Lower prediagnostic serum 25-hydroxyvitamin D concentration is associated with higher risk of insulin-requiring diabetes: a nested case–control study

• Published in: Diabetologia Vol. 55; no. 12; pp. 3224 - 3227
• Main Authors: Gorham, E. D., Garland, C. F., Burgi, A. A., Mohr, S. B., Zeng, K., Hofflich, H., Kim, J. J., Ricordi, C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-12-2012; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Biological and medical sciences; Case-Control Studies; Defense; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - epidemiology; Diabetes. Impaired glucose tolerance; Dietary Supplements; Dose-Response Relationship, Drug; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Health care; Human Physiology; Humans; Hypoglycemic Agents - administration & dosage; Incidence; Insulin; Insulin - administration & dosage; Internal Medicine; Laboratories; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Military personnel; Military service; Preventive medicine; Review boards; Risk Assessment; Risk Factors; Short Communication; Statistical analysis; Statistical significance; Surveillance; United States - epidemiology; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; Vitamin D Deficiency - diagnosis; Vitamin deficiency; La Jolla California; United States > US; Nested case–control study; Insulin-requiring diabetes; Military populations; 25-Hydroxyvitamin D; Type 1 diabetes mellitus; Endocrinopathy; Immunopathology; Pancreatic hormone; Autoimmune disease; Case control study; Insulin; Type 1 diabetes; Risk factor; Serum; Nested case―control study; Military
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-012-2709-8

Aims/hypothesis
Low serum 25-hydroxyvitamin D [25(OH)D] concentration may increase risk of insulin-requiring diabetes.
Methods
A nested case–control study was performed using serum collected during 2002–2008 from military service members. One thousand subjects subsequently developed insulin-requiring diabetes. A healthy control was individually matched to each case on blood-draw date (±2 days), age (±3 months), length of service (±30 days) and sex. The median elapsed time between serum collection and first diagnosis of diabetes was 1 year (range 1 month to 10 years). Statistical analysis used matched pairs and conditional logistic regression.
Results
ORs for insulin-requiring diabetes by quintile of serum 25(OH)D, from lowest to highest, were 3.5 (95% CI 2.0, 6.0), 2.5 (1.5, 4.2), 0.8 (0.4, 1.4), 1.1 (0.6, 2.8) and 1.0 (reference) (
p
trend
<0.001). The quintiles (based on fifths using serum 25(OH)D concentration in the controls) of serum 25(OH)D in nmol/l, were <43 (median 28), 43–59 (median 52), 60–77 (median 70), 78–99 (median 88) and ≥100 (median 128).
Conclusions/interpretation
Individuals with lower serum 25(OH)D concentrations had higher risk of insulin-requiring diabetes than those with higher concentrations. A 3.5-fold lower risk was associated with a serum 25(OH)D concentration ≥60 nmol/l.