Mustafa Akif, Shekhar Chander
International Institute for Population Sciences (IIPS), Mumbai, 400088, India.
Department of Fertility Studies, International Institute for Population Sciences (IIPS), Mumbai, India.
BMC Nutr. 2022 Jul 25;8(1):69. doi: 10.1186/s40795-022-00568-x.
Vitamin D deficiency has been found to associated with numerous skeletal and non-skeletal diseases including Diabetes Mellitus. Insulin Resistance (IR) is considered as one of the primary reasons of Type-2 Diabetes Mellitus (T2DM). The association between vitamin D deficiency and IR has been extensively explore in previous studies, but none of them focused on Indian adolescents, and none of them used the TyG index as IR marker. Hence, this population-based cross-sectional study investigates the relationship between insulin resistance (IR) assessed using the Triglycerides Glucose Index (TyG index) and vitamin D measured by serum 25-hydroxyvitamin-D (25(OH)D).
For this study, we utilized data from the Comprehensive National Nutrition Survey (CNNS, 2016-18). The study is based on a sample size of 10,167 adolescents aged 10-19 years. The TyG index cut-off value of 4.65 was used to classify IR. We examined associations between the TyG index and serum 25(OH)D using multiple linear regression models adjusted for potential confounders. Odds of Insulin Resistance among vitamin D deficient/insufficient adolescents were assessed using multivariable logistic regression.
A significant negative association was found between serum 25(OH)D and the TyG index, where a 10% increase in serum 25(OH)D was associated with 0.56 (95% CI = -0.67, -0.45) unit decrement in the TyG index. The odds of having IR were 90% higher among vitamin D deficient adolescents (OR: 1.90; 95% CI = 1.62-2.23) compared to adolescents with adequate levels of vitamin D. The association between vitamin D deficiency and IR was independent of sex; in other words, the association between vitamin D and IR was significant in both the sexes.
Independent of sex, this study found a significant inverse association between vitamin D and insulin resistance in Indian adolescents. The findings of this study highlight the utility of TyG index and the importance of vitamin D in lowering the risk of T2DM in future generations of the country.
维生素D缺乏已被发现与包括糖尿病在内的多种骨骼和非骨骼疾病有关。胰岛素抵抗（IR）被认为是2型糖尿病（T2DM）的主要原因之一。维生素D缺乏与IR之间的关联在以往研究中已得到广泛探讨，但均未聚焦于印度青少年，且均未使用TyG指数作为IR标志物。因此，这项基于人群的横断面研究调查了使用甘油三酯葡萄糖指数（TyG指数）评估的胰岛素抵抗（IR）与血清25-羟基维生素D（25(OH)D）测量的维生素D之间的关系。
在本研究中，我们利用了全国综合营养调查（CNNS，2016 - 18年）的数据。该研究基于10167名10 - 19岁青少年的样本量。TyG指数临界值4.65用于分类IR。我们使用针对潜在混杂因素进行调整的多元线性回归模型检查TyG指数与血清25(OH)D之间的关联。使用多变量逻辑回归评估维生素D缺乏/不足青少年中胰岛素抵抗的几率。
血清25(OH)D与TyG指数之间存在显著负相关，血清25(OH)D每增加10%，TyG指数下降0.56（95%CI = -0.67，-0.45）单位。与维生素D水平充足的青少年相比，维生素D缺乏青少年发生IR的几率高90%（OR：1.90；95%CI = 1.62 - 2.23）。维生素D缺乏与IR之间的关联独立于性别；换句话说，维生素D与IR之间的关联在两性中均显著。
本研究发现，独立于性别，维生素D与印度青少年的胰岛素抵抗之间存在显著的负相关。本研究结果突出了TyG指数的效用以及维生素D在降低该国后代患T2DM风险方面的重要性。
