Lu Ling, Yu Zhijie, Pan An, Hu Frank B, Franco Oscar H, Li Huaixing, Li Xiaoying, Yang Xilin, Chen Yan, Lin Xu
Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, China.
Diabetes Care. 2009 Jul;32(7):1278-83. doi: 10.2337/dc09-0209. Epub 2009 Apr 14.
To evaluate the association between 25-hydroxyvitamin D [25(OH)D] and metabolic syndrome in the Chinese population.
Plasma 25(OH)D was measured in a cross-sectional sample of 1,443 men and 1,819 women aged 50-70 years from Beijing and Shanghai. Metabolic syndrome was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans. Fasting plasma glucose, insulin, lipid profile, A1C, and inflammatory markers were measured.
The geometric mean of plasma 25(OH)D was 40.4 nmol/l, and percentages of vitamin D deficiency [25(OH)D <50 nmol/l] and insufficiency [50 <or= 25(OH)D <75 nmol/l] were 69.2 and 24.4%, respectively. Compared with the highest 25(OH)D quintile (>or=57.7 nmol/l), the odds ratio for metabolic syndrome in the lowest quintile (<or=28.7 nmol/l) was 1.52 (95% CI 1.17-1.98, P(trend) = 0.0002) after multiple adjustment. Significant inverse associations also existed between 25(OH)D and individual metabolic syndrome components plus A1C. Moreover, we observed significant inverse associations of 25(OH)D with fasting insulin and the insulin resistance index (homeostasis model assessment of insulin resistance [HOMA-IR]) in overweight and obese individuals (BMI >or=24 kg/m(2)) but not in their normal-weight counterparts (test for interaction: P = 0.0363 and 0.0187 for insulin and HOMA-IR, respectively).
Vitamin D deficiency is common in the middle-aged and elderly Chinese population, and a low 25(OH)D level is significantly associated with an increased risk of having metabolic syndrome and insulin resistance. Prospective studies and randomized clinical trials are warranted to determine the role of 25(OH)D in the development of metabolic syndrome and related metabolic diseases.
评估中国人群中25-羟基维生素D[25(OH)D]与代谢综合征之间的关联。
对来自北京和上海的1443名50至70岁男性及1819名50至70岁女性的横断面样本测量血浆25(OH)D。根据更新后的美国国家胆固醇教育计划成人治疗小组III针对亚裔美国人的标准定义代谢综合征。测量空腹血糖、胰岛素、血脂谱、糖化血红蛋白(A1C)及炎症标志物。
血浆25(OH)D的几何平均值为40.4nmol/L,维生素D缺乏[25(OH)D<50nmol/L]和不足[50≤25(OH)D<75nmol/L]的比例分别为69.2%和24.4%。经过多重校正后,与最高的25(OH)D五分位数(≥57.7nmol/L)相比,最低五分位数(≤28.7nmol/L)发生代谢综合征的比值比为1.52(95%置信区间1.17 - 1.98,P趋势 = 0.0002)。25(OH)D与各个代谢综合征组分以及A1C之间也存在显著的负相关。此外,我们观察到在超重和肥胖个体(体重指数BMI≥24kg/m²)中,25(OH)D与空腹胰岛素及胰岛素抵抗指数(胰岛素抵抗稳态模型评估[HOMA-IR])存在显著负相关,而在体重正常的个体中则无此现象(交互作用检验:胰岛素和HOMA-IR的P值分别为0.0363和0.0187)。
维生素D缺乏在中国中老年人群中普遍存在,低25(OH)D水平与代谢综合征及胰岛素抵抗风险增加显著相关。有必要进行前瞻性研究和随机临床试验以确定25(OH)D在代谢综合征及相关代谢疾病发生发展中的作用。