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American Journal of Clinical Nutrition, Vol. 79, No. 5, 820-825, May 2004
© 2004 American Society for Clinical Nutrition

ORIGINAL RESEARCH COMMUNICATION

Hypovitaminosis D is associated with insulin resistance and ß cell dysfunction1,2,3

Ken C Chiu, Audrey Chu, Vay Liang W Go and Mohammed F Saad

1 From the Division of Clinical Epidemiology and Preventive Medicine (KCC, AC, MFS) and the Center for Clinical Nutrition (VLWG), Department of Medicine, University of California, Los Angeles, School of Medicine, Los Angeles.

Background: Although the role of vitamin D in type 2 diabetes is well recognized, its relation to glucose metabolism is not well studied.

Objective: We investigated the relation of 25-hydroxyvitamin D [25(OH)D] concentrations to insulin sensitivity and ß cell function.

Design: We enrolled 126 healthy, glucose-tolerant subjects living in California. Insulin sensitivity index (ISI) and first- and second-phase insulin responses (1stIR and 2ndIR) were assessed by using a hyperglycemic clamp.

Results: Univariate regression analyses showed that 25(OH)D concentration was positively correlated with ISI (P < 0.0001) and negatively correlated with 1stIR (P = 0.0045) and 2ndIR (P < 0.0001). Multiple regression analyses confirmed an independent correlation between 25(OH)D concentration and ISI (P = 0.0007). No independent correlation was observed between 25(OH)D concentration and 1stIR or 2ndIR. However, an independent negative relation of 25(OH)D concentration with plasma glucose concentration was observed at fasting (P = 0.0258), 60 min (P = 0.0011), 90 min (P = 0.0011), and 120 min (P = 0.0007) during the oral-glucose-tolerance test. Subjects with hypovitaminosis D (<20 ng/mL) had a greater prevalence of components of metabolic syndrome than did subjects without hypovitaminosis D (30% compared with 11%; P = 0.0076).

Conclusions: The data show a positive correlation of 25(OH)D concentration with insulin sensitivity and a negative effect of hypovitaminosis D on ß cell function. Subjects with hypovitaminosis D are at higher risk of insulin resistance and the metabolic syndrome. Further studies are required to explore the underlying mechanisms.

Key Words: Diabetes mellitus • insulin sensitivity • ß cell function • glucose metabolism • insulin resistance • vitamin D • hypovitaminosis D • metabolic syndrome




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