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

Clin Endocrinol (Oxf). 2013 Aug;79(2):192-8. doi: 10.1111/cen.12024. Epub 2013 Apr 1.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / etiology
  • Coronary Angiography
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Female
  • Germany
  • Humans
  • Hyperglycemia / complications
  • Inflammation / complications
  • Insulin / blood
  • Male
  • Middle Aged
  • Prediabetic State / blood
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications

Substances

  • Blood Glucose
  • Insulin
  • Vitamin D
  • 25-hydroxyvitamin D