MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Nutr Diabetes. 2022 Jul 29;12(1):34. doi: 10.1038/s41387-022-00215-1.
An inverse association between vitamin D status and cardiometabolic risk has been reported but this relationship may have been affected by residual confounding from adiposity and physical activity due to imprecise measures of these variables. We aimed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) and cardiometabolic risk factors, with adjustment for objectively-measured physical activity and adiposity.
This was a population-based cross-sectional study in 586 adults in Cameroon (63.5% women). We assessed markers of glucose homoeostasis (fasting blood glucose (BG), 2 h post glucose load BG, HOMA-IR)) and computed a metabolic syndrome score by summing the sex-specific z-scores of five risk components measuring central adiposity, blood pressure, glucose, HDL cholesterol and triglycerides.
Mean±SD age was 38.3 ± 8.6 years, and serum 25(OH)D was 51.7 ± 12.5 nmol/L. Mean 25(OH)D was higher in rural (53.4 ± 12.8 nmol/L) than urban residents (50.2 ± 12.1 nmol/L), p = 0.002. The prevalence of vitamin D insufficiency (<50 nmol/L) was 45.7%. There was an inverse association between 25(OH)D and the metabolic syndrome score in unadjusted analyses (β = -0.30, 95% CI -0.55 to -0.05), which became non-significant after adjusting for age, sex, smoking status, alcohol intake and education level. Serum 25(OH)D was inversely associated with fasting BG (-0.21, -0.34 to -0.08)), which remained significant after adjustment for age, sex, education, smoking, alcohol intake, the season of data collection, BMI and physical activity (-0.17, -0.29 to -0.06). There was an inverse association of 25(OH)D with 2-h BG (-0.20, -0.34 to -0.05) and HOMA-IR (-0.12, -0.19 to -0.04) in unadjusted analysis, but these associations became non-significant after adjustment for potential confounders.
Vitamin D insufficiency was common in this population. This study showed an inverse association between vitamin D status and fasting glucose that was independent of potential confounders, including objectively measured physical activity and adiposity, suggesting a possible mechanism through insulin secretion.
已有研究报道维生素 D 状态与心血管代谢风险之间呈负相关，但由于这些变量的测量不够精确，可能会受到肥胖和身体活动的残余混杂因素的影响。我们旨在研究血清 25-羟维生素 D（25（OH）D）与心血管代谢风险因素之间的关系，并针对通过客观测量得到的身体活动和肥胖情况进行调整。
这是在喀麦隆的 586 名成年人（63.5%为女性）中进行的一项基于人群的横断面研究。我们评估了血糖稳态的标志物（空腹血糖（BG）、葡萄糖负荷后 2 小时 BG、HOMA-IR），并通过计算五个风险成分的性别特异性 z 分数来计算代谢综合征评分，这些风险成分分别测量中心性肥胖、血压、血糖、高密度脂蛋白胆固醇和甘油三酯。
平均年龄为 38.3±8.6 岁，血清 25（OH）D 为 51.7±12.5 nmol/L。与城市居民（50.2±12.1 nmol/L）相比，农村居民的平均 25（OH）D 更高（53.4±12.8 nmol/L），p=0.002。维生素 D 不足（<50 nmol/L）的患病率为 45.7%。在未调整分析中，25（OH）D 与代谢综合征评分呈负相关（β=-0.30，95%CI-0.55 至-0.05），但在调整年龄、性别、吸烟状况、饮酒量和教育水平后，该相关性不再显著。血清 25（OH）D 与空腹血糖呈负相关（-0.21，-0.34 至-0.08），但在调整年龄、性别、教育、吸烟、饮酒、数据采集季节、BMI 和身体活动后，该相关性仍有意义（-0.17，-0.29 至-0.06）。在未调整分析中，25（OH）D 与 2 小时 BG（-0.20，-0.34 至-0.05）和 HOMA-IR（-0.12，-0.19 至-0.04）呈负相关，但在调整潜在混杂因素后，这些相关性不再显著。
该人群中维生素 D 不足很常见。本研究表明，维生素 D 状态与空腹血糖之间存在负相关，这种相关性独立于潜在的混杂因素，包括通过客观测量得到的身体活动和肥胖情况，这表明可能存在通过胰岛素分泌起作用的机制。
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