Artikel
Serum 25-hydroxyvitamin D and risk of type 2 diabetes mellitus: Results from the MONICA/KORA Augsburg study
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Veröffentlicht: | 20. September 2011 |
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Background: It has been suggested that vitamin D reduces the risk of type 2 diabetes mellitus (T2DM). Also 25-hydroxyvitamin D (25[OH]D) may have immunomodulatory effects and it is well established that subclinical inflammation increases the risk of T2DM. Therefore, the aim was to assess the association between serum 25[OH]D and T2DM development and to determine whether the effect of 25[OH]D on T2DM risk is mediated by subclinical inflammation.
Methods: Using a case-cohort design, baseline serum levels of 25[OH]D were measured in 231 male and 185 female cases with incident T2DM and 657 male and 610 female non-cases selected from a source population of 7,936 middle-aged participants in the population-based MONICA/KORA Augsburg studies. The mean follow-up time was 11.0 ± 4.7 years.
Results: After adjustment for age, sex, survey, season of blood sampling, lifestyle factors, parental history of diabetes and standard metabolic risk factors a significant inverse association was observed between serum 25[OH]D and incident T2DM. The hazard ratio (HR) and 95% confidence interval (CI) comparing tertile extremes was 0.63 (0.44-0.90); p-value for trend: 0.010. Further adjustment for C-reactive protein, interleukin-6, soluble intercellular adhesion molecule-1 (sICAM-1) and interferon inducible protein (IP-10)/CXCL10 attenuated the association (HR [95% CI]: 0.73 [0.50-1.05]; p-trend=0.090). Stratified analyses demonstrated a significant association between 25[OH]D and incident T2DM in younger women (<52 years), but not in older women (≥52 years). In men, the association tended to be more pronounced at an older age.
Conclusions: Our findings indicate that vitamin D status is inversely related to T2DM risk and that this association is only partially mediated by the effects of 25[OH]D on inflammation. Furthermore, our results suggest a modulating role of age and possibly hormone levels which needs to be clarified in further studies.