Sun Ying, Zhang Haojie, Wang Bin, Wang Yuying, Chen Chi, Chen Yi, Lu Yingli, Wang Ningjian
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China.
Department of Endocrinology and Metabolism and Department of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2024 Apr 20;137(8):972-979. doi: 10.1097/CM9.0000000000002794. Epub 2023 Aug 24.
The serum vitamin D level varies widely by population, and studies have linked vitamin D levels with the risk of type 2 diabetes mellitus (T2DM). However, the relationship is inconsistent and the impact of vitamin D on T2DM among East Chinese adults is unclear. The study aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and the risk of T2DM and evaluated whether the association is modified by genetic predisposition.
In the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cohort, 1862 participants free of T2DM at baseline were included. A weighted genetic risk score was calculated with 28 variants associated with T2DM. Hierarchical logistic models were used to examine the association of serum 25(OH)D and genetic risk with T2DM.
After a 5-year follow-up, 132 cases of T2DM were documented. We observed no significant association between quartiles of serum 25(OH)D and T2DM risk after multivariable adjustment (χ 2 = 0.571, Pfor trend = 0.426). Compared to those in the lowest quartile of 25(OH)D, the odds ratios (ORs) (95% confidence interval [CI]) for participants with increased quartiles were 1.29 (0.74-2.25), 1.35 (0.77-2.36), and 1.27 (0.72-2.24), respectively. We observed a positive association of glycated hemoglobin (HbA1c) with 25(OH)D at baseline (β = 1.752, P = 0.001) and after follow-up (β = 1.385, P = 0.003), and a negative association of ln conversion homeostasis model assessment (HOMA)-β with 25(OH)D at baseline (β = -0.982, P = 0.021). There was no significant interaction between 25(OH)D and diabetes genetic predisposition on the risk of T2DM (χ 2 = 2.710, Pfor interaction = 0.100). The lowest OR (95% CI) of T2DM was among participants with low genetic risk and the highest quartile of 25(OH)D (0.17 [0.05-0.62]).
Serum 25(OH)D may be irrelevant to the risk of incident T2DM among East Chinese adults regardless of genetic predisposition.
血清维生素D水平在不同人群中差异很大，且研究已将维生素D水平与2型糖尿病（T2DM）风险联系起来。然而，这种关系并不一致，维生素D对中国东部成年人T2DM的影响尚不清楚。本研究旨在调查血清25-羟基维生素D（25[OH]D）水平与T2DM风险之间的关联，并评估这种关联是否会因遗传易感性而改变。
在中国东部代谢性疾病和危险因素患病率调查（SPECT-中国）队列中，纳入了1862名基线时无T2DM的参与者。使用与T2DM相关的28个变异计算加权遗传风险评分。采用分层逻辑模型来检验血清25(OH)D和遗传风险与T2DM之间的关联。
经过5年的随访，记录了132例T2DM病例。多变量调整后，我们观察到血清25(OH)D四分位数与T2DM风险之间无显著关联（χ2 = 0.571，趋势P = 0.426）。与25(OH)D最低四分位数者相比，25(OH)D四分位数增加的参与者的优势比（OR）（95%置信区间[CI]）分别为1.29（0.74 - 2.25）、1.35（0.77 - 2.36）和1.27（0.72 - 2.24）。我们观察到糖化血红蛋白（HbA1c）在基线时（β = 1.752，P = 0.001）和随访后（β = 1.385，P = 0.003）与25(OH)D呈正相关，而ln转换稳态模型评估（HOMA）-β在基线时（β = -0.982，P = 0.021）与25(OH)D呈负相关。25(OH)D与糖尿病遗传易感性在T2DM风险上无显著交互作用（χ2 = 2.710，交互作用P = 0.100）。T2DM的最低OR（95%CI）出现在遗传风险低且25(OH)D处于最高四分位数的参与者中（0.17[0.05 - 0.62]）。
无论遗传易感性如何，血清25(OH)D可能与中国东部成年人发生T2DM的风险无关。
