Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nutr Diabetes. 2022 Oct 13;12(1):43. doi: 10.1038/s41387-022-00220-4.
Incident diabetes risk is inversely proportional to 25-hydroxyvitamin D [25(OH)D] levels among non-Hispanic white but is unclear among African American (AA) populations. Serum 25(OH)D2 may be an important component of total 25(OH)D among AA populations due to higher levels of melanin.
To assess the association of serum 25(OH)D with incident diabetes among AAs and stratify by detectable 25(OH)D2.
Serum 25(OH)D2 and 25(OH)D3 were collected from 2000 to 2004 among AA participants in the Jackson Heart Study. A cosinor model was used to adjust for the seasonality of 25(OH)D3; 25(OH)D3 and 25(OH)D2 were combined to ascertain total 25(OH)D. Incident diabetes (fasting glucose ≥126 mg/dl, use of diabetes drugs, or HbA1c ≥6.5%) was assessed over 12 years among adults without diabetes at baseline. Participants with missing baseline covariates or diabetes follow-up were excluded. Hazard ratios (HR) were estimated using Cox modeling, adjusting for age, sex, education, occupation, smoking, physical activity, alcohol use, aldosterone, and body-mass index.
Among 3311 adults (mean age 53.3 years, 63% female) 584 participants developed diabetes over a median of 7.7 years. After adjustment, 25(OH)D ≥20 compared to <12 ng/ml was associated with a HR 0.78 (95% CI: 0.61, 1.00). Among participants with detectable 25(OH)D2 and 25(OH)D3 (n = 1671), 25(OH)D ≥ 20 ng/ml compared to <12 ng/ml was associated with a 35% (HR 0.65, 95% CI: 0.46, 0.91) lower risk of diabetes.
Higher levels of 25(OH)D may be protective against the development of diabetes among AA individuals, particularly among those with detectable 25(OH)D2 and 25(OH)D3.
非西班牙裔白种人群体中，25-羟维生素 D [25(OH)D] 水平与糖尿病发病风险呈反比，但非裔美国人 (AA) 人群中的情况尚不清楚。由于黑色素水平较高，血清 25(OH)D2 可能是 AA 人群总 25(OH)D 的重要组成部分。
评估 AA 人群中血清 25(OH)D 与新发糖尿病的相关性，并按可检测到的 25(OH)D2 进行分层。
2000 年至 2004 年，在杰克逊心脏研究的 AA 参与者中收集血清 25(OH)D2 和 25(OH)D3。采用余弦模型调整 25(OH)D3 的季节性；将 25(OH)D3 和 25(OH)D2 结合起来确定总 25(OH)D。在基线时无糖尿病的成年人中，在 12 年内评估新发糖尿病（空腹血糖≥126mg/dl、使用糖尿病药物或 HbA1c≥6.5%）。排除基线时缺失协变量或糖尿病随访的参与者。使用 Cox 建模估计风险比 (HR)，并调整年龄、性别、教育程度、职业、吸烟、体力活动、饮酒、醛固酮和体重指数。
在 3311 名成年人（平均年龄 53.3 岁，63%为女性）中，584 名参与者在中位数为 7.7 年的时间内发生糖尿病。调整后，25(OH)D≥20 与 <12ng/ml 相比，HR 为 0.78（95%CI：0.61, 1.00）。在可检测到 25(OH)D2 和 25(OH)D3 的参与者中（n=1671），25(OH)D≥20ng/ml 与 <12ng/ml 相比，糖尿病风险降低 35%（HR 0.65，95%CI：0.46, 0.91）。
较高水平的 25(OH)D 可能对 AA 个体发生糖尿病具有保护作用，尤其是在可检测到 25(OH)D2 和 25(OH)D3 的个体中。
