Department of Medicine and Surgery, "Kore" University of Enna, 94100 Enna, Italy.
Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy.
Nutrients. 2024 May 22;16(11):1561. doi: 10.3390/nu16111561.
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50-60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017.
维生素 D 缺乏在全球范围内非常普遍，尤其是在老年人中，老年人处于维生素 D 缺乏症负面不良后果的最高风险中。除了在钙吸收、骨骼重塑和骨骼生长的调节中具有公认的功能外，维生素 D 还作为一种激素发挥着关键作用，这得到了与各种人类器官和系统相关的各种酶、生理、代谢和病理生理过程的支持。越来越多的证据支持维生素 D 在 2 型糖尿病的胰岛功能障碍和胰岛素抵抗中发挥关键作用。从流行病学的角度来看，许多研究表明，人类 2 型糖尿病发病率的上升可能与普遍存在的维生素 D 不足的全球趋势有关。过去，由于结果存在争议，这种关联引发了讨论，但最近越来越多的证据表明维生素 D 补充在预防 2 型糖尿病方面的真正作用。评估这种作用的大多数荟萃分析都是在成年人或年轻老年人（50-60 岁）中进行的，只有一项分析关注老年人，即使这是维生素 D 缺乏症和 2 型糖尿病风险更高的人群。因此，我们更新了之前的系统评价和荟萃分析，研究了低血清 25-羟维生素 D 水平（25OHD）是否可以预测老年人前瞻性纵向研究中的糖尿病发病情况。我们发现，即使在调整了几个相关的潜在混杂因素后，低 25OHD 与老年人的糖尿病发病相关，这证实并更新了 2017 年进行的唯一荟萃分析的结果。
