Department of Food and Nutrition, Eulji University, Seongnam, Republic of Korea.
Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea.
J Med Food. 2020 Jul;23(7):711-718. doi: 10.1089/jmf.2019.4528. Epub 2020 May 11.
Vitamin D and fiber intake are nutritional factors that could affect the development of type 2 diabetes (T2D), potentially by reducing insulin resistance. Therefore, we hypothesized that the influence of vitamin D on T2D might depend on fiber intake. This study investigated the association between vitamin D status and T2D according to fiber intake. The present study analyzed data from 9,656 American adults (≥20 years old) who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2010. The serum concentration of 25-hydroxyvitamin D [25(OH)D] was used as a biomarker for vitamin D status. The T2D classification was based on two criteria: T2D was identified using only self-reported questionnaire data and T2D was identified based on both survey and laboratory data. The deficient vitamin D status (<50 nmol/L) was used as the reference group. After controlling for sociodemographic, behavioral, and dietary factors, the odds ratios (ORs) were 0.72 (95% confidence interval [CI]: 0.58, 0.90) for T2D and 0.60 (0.50, 0.80) for T2D in the sufficient vitamin D status (≥75 nmol/L). Furthermore, the total vitamin D concentration exhibited dose-dependent associations with lower OR values for T2D ( for trend = .005) and T2D ( for trend <.001). Among participants with high-fiber intake, the OR values for T2D were 0.60 (95% CI: 0.42, 0.90) at suboptimal vitamin D status and 0.49 (95% CI: 0.31, 0.77) at sufficient vitamin D status. Moreover, the significant dose-dependent association persisted in the high-fiber-intake subgroup ( for trend = .004). Therefore, combining vitamin D plus high-fiber intake would help reduce the prevalence of diabetes, although the interaction analysis results were not statistically significant.
维生素 D 和纤维摄入量是可能影响 2 型糖尿病（T2D）发展的营养因素，其可能通过降低胰岛素抵抗来起作用。因此，我们假设维生素 D 对 T2D 的影响可能取决于纤维摄入量。本研究根据纤维摄入量来探讨维生素 D 状态与 T2D 之间的关联。本研究分析了 9656 名参加 2007-2010 年美国国家健康和营养调查（NHANES）的美国成年人（≥20 岁）的数据。血清 25-羟维生素 D [25(OH)D]浓度被用作维生素 D 状态的生物标志物。T2D 的分类基于两个标准：仅使用自我报告的问卷数据识别 T2D 和基于调查和实验室数据识别 T2D。将维生素 D 缺乏状态（<50 nmol/L）作为参考组。在控制了社会人口统计学、行为和饮食因素后，T2D 的优势比（OR）为 0.72（95%置信区间[CI]：0.58，0.90），维生素 D 充足状态（≥75 nmol/L）的 OR 为 0.60（0.50，0.80）。此外，总维生素 D 浓度与 T2D 的较低 OR 值呈剂量依赖性相关（趋势检验 = .005）和 T2D（趋势检验<.001）。在高纤维摄入量的参与者中，维生素 D 状态不佳时 T2D 的 OR 值为 0.60（95% CI：0.42，0.90），维生素 D 充足时为 0.49（95% CI：0.31，0.77）。此外，在高纤维摄入量亚组中，这种显著的剂量依赖性关联仍然存在（趋势检验 = .004）。因此，结合维生素 D 和高纤维摄入有助于降低糖尿病的患病率，尽管交互分析结果没有统计学意义。
