Association of 25-hydroxyvitamin D with type 2 diabetes among patients undergoing coronary angiography: cross-sectional findings from the LUdwigshafen Risk and Cardiovascular Health (LURIC) Study

• Published in: Clinical endocrinology (Oxford) Vol. 79; no. 2; pp. 192 - 198
• Main Authors: O'Hartaigh, Bríain, Neil Thomas, G., Silbernagel, Günther, Bosch, Jos A., Pilz, Stefan, Loerbroks, Adrian, Kleber, Marcus E., Grammer, Tanja B., Böhm, Bernhard O., März, Winfried
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01-08-2013; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Glucose - metabolism; Cardiovascular Diseases - etiology; Cardiovascular system; Coronary Angiography; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - prevention & control; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fundamental and applied biological sciences. Psychology; Germany; Humans; Hyperglycemia - complications; Inflammation - complications; Insulin - blood; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Prediabetic State - blood; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Vertebrates: endocrinology; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - complications; Endocrinopathy; Type 2 diabetes; Human; Radiodiagnosis; Steroid hormone; Metabolic diseases; Patient; Risk; Coronary arteriography; Association; Vitamin D; Cross sectional study; Cholecalciferol(25-hydroxy); Risk factor; Circulatory system; Endocrinology; Public health
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.12024

Summary
Objective
Evidence suggests that vitamin D may protect against the onset of diabetes. However, the mechanisms underlying the role of vitamin D on glycaemic status are unclear and warrant further investigation. We sought to determine the relationship between serum 25‐hydroxyvitamin D (25[OH]D) and glycaemic status among intermediate‐to‐high‐risk patients scheduled for coronary angiography.
Methods
Participants were 3316 male and female patients (mean ± SD age, 62·7 ± 10·6 years). Four categories were formed according to serum 25[OH]D levels. The association between serum 25[OH]D and diabetes was assessed using multivariable logistic regression.
Results
Fasting and 2 h post‐load glucose, HbA1c and the HOMA‐IR indices diminished with increasing serum 25[OH]D levels (P < 0·001). However, no associations were observed between insulin, pro‐insulin or C‐peptide and serum 25[OH]D concentrations. The pro‐inflammatory markers IL‐6 and hs‐CRP also decreased considerably with higher vitamin D levels (P < 0·001). After full adjustment, those with optimal serum 25[OH]D levels had a reduced odds for fasting diabetes (OR = 0·63; 95% CI, 0·46–0·86; Ptrend = 0·01), 2 h post‐load diabetes (OR = 0·46; 95% CI, 0·29–0·74; Ptrend = 0·004), both fasting/2 h post‐load diabetes (OR = 0·61; 95% CI, 0·42–0·87; Ptrend = 0·001) and all of the combined hyperglycaemic states (OR = 0·68; 95% CI, 0·52–0·80; Ptrend = 0·01).
Conclusions
Higher serum 25[OH]D levels were associated with better glycaemic status and lower inflammation. Should these observations be confirmed in future studies, vitamin D supplementation may prove a useful adjunct in attenuating the onset of diabetes.