College of Life Sciences, Brigham Young University, Provo, UT 84602, USA.
Nutrients. 2022 Apr 28;14(9):1844. doi: 10.3390/nu14091844.
The primary aim of this study was to determine the associations between serum, dietary, and supplemental vitamin D levels and insulin resistance in 6294 non-diabetic U.S. adults. A total of 8 years of data from the 2011−2018 National Health and Nutrition Examination Survey (NHANES) and a cross-sectional design were utilized to answer the research questions. Serum vitamin D levels were quantified using high-performance liquid chromatography−tandem mass spectrometry. Dietary and supplemental vitamin D intakes were assessed using the average of two 24 h dietary recalls taken 3−10 days apart. The homeostatic model assessment (HOMA), based on fasting glucose and fasting insulin levels, was employed to index insulin resistance. Demographic covariates were age, sex, race, and year of assessment. Differences in physical activity, body mass index (BMI), cigarette smoking, body weight, season, and energy intake were also controlled statistically. Serum levels of vitamin D differed significantly, and in a dose−response order, across quartiles of HOMA-IR, after adjusting for year, age, sex, and race (F = 30.3, p < 0.0001) and with all the covariates controlled (F = 5.4, p = 0.0029). Dietary vitamin D levels differed similarly across HOMA-IR quartiles, but to a lesser extent, respectively (F = 8.1, p = 0.0001; F = 2.9, p = 0.0437). Likewise, supplemental vitamin D levels also differed across the HOMA-IR quartiles, respectively (F = 3.5, p = 0.0205; F = 3.3, p = 0.0272). With all the covariates controlled, the odds of having insulin resistance were significantly greater for those in the lowest quartile of serum and supplemental vitamin D intake compared to the other quartiles combined. In conclusion, in this nationally representative sample, serum, dietary, and supplemental vitamin D were each predictive of insulin resistance, especially in those with low serum levels and those with no supplemental intake of vitamin D.
本研究的主要目的是确定血清、饮食和补充维生素 D 水平与 6294 名美国非糖尿病成年人胰岛素抵抗之间的关联。利用 2011-2018 年全国健康与营养调查（NHANES）8 年的数据和横断面设计来回答研究问题。使用高效液相色谱-串联质谱法对血清维生素 D 水平进行定量。通过两次相隔 3-10 天的 24 小时饮食回忆的平均值来评估饮食和补充维生素 D 的摄入量。基于空腹血糖和空腹胰岛素水平的稳态模型评估（HOMA）用于指数胰岛素抵抗。人口统计学协变量为年龄、性别、种族和评估年份。还通过统计学方法控制了体力活动、体重指数（BMI）、吸烟、体重、季节和能量摄入的差异。经过年份、年龄、性别和种族的调整（F = 30.3，p < 0.0001），以及所有协变量的控制（F = 5.4，p = 0.0029），血清维生素 D 水平在 HOMA-IR 四分位数之间存在显著差异，且呈剂量反应关系。饮食维生素 D 水平在 HOMA-IR 四分位数之间的差异也相似，但程度较小（F = 8.1，p = 0.0001；F = 2.9，p = 0.0437）。同样，补充维生素 D 水平在 HOMA-IR 四分位数之间也存在差异（F = 3.5，p = 0.0205；F = 3.3，p = 0.0272）。在控制所有协变量的情况下，与其他四分位数相比，血清和补充维生素 D 摄入量最低四分位数的人发生胰岛素抵抗的可能性显著更高。总之，在这个具有代表性的全国性样本中，血清、饮食和补充维生素 D 均与胰岛素抵抗相关，尤其是在血清水平较低和没有补充维生素 D 摄入的人群中。
