Associations of circulating 25(OH)D with cardiometabolic disorders underlying type 2 diabetes mellitus in an Aboriginal Canadian community

作者：Mansuri Sudaba; Badawi Alaa; Kayaniyil Sheena; Cole David E; Harris Stewart B; Mamakeesick Mary; Maguire Jonathon; Zinman Bernard; Connelly Philip W; Hanley Anthony J^*

来源：Diabetes Research and Clinical Practice, 2015, 109(2): 440-449.

DOI：10.1016/j.diabres.2015.04.017

• Aboriginal
• 25(OH)D
• Insulin resistance
• Beta cell dysfunction
• Metabolic syndrome

Aims: To investigate the associations of 25-hydroxyvitamin D (25(OH)D) with insulin resistance (IR), beta-cell function and metabolic syndrome (MetS) in a First Nations population.
Methods: We conducted a cross-sectional analysis using data from the Sandy Lake Health and Diabetes Project (2003-2005). A total of 390 participants (>12 y) were assessed for 25(OH) D, fasting glucose, insulin, lipids, blood pressure, inflammatory markers, anthropometric and lifestyle variables and a 75-g oral glucose tolerance test was administered. IR was calculated using the Matsuda insulin sensitivity index (ISOGTT) and the computational homeostasis model assessment of IR (HOMA2-IR). Beta-cell function was calculated using the insulinogenic index (IGI) divided by HOMA-IR (IGI/IR) and the insulin secretion sensitivity index-2 (ISSI-2). The 2009 harmonized criteria were used to define MetS.
Results: Higher 25(OH) D was associated with a decreased prevalence of dysglycemia (OR = 0.71 95% CI, 0.51-0.97 per SD increase). In addition, there were significant associations of 25(OH) D with measures of insulin action (ISOGTT; beta = 0.31; 95% CI, 0.12, 0.49; HOMA2-IR; beta = -29; 95% CI -0.46, -0.11 and beta-cell ISSI-2; beta = 0.15; 95% CI, 0.02, 0.28). The prevalence of MetS was 41%. There was a decreased risk (OR = 0.73, 95% CI 0.56, 0.94) of MetS per SD increase in baseline 25(OH)D. Finally, there was a significant positive association of 25(OH) D with adiponectin (beta = 0.16; 95% CI = 0.01, 0.31).
Conclusions: These results support a potential role for vitamin D metabolism in the natural history of T2DM among Aboriginal Canadians, although carefully designed randomized trials will be required to establish causality.

• 出版日期2015-8