 10.1001/ jama.2012.14517
Miranda JJ, Herrera VM, Chirinos JA, et al. Major cardiovas-cular risk factors in latin america: A comparison with the United States. The Latin American Consortium of Studies in Obesity (LASO). PLoS One. 2013; 8(1): e54056. doi: 10.1371/journal. pone.0054056
Center for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey (BRFSS) data. Avail-able at: http: //www.cdc.gov/BRFSS/. Accessed 2009.
Perez CM, Guzman M, Ortiz AP, et al. Prevalence of the meta-bolic syndrome in san Juan, Puerto Rico. Ethn Dis. 2008; 18(4): 434-441.
Center for Disease Control and Prevention (CDC). Deaths: Final data for 2011. Atlanta, GA: 2011; National Vital Statistics Report (NVSR).
Song Y, Wang L, Pittas AG, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: A meta-analysis of pro-spective studies. Diabetes Care. 2013; 36(5): 1422-1428. doi: 10.2337/dc12-0962
Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vi-tamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007; 92(6): 2017- 2029. doi: http://dx.doi.org/10.1210/jc.2007-0298
Palacios C, Gonzalez L. Is vitamin D deficiency a major glob-al public health problem? J Steroid Biochem Mol Biol. 2014; 144(Pt A): 138-145. doi: 10.1016/j.jsbmb.2013.11.003
Ganji V, Zhang X, Tangpricha V. Serum 25-hydroxyvitamin D concentrations and prevalence estimates of hypovitaminosis D in the U.S. population based on assay-adjusted data. J Nutr. 2012; 142(3): 498-507. doi: 10.3945/jn.111.151977
Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 2002; 30(5): 771-777. doi: http://dx.doi.org/10.1016/ S8756-3282(02)00692-0
Jacobs ET, Alberts DS, Foote JA, et al. Vitamin D insuf-ficiency in southern Arizona. Am J Clin Nutr. 2008; 87(3): 608- 613.
Oliveri B, Plantalech L, Bagur A, et al. High prevalence of vitamin D insufficiency in healthy elderly people living at home in argentina. Eur J Clin Nutr. 2004; 58(2): 337-342. doi: 10.1038/sj.ejcn.1601786
Reasner CA 2nd, Dunn JF, Fetchick DA, et al. Alteration of vitamin D metabolism in mexican-americans. J Bone Miner Res. 1990; 5(1): 13-17. doi: 10.1002/jbmr.5650050105
Levis S, Gomez A, Jimenez C, et al. Vitamin d deficiency and seasonal variation in an adult south florida population. J Clin Endocrinol Metab. 2005; 90(3): 1557-1562. doi: http:// dx.doi.org/10.1210/jc.2004-0746
Araujo AB, Travison TG, Esche GR, Holick MF, Chen TC, McKinlay JB. Serum 25-hydroxyvitamin D and bone mineral density among Hispanic men. Osteoporos Int. 2009; 20(2): 245- 255. doi: 10.1007/s00198-008-0652-9
Suarez-Martinez EB, Perez CM, Cruz SK, Khorsandi S, Chardon C, Ferder L. Importance of vitamin D and vitamin D levels status in puerto ricans. J Health Care Poor Underserved. 2013; 24(4 Suppl): 38-47. doi: 10.1353/hpu.2014.0000
Holick MF. Vitamin D status: Measurement, interpretation, and clinical application. Ann Epidemiol. 2009; 19(2): 73-78. doi: 10.1016/j.annepidem.2007.12.001
Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academy Press; 2011.
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Eval-uation, treatment, and prevention of vitamin d deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7): 1911-1930. doi: 10.1210/jc.2011-0385
American Diabetes Association (ADA). Diagnosis and clas-sification of diabetes mellitus. Diabetes care. 2013; 36(Suppl 1): S67-S74.
Malkani S, Mordes JP. Implications of using hemoglobin A1C for diagnosing diabetes mellitus. Am J Med. 2011; 124(5): 395-401. doi: 10.1016/j.amjmed.2010.11.025
O’Hartaigh B, Neil Thomas G, Silbernagel G, et al. Asso-ciation of 25-hydroxyvitamin D with type 2 diabetes among patients undergoing coronary angiography: Cross-sectional findings from the LUdwigshafen risk and cardiovascular health (LURIC) study. Clin Endocrinol (Oxf). 2013; 79(2): 192-198. doi: 10.1111/cen.12024
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): 1236-1238. doi: 10.2337/dc09-2150
Zoppini G, Galletti A, Targher G, et al. Glycated haemo-globin is inversely related to serum vitamin D levels in type 2 diabetic patients. PLoS One. 2013; 8(12): e82733. doi: 10.1371/ journal.pone.0082733
Hurskainen AR, Virtanen JK, Tuomainen TP, Nurmi T, Vou-tilainen S. Association of serum 25-hydroxyvitamin D with type 2 diabetes and markers of insulin resistance in a general older population in finland. Diabetes Metab Res Rev. 2012; 28(5): 418-423. doi: 10.1002/dmrr.2286
Gonzalez-Molero I, Rojo-Martinez G, Morcillo S, et al. Vita-min D and incidence of diabetes: A prospective cohort study. Clin Nutr. 2012; 31(4): 571-573. doi: 10.1016/j.clnu.2011.12.001
Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mel-litus type 2. Ther Adv Endocrinol Metab. 2013; 4(4): 122-128. doi: 10.1177/2042018813501189
Deleskog A, Hilding A, Brismar K, Hamsten A, Efendic S, Ostenson CG. Low serum 25-hydroxyvitamin D level predicts progression to type 2 diabetes in individuals with prediabetes but not with normal glucose tolerance. Diabetologia. 2012; 55(6): 1668-1678. doi: 10.1007/s00125-012-2529-x
Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The ef-fects of calcium and vitamin D supplementation on blood glu-cose and markers of inflammation in nondiabetic adults. Diabe-tes Care. 2007; 30(4): 980-986. doi: 10.2337/dc06-1994
Chagas CE, Borges MC, Martini LA, Rogero MM. Focus on vitamin D, inflammation and type 2 diabetes. Nutrients. 2012; 4(1): 52-67. doi: 10.3390/nu4010052
Maestro B, Molero S, Bajo S, Davila N, Calle C. Transcrip-tional activation of the human insulin receptor gene by 1,25- dihydroxyvitamin D(3). Cell Biochem Funct. 2002; 20(3): 227- 232. doi: 10.1002/cbf.951
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