DOI QR코드

DOI QR Code

Vitamin D intake and Diabetes Mellitus in Korean Adults

한국 성인의 비타민 D와 당뇨병의 관련성

  • Hwang, Yerin (Department of Preventive Medicine, Gachon University College of Medicine) ;
  • Kwak, Jung Hyun (Department of Preventive Medicine, Gachon University College of Medicine) ;
  • Kim, Junghoon (Department of Preventive Medicine, Gachon University College of Medicine) ;
  • Choi, Yoon-Hyeong (Department of Preventive Medicine, Gachon University College of Medicine)
  • 황예린 (가천대학교 의과대학 예방의학과) ;
  • 곽정현 (가천대학교 의과대학 예방의학과) ;
  • 김정훈 (가천대학교 의과대학 예방의학과) ;
  • 최윤형 (가천대학교 의과대학 예방의학과)
  • Received : 2018.04.01
  • Accepted : 2018.04.20
  • Published : 2018.04.28

Abstract

Objectives: This study aimed to investigate the association between vitamin D deficiency and the risk of diabetes mellitus, and also examined whether their association is differed by sex and age. Methods: We analyzed the data from 28,135 subjects ${\geq}20years$ old who were registered for the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2014. Vitamin D was measured using serum 25-hydroxyvitamin D (25(OH)D) concentrations. Results: After adjusting for potential confounders (age, sex, education, income, total energy intake, smoking, physical activity, body mass index, and waist circumference), lower vitamin D was dose-dependently associated with a higher risk of diabetes mellitus (p-trend=0.004). When compared with the sufficient group (25(OH)D ${\geq}30ng/mL$), the severe deficient group (25(OH)D <10 ng/mL) had 1.46 (95% CI 1.11-1.94) odds ratio for the risk of diabetes mellitus. This association was markedly strong in men and adults aged ${\geq}40$, whereas no significant association was observed in women and adults aged <40. Conclusions: We found that vitamin D deficiency may be associated with an increased risk for diabetes mellitus in Korean adults. Our findings suggest that intake of higher vitamin D may help reduce the risk of diabetes mellitus.

