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The Differential Role of Vitamin D in Type 2 Diabetes Management and Control in Minority Populations

  • Miyong To Kim
  • Kim Byeng KimEmail author
  • Jisook Ko
  • Nicole Murry
  • David Levine
  • Ju-Young Lee
Original Paper

Abstract

Vitamin D deficiency is associated with incidence of type 2 diabetes (T2DM) as well as poor glycemic control among T2DM patients, yet comparative studies of its association among ethnic minority populations are scarce. Using baseline data from a behavioral intervention study of Korean Americans (KAs) with T2DM (N = 250 KAs) and the NHANES data set, we explored differential roles of vitamin D on HbA1C level or T2DM control in several racial groups. Significantly more KAs (55.2%) were vitamin D-deficient (U.S. average, 37.8%). Both common and unique correlates of vitamin D deficiency in minority populations were identified, including significant associations between Vitamin D and HbA1C in both non-diabetic and diabetic populations. Future studies are warranted to explain the causal mechanism of the effect of vitamin D and glycemic control as well as to examine contextual factors associated with vitamin D deficiency in certain minority groups.

Clinical Trials Registry: Identifier NCT01264796

Keywords

Vitamin D Type 2 diabetes Self-help Korean Americans NHANES 

Notes

Acknowledgements

The study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R18DK083936), with material support from LifeScan, including devices (OneTouch glucometers, OneTouch UltraSoft® test strips, and OneTouch UltraSoft lancets) for study participants. In addition, the Johns Hopkins ICTR supported the cost of blood serum lab tests. The authors are grateful for substantial editorial assistance provided by Dr. Deborah McClellan. Editorial support with manuscript development was also provided by the Cain Center for Nursing Research and the Center for Transdisciplinary Collaborative Research in Self-management Science (P30, NR015335) at The University of Texas at Austin School of Nursing. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other supporters.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human Participant Protection

The research protocol was approved by the Johns Hopkins Medical Institutