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维生素 D 状况、新发糖尿病与老年人群葡萄糖代谢的前瞻性变化:霍恩研究。

Vitamin D status, incident diabetes and prospective changes in glucose metabolism in older subjects: the Hoorn study.

机构信息

Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.

出版信息

Nutr Metab Cardiovasc Dis. 2012 Oct;22(10):883-9. doi: 10.1016/j.numecd.2012.03.008. Epub 2012 Jun 5.

DOI:10.1016/j.numecd.2012.03.008
PMID:22673769
Abstract

BACKGROUND AND AIMS

Vitamin D deficiency may contribute to impaired glucose metabolism and type 2 diabetes, especially in the elderly population. We aimed to evaluate whether baseline 25-hydroxyvitamin D (25[OH]D) levels are prospectively associated with deterioration of glucose metabolism and the incidence of diabetes.

METHODS AND RESULTS

We examined a subsample from the population based Hoorn study among older men and women. Physical examinations were performed from 2000 to 2001 and included measurements of 25(OH)D. Glucose tolerance tests and HbA1c measurements were performed at baseline and at a follow-up between 2007 and 2009. We included 351 study participants (51% females; 67.9 ± 5.7 years). Baseline 25(OH)D levels were 56.7 ± 18.8 nmol/L and follow-up visits were performed after 7.5 ± 0.5 years. Among 280 study participants without diabetes at baseline we recorded 45 cases of incident diabetes. There was no significant association of 25(OH)D with the incidence of diabetes and with fasting and 2h postload glucose levels at follow-up. In analyses adjusted for age, sex, and baseline HbA1c there was, however, a significant association of 25(OH)D with follow-up HbA1c levels (beta coefficient=-0.085, p=0.085). This association was attenuated after further adjustments for BMI (beta coefficient=-0.079, p=0.064).

CONCLUSIONS

In this study among the older population we observed no significant association of baseline 25(OH)D with glucose metabolism and incident diabetes. We found, however, a non-significant trend towards an inverse association of 25(OH)D with prospective changes in HbA1c that deserves further investigations.

摘要

背景和目的

维生素 D 缺乏可能导致葡萄糖代谢受损和 2 型糖尿病,尤其是在老年人群中。我们旨在评估基线 25-羟维生素 D(25[OH]D)水平是否与葡萄糖代谢恶化和糖尿病的发生存在前瞻性关联。

方法和结果

我们对基于人群的 Hoorn 研究中的老年男性和女性亚组进行了研究。体格检查于 2000 年至 2001 年进行,包括 25(OH)D 的测量。基线和 2007 年至 2009 年之间的随访期间进行了葡萄糖耐量试验和 HbA1c 测量。我们纳入了 351 名研究参与者(51%为女性;67.9±5.7 岁)。基线 25(OH)D 水平为 56.7±18.8 nmol/L,随访时间为 7.5±0.5 年。在基线无糖尿病的 280 名研究参与者中,我们记录了 45 例新发糖尿病病例。25(OH)D 与糖尿病的发生率以及随访时的空腹和 2 小时餐后血糖水平均无显著相关性。在调整年龄、性别和基线 HbA1c 后,25(OH)D 与随访时的 HbA1c 水平呈显著负相关(β系数=-0.085,p=0.085)。进一步调整 BMI 后,这种相关性减弱(β系数=-0.079,p=0.064)。

结论

在这项针对老年人群的研究中,我们没有观察到基线 25(OH)D 与葡萄糖代谢和新发糖尿病之间存在显著关联。然而,我们发现 25(OH)D 与 HbA1c 的前瞻性变化呈负相关的趋势,但无统计学意义,值得进一步研究。

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