Keywords

References

  1. Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014; 103(2): 137-149. https://doi.org/10.1016/j.diabres.2013.11.002
  2. The seventh Korea National Health and Nutrition Examination Survey (KNHANES VII): Korea Centers for Disease Control and Prevention; 2016.
  3. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA. 1979; 241(19): 2035-2038. https://doi.org/10.1001/jama.1979.03290450033020
  4. Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999; 281(14): 1291-1297. https://doi.org/10.1001/jama.281.14.1291
  5. Goraya TY, Leibson CL, Palumbo PJ, Weston SA, Killian JM, Pfeifer EA, et al. Coronary atherosclerosis in diabetes mellitus: a population-based autopsy study. J Am Coll Cardiol. 2002; 40(5): 946-953. https://doi.org/10.1016/S0735-1097(02)02065-X
  6. Stamler J, Vaccaro O, Neaton JD, Wentworth D, Group MRFITR. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993; 16(2): 434-444. https://doi.org/10.2337/diacare.16.2.434
  7. Christodoulou S, Goula T, Ververidis A, Drosos G. Vitamin D and bone disease. Biomed Res Int. 2013; 2013: 396541.
  8. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004; 80(6 Suppl): 1678s-1688s. https://doi.org/10.1093/ajcn/80.6.1678S
  9. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357(3): 266-281. https://doi.org/10.1056/NEJMra070553
  10. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008; 87(4): 1080S-1086S. https://doi.org/10.1093/ajcn/87.4.1080S
  11. Gonzalez H, Tarras-Wahlberg N, Strömdahl B, Juzeniene A, Moan J, Larkö O, et al. Photostability of commercial sunscreens upon sun exposure and irradiation by ultraviolet lamps. BMC Dermatol. 2007; 7: 1. https://doi.org/10.1186/1471-5945-7-1
  12. Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 2012; 3(2): 118-126. https://doi.org/10.4103/0976-500X.95506
  13. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, et al. Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab. 2011; 96(3): 643-651. https://doi.org/10.1210/jc.2010-2133
  14. Kim J. The factors affecting serum vitamin D deficiency in Korean women: using KNHANES 2012. J Digit Converg. 2017; 15(10): 257-266.
  15. Lim S, Kung A, Sompongse S, Soontrapa S, Tsai K. Vitamin D inadequacy in postmenopausal women in Eastern Asia. Curr Med Res Opin. 2008; 24(1): 99-106. https://doi.org/10.1185/030079908X253429
  16. Zhang R, Naughton DP. Vitamin D in health and disease: current perspectives. Nutr J. 2010; 9: 65. https://doi.org/10.1186/1475-2891-9-65
  17. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011; 86(1): 50-60. https://doi.org/10.4065/mcp.2010.0567
  18. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endo crinol Metab. 2007; 92(6): 2017-2029. https://doi.org/10.1210/jc.2007-0298
  19. Vaidya A, Williams JS. The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes. Metabolism. 2012; 61(4): 450-458. https://doi.org/10.1016/j.metabol.2011.09.007
  20. Rhee SY, Hwang YC, Chung HY, Woo JT. Vitamin D and diabetes in Koreans: analyses based on the Fourth Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2009. Diabet Med. 2012; 29(8): 1003-1010. https://doi.org/10.1111/j.1464-5491.2012.03575.x
  21. Nam H, Kim HY, Choi JS, Kweon SS, Lee YH, Nam HS, et al. Association between Serum 25- hydroxyvitamin D Levels and Type 2 Diabetes in Korean Adults. CMJ. 2017; 53(1): 73-77.
  22. Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin North Am. 2014; 43(1): 205-232. https://doi.org/10.1016/j.ecl.2013.09.010
  23. Lee JH, O'Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008; 52(24): 1949-1956. https://doi.org/10.1016/j.jacc.2008.08.050
  24. Chuck KW, Hwang M, Choi KS, Suh M, Jun JK, Park B. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009. Epidemiol Health. 2017; 39:e2017036. https://doi.org/10.4178/epih.e2017036
  25. Park DH KC, Kim KJ. Consideration about Physical Activity Guideline and Exercise Intensity for Adult. Exercise Science. 2015; 24(2): 99-109. https://doi.org/10.15857/ksep.2015.24.2.99
  26. JH N. Vitamin D and Diabetes Mellitus. Diabetes Metab J. 2009; 33(4): 276-278. https://doi.org/10.4093/kdj.2009.33.4.276
  27. Choi HS, Kim KA, Lim CY, Rausch T, Roos F, Wahl DA, et al. Low serum vitamin D is associated with high risk of diabetes in Korean adults. J Nutr. 2011; 141(8): 1524-1528. https://doi.org/10.3945/jn.111.139121
  28. Choi YM LJ, Han JS. Effects of Vitamin D and Calcium Intervention on the Improvement of Resistance in Patients with Type 2 Diabetes Mellitus. Diabetes Metab J. 2009; 33(4): 324-334. https://doi.org/10.4093/kdj.2009.33.4.324
  29. Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006; 29(3): 650-656. https://doi.org/10.2337/diacare.29.03.06.dc05-1961
  30. Rafiq S, Jeppesen PB. Is Hypovitaminosis D Related to Incidence of Type 2 Diabetes and High Fasting Glucose Level in Healthy Subjects: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2018; 10(1): 59. https://doi.org/10.3390/nu10010059
  31. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care. 2004; 27(12): 2813-2818. https://doi.org/10.2337/diacare.27.12.2813
  32. Geer EB, Shen W. Gender differences in insulin resistance, body composition, and energy balance. Gend Med. 2009; 6(Suppl 1): 60-75. https://doi.org/10.1016/j.genm.2009.02.002
  33. Stout MB, Justice JN, Nicklas BJ, Kirkland JL. Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty. Physiology 2017; 32(1): 9-19. https://doi.org/10.1152/physiol.00012.2016
  34. Hilger J, Friedel A, Herr R, Rhee SY, Hwang YC, Kim KM, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014; 111(1): 23-45. https://doi.org/10.1017/S0007114513001840
  35. Kim Y. The Korea National Health and Nutrition Examination Survey (KNHANES): current status and challenges. Epidemiol Health. 2014; 36: e2014002. https://doi.org/10.4178/epih/e2014002
  36. Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care. 2000; 23(10): 1516-1526. https://doi.org/10.2337/diacare.23.10.1516
  37. Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ. 2010; 340:b5664. https://doi.org/10.1136/bmj.b5664