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

Authors

  • Bríain O'Hartaigh,

    1. Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
    2. School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK
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  • G. Neil Thomas,

    Corresponding author
    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
    • Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
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  • Günther Silbernagel,

    1. Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University, Tübingen, Germany
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  • Jos A. Bosch,

    1. School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK
    2. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
    3. Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
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  • Stefan Pilz,

    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
    2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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  • Adrian Loerbroks,

    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
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  • Marcus E. Kleber,

    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
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  • Tanja B. Grammer,

    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
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  • Bernhard O. Böhm,

    1. Division of Endocrinology and Diabetes, Department of Internal Medicine I, Ulm University, Ulm, Germany
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  • Winfried März

    1. Social and Preventive Medicine, Mannheim Medical Faculty, Institute of Public Health, University of Heidelberg, Mannheim, Germany
    2. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
    3. Synlab Academy, Synlab Services GmbH, Mannheim, Germany
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Correspondence: G. Neil Thomas, Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, B15 2TT, UK.Tel.: +44 121 4148696; Fax: +44 121 4147878; E-mail: gneilthomas@yahoo.co.uk

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.

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