Knekt Paul, Laaksonen Maarit, Mattila Catharina, Härkänen Tommi, Marniemi Jukka, Heliövaara Markku, Rissanen Harri, Montonen Jukka, Reunanen Antti
National Public Health Institute, Department of Health and Functional Capacity, Mannerheimintie 166, 00300 Helsinki, Finland.
Epidemiology. 2008 Sep;19(5):666-71. doi: 10.1097/EDE.0b013e318176b8ad.
Low vitamin D status has been suggested as a risk factor for type 2 diabetes. Although the epidemiologic evidence is scarce, 2 recent studies have suggested an association. The present study investigated the relation of serum vitamin D with type 2 diabetes incidence using pooled data from these 2 cohorts.
Two nested case-control studies, collected by the Finnish Mobile Clinic in 1973-1980, were pooled for analysis. The study populations consisted of men and women aged 40-74 years and free of diabetes at baseline. During a follow-up period of 22 years, 412 incident type 2 diabetes cases occurred, and 986 controls were selected by individual matching. Serum vitamin D (serum 25(OH)D) was determined from frozen samples, stored at baseline. Pooled estimates of the relationship between serum vitamin D concentration and type 2 diabetes incidence were calculated.
Men had higher serum vitamin D concentrations than women and showed a reduced risk of type 2 diabetes in their highest vitamin D quartile. The relative odds between the highest and lowest quartiles was 0.28 (95% confidence interval = 0.10-0.81) in men and 1.14 (0.60-2.17) in women after adjustment for smoking, body mass index, physical activity, and education.
The results support the hypothesis that high vitamin D status provides protection against type 2 diabetes. Residual confounding may contribute to this association.
低维生素D水平被认为是2型糖尿病的一个风险因素。尽管流行病学证据稀少,但最近的两项研究表明存在关联。本研究使用这两个队列的汇总数据调查了血清维生素D与2型糖尿病发病率之间的关系。
将芬兰流动诊所于1973年至1980年收集的两项巢式病例对照研究汇总进行分析。研究人群包括年龄在40至74岁之间且基线时无糖尿病的男性和女性。在22年的随访期内,发生了412例2型糖尿病新发病例,并通过个体匹配选择了986名对照。从基线时储存的冷冻样本中测定血清维生素D(血清25(OH)D)。计算血清维生素D浓度与2型糖尿病发病率之间关系的汇总估计值。
男性的血清维生素D浓度高于女性,并且在维生素D水平最高的四分位数组中2型糖尿病风险降低。在对吸烟、体重指数、身体活动和教育程度进行调整后,男性最高四分位数组与最低四分位数组之间的相对比值比为0.28(95%置信区间=0.10-0.81),女性为1.14(0.60-2.17)。
结果支持高维生素D水平可预防2型糖尿病这一假设。残余混杂因素可能导致了这种关联。