Shen Zhi-Jun, Liu Miao, Zhang Jun-Xia, Huang Yu, Kong Ying, Liu Shi-Guo
Department of Clinical Laboratory, Hubei Third People´s Hospital Affiliated to Jianghan University, Wuhan, 430033, People's Republic of China.
J Inflamm Res. 2024 Sep 2;17:5915-5922. doi: 10.2147/JIR.S475180. eCollection 2024.
Although observational studies have reported a correlation between vitamin D deficiency and type 2 diabetes mellitus (T2DM), epidemiological evidence on the risk of obese subjects suffering T2DM due to a vitamin D deficiency is limited. Therefore, we investigated the correlation between T2DM and serum vitamin D, lipids, blood pressure, insulin indexes in an obese population.
A total of 1440 participants including 450 healthy controls and 990 obese subjects, 470 without T2DM and 520 with T2DM. Serum vitamin D levels were measured, and the association between low levels and T2DM in obese subjects was examined using multinomial and linear regression analyses.
Of the participants, 35% had deficient or insufficient vitamin D levels (ie, <20 ng/mL). Compared with healthy controls, obese subjects, particularly those with T2DM had lower vitamin D levels. Multinomial logistic regression analysis showed that obese subjects with T2DM had a gradually increasing risk for desirable ( = 1.41, 95% 1.06-1.93, = 0.027), insufficient ( = 1.83, 95% 1.27-2.84, < 0.001), or deficient (( = 2.14, 95% 1.15-3.75, = 0.014) vitamin D levels. In obese subjects with T2DM, vitamin D levels correlated inversely with the risk indicators for diabetes, such as the levels of HbA1c (β = -0.16, = 0.002), fasting insulin (Fins; β = -0.31, P = 0.008), and HOMA-IR (β = -0.19, < 0.001). In obese subjects without T2DM, vitamin D was associated negatively with the risk of having T2DM at five-year follow-up (relative risk = 0.93, 95% 0.79-0.97, = 0.037).
This study demonstrates that low vitamin D levels correlate with the presence of T2DM in the obese population. This finding indicates that hypovitaminosis D may be a potential biological vulnerability factor for the development of T2DM in obese subjects.
尽管观察性研究报告了维生素D缺乏与2型糖尿病（T2DM）之间的相关性，但关于肥胖受试者因维生素D缺乏而患T2DM风险的流行病学证据有限。因此，我们在肥胖人群中研究了T2DM与血清维生素D、脂质、血压、胰岛素指标之间的相关性。
共有1440名参与者，包括450名健康对照者和990名肥胖受试者，其中470名无T2DM，520名患有T2DM。测量血清维生素D水平，并使用多项和线性回归分析检查肥胖受试者中低水平维生素D与T2DM之间的关联。
在参与者中，35%的人维生素D水平不足或缺乏（即<20 ng/mL）。与健康对照者相比，肥胖受试者，尤其是患有T2DM的受试者维生素D水平较低。多项逻辑回归分析表明，患有T2DM的肥胖受试者维生素D水平达到理想水平（比值比=1.41，95%置信区间1.06 - 1.93，P = 0.027）、不足（比值比=1.83，95%置信区间1.27 - 2.84，P < 0.001）或缺乏（比值比=2.14，95%置信区间1.15 - 3.75，P = 0.014）的风险逐渐增加。在患有T2DM的肥胖受试者中，维生素D水平与糖尿病风险指标呈负相关，如糖化血红蛋白（HbA1c）水平（β = -0.16，P = 0.002）、空腹胰岛素（Fins；β = -0.31，P = 0.008）和稳态模型评估胰岛素抵抗（HOMA-IR）（β = -0.19，P < 0.001）。在无T2DM的肥胖受试者中，维生素D与五年随访时患T2DM的风险呈负相关（相对风险=0.93，95%置信区间0.79 - 0.97，P = 0.037）。
本研究表明，低维生素D水平与肥胖人群中T2DM的存在相关。这一发现表明维生素D缺乏可能是肥胖受试者发生T2DM的潜在生物学易损因素。
