美国成年人中血清25羟维生素D浓度作为糖化血红蛋白预测指标的研究：2003年至2010年美国国家健康和营养检查调查
Serum 25OHD concentration as a predictor of haemoglobin A1c among adults living in the USA: NHANES 2003 to 2010.
作者信息
Nicolo Michele, Boullata Joseph I
机构信息
Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Nutrition Sciences, Drexel University, Philadelphia, Pennsylvania, USA.
出版信息
BMJ Nutr Prev Health. 2019 Jun 10;2(1):35-38. doi: 10.1136/bmjnph-2019-000029. eCollection 2019.
BACKGROUND
Vitamin D status influences glucose metabolism. Serum 25-hydroxyvitamin D (25OHD) concentrations have been inversely associated with type 2 diabetes risk. The optimal serum 25OHD level needed for adequate glycaemic control is unknown.
OBJECTIVE
To determine the relationship among serum 25OHD concentrations and degree of glucose regulation using percentage of haemoglobin A1c (HbA1c%).
METHODS
Data for adults 20 years from the National Health and Nutrition Examination Survey (NHANES) (2003-2010) were included. A binary logistic regression was used for serum 25OHD (nmol/L) as a continuous variable to determine the OR and 95% CI for HbA1c >6.5%, adjusting for sex, race and body mass index (BMI). Measures of serum 25OHD were grouped into quartiles and entered into a binary logistic regression model to determine the OR and 95% CI for HbA1c >6.5% in an adjusted model.
RESULTS
Across all NHANES cycles, lower serum 25OHD was associated with greater odds of HbA1c 6.5% when adjusting for sex, race, age and BMI (NHANES 2003-2004 (N=4402): OR 0.985, 95% CI 0.979 to 0.990; NHANES 2005-2006 (N=4409): OR 0.976, 95% CI 0.969 to 0.982; NHANES 2007-2008 (N=4525): OR 0.989, 95% CI 0.984 to 0.993; and NHANES 2009-2010 (N=5660): OR 0.988, 95% CI 0.984 to 0.991). In an adjusted model, the lowest quartile of serum 25OHD (0-41 nmol/L, N=4879) was associated with greater odds of HbA1c 6.5% compared with the highest quartile (73-260 nmol/L, N=4472), OR 2.37, 95% CI 2.03 to 2.77. The odds of HbA1c 6.5% were also greater for adults with serum 25OHD considered to be sufficient compared with the highest quartile, OR 1.68, 95% CI 1.56 to 1.61).
CONCLUSION
Lower serum 25OHD concentrations are associated with poor glycaemic control (HbA1c 6.5%). Sufficient serum 25OHD levels were also associated with poorer blood glucose control. Further research is needed to investigate an optimal serum concentration or threshold to support adequate blood glucose control.
背景
维生素D状态会影响葡萄糖代谢。血清25-羟基维生素D（25OHD）浓度与2型糖尿病风险呈负相关。目前尚不清楚实现充分血糖控制所需的最佳血清25OHD水平。
目的
使用糖化血红蛋白（HbA1c）百分比来确定血清25OHD浓度与血糖调节程度之间的关系。
方法
纳入了美国国家健康与营养检查调查（NHANES）（2003 - 2010年）中20岁及以上成年人的数据。将血清25OHD（nmol/L）作为连续变量进行二元逻辑回归，以确定糖化血红蛋白>6.5%时的比值比（OR）和95%置信区间（CI），并对性别、种族和体重指数（BMI）进行调整。将血清25OHD测量值分为四分位数，并纳入二元逻辑回归模型，以确定在调整模型中糖化血红蛋白>6.5%时的OR和95%CI。
结果
在所有NHANES周期中，在对性别、种族、年龄和BMI进行调整后，较低的血清25OHD与糖化血红蛋白>6.5%的较高几率相关（NHANES 2003 - 2004年（N = 4402）：OR 0.985，95%CI 0.979至0.990；NHANES
Zotero 插件