Short Communication

Diabetologia

, Volume 55, Issue 12, pp 3224-3227

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

  • E. D. GorhamAffiliated withNaval Health Research CenterDepartment of Family and Preventive Medicine, University of California San Diego Email author 
  • , C. F. GarlandAffiliated withNaval Health Research CenterDepartment of Family and Preventive Medicine, University of California San Diego
  • , A. A. BurgiAffiliated withNaval Health Research Center
  • , S. B. MohrAffiliated withNaval Health Research CenterDepartment of Family and Preventive Medicine, University of California San Diego
  • , K. ZengAffiliated withNaval Health Research Center
  • , H. HofflichAffiliated withDivision of Internal Medicine, Department of Medicine, University of California San Diego
  • , J. J. KimAffiliated withNaval Health Research Center
  • , C. RicordiAffiliated withMiami Diabetes Research Institute, Department of Surgery and Cell Transplant Center, University of Miami Miller School of Medicine

Abstract

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.

Keywords

25-Hydroxyvitamin D Insulin-requiring diabetes Military populations Nested case–control study Type 1 diabetes mellitus