Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Association of Serum Vitamin D with Insulin Resistance and Beta Cell Function in Korean Health Checkup Examinees

건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성

  • Kim, Han-soo (Laboratory Medicine, Haenam Hankook Hospital) ;
  • Ryu, So Yeon (Department of Preventive Medicine, Chosun University Medical School) ;
  • Park, Jong (Department of Preventive Medicine, Chosun University Medical School) ;
  • Han, Mi-Ah (Department of Preventive Medicine, Chosun University Medical School) ;
  • Choi, Seong-Woo (Department of Preventive Medicine, Chosun University Medical School) ;
  • Shin, Min-Ho (Department of Preventive Medicine, Chonnam National University Medical School)
  • 김한수 (해남한국병원 진단검사의학과) ;
  • 류소연 (조선대학교 의과대학 예방의학교실) ;
  • 박종 (조선대학교 의과대학 예방의학교실) ;
  • 한미아 (조선대학교 의과대학 예방의학교실) ;
  • 최성우 (조선대학교 의과대학 예방의학교실) ;
  • 신민호 (전남대학교 의과대학 예방의학교실)
  • Received : 2018.02.20
  • Accepted : 2018.03.19
  • Published : 2018.03.31
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Abstract

Objectives: This study was conducted to examine the association of serum Vitamin D with insulin resistance and ${\beta}-cell$ function in Korean health checkup examinees. Methods: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and $HOMA-{\beta}$, the used statistical analysis were ANOVA and ANCOVA. Results: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were $1.92{\pm}1.08$ in sufficient group, $1.99{\pm}1.04$ in the insufficient group and $2.91{\pm}1.05$ in deficient group and there were statistically significant different(p<0.001). The mean values of $HOMA-{\beta}$ were $84.69{\pm}1.07$ in sufficient group, $78.41{\pm}1.04$ in the insufficient group and $80.48{\pm}1.04$ in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of $HOMA-{\beta}$ were not statistically significant according to the level of serum Vitamin D. Conclusion: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.

본 연구는 농촌 지역에 거주하며 당뇨병이 없는 건강한 성인을 대상으로 혈청 비타민 D와 인슐린 저항성 및 췌장의 베타세포 기능과의 관련성을 확인하기 위하여 시행되었다. 연구대상은 전라남도 해남군에 소재한 종합병원 건강검진실에서 건강검진을 받은 당뇨병이 없는 20세 이상 성인 374명이었고, 분산분석과 공분산분석을 이용하여 혈청 비타민 D 수준에 따라 HOMA-IR과 $HOMA-{\beta}$을 비교하였다. 분석결과, 연구대상 중 비타민 D 결핍군, 불충분군, 충분군은 각각 38.5%, 48.1%, 13.4%이었다. 비타민 D 수준에 따른 HOMA-IR 평균은 충분군 $1.92{\pm}1.08$, 불충분군 $1.99{\pm}1.04$, 결핍군 $2.91{\pm}1.05$로 통계적으로 유의한 차이가 있었으며, 다른 관련변수를 통제한 상태에서 비교한 공분산 분석 결과에서도 비타민 D 수준에 따른 HOMA-IR은 통계적으로 유의한 차이가 있었다. 비타민 D 수준에 따른 $HOMA-{\beta}$ 평균은 충분군 $84.69{\pm}1.07$, 불충분군 $78.41{\pm}1.04$, 결핍군 $80.48{\pm}1.04$ 이었고, 통계적으로 유의한 차이가 없었다. 결론적으로 우리나라 농촌지역 성인의 혈청 비타민 D 수준은 부족한 경우가 매우 높았고, 비타민 D 수준에 따른 인슐린 저항성은 관련이 있음을 알 수 있었다. 인슐린 저항성 및 당뇨병 예방을 위해서 비타민 D의 충분한 형성을 위한 보충제, 햇볕 노출과 영양 섭취 등에 대한 충분한 정보 및 교육이 필요할 것으로 생각된다.

Keywords

References

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