维生素 D、糖尿病前期和 2 型糖尿病：双向孟德尔随机化分析。

Vitamin D, prediabetes and type 2 diabetes: bidirectional Mendelian randomization analysis.

机构信息

Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.

出版信息

Eur J Nutr. 2020 Jun;59(4):1379-1388. doi: 10.1007/s00394-019-01990-x. Epub 2019 May 10.

DOI:10.1007/s00394-019-01990-x

PMID:31076857

Abstract

BACKGROUND

Vitamin D deficiency is associated with glycemic dysregulation in many observational studies. However, the causality between them has not been fully established, especially in Asian origin. We used bidirectional Mendelian randomization (MR) analysis to explore the causal relationship between 25-hydroxyvitamin D [25(OH)D] and glycemic status and indices.

METHODS

Participants were included from a survey in East China from 2014 to 2016 (10,338 and 10,655 participants having diabetes and vitamin D-related genotyping information). We calculated weighted genetic risk scores (GRS) as the instrumental variables for 25(OH)D concentration and diabetes based on related single nucleotide polymorphisms. Diagnosis of type 2 diabetes and prediabetes was based on American Diabetes Association criteria.

RESULTS

The MR-derived odds ratios of genetically determined 25(OH)D for risk of type 2 diabetes (1565/10655) and prediabetes (3915/10655) was 0.985 (95% CI 0.940, 1.032) and 0.982 (95% CI 0.948, 1.016), respectively. The MR-derived estimates for fasting plasma glucose and HbA were also not significant. Moreover, the MR-derived regression coefficients of genetically determined diabetes and prediabetes for 25(OH)D was 0.448 (95% CI - 0.395, 1.291) and 1.303 (95% CI - 1.210, 3.816).

CONCLUSIONS

Our results support the conclusion that there is no causal association between vitamin D and type 2 diabetes and prediabetes using a bidirectional MR approach in a Chinese population.

摘要

背景

在许多观察性研究中，维生素 D 缺乏与血糖调节异常有关。然而，它们之间的因果关系尚未完全确定，尤其是在亚洲人群中。我们使用双向孟德尔随机化（MR）分析来探讨 25-羟维生素 D [25（OH）D]与血糖状态和指标之间的因果关系。

方法

参与者来自 2014 年至 2016 年华东地区的一项调查（10338 名和 10655 名参与者有糖尿病和维生素 D 相关基因分型信息）。我们根据相关单核苷酸多态性计算了 25（OH）D 浓度和糖尿病的加权遗传风险评分（GRS）作为工具变量。根据美国糖尿病协会的标准诊断 2 型糖尿病和糖尿病前期。

结果

基于相关单核苷酸多态性，通过遗传确定的 25（OH）D 与 2 型糖尿病（1565/10655）和糖尿病前期（3915/10655）风险相关的 MR 衍生比值比分别为 0.985（95%CI 0.940，1.032）和 0.982（95%CI 0.948，1.016）。空腹血浆葡萄糖和糖化血红蛋白的 MR 衍生估计值也没有显著差异。此外，遗传确定的糖尿病和糖尿病前期的 25（OH）D 的 MR 衍生回归系数分别为 0.448（95%CI-0.395，1.291）和 1.303（95%CI-1.210，3.816）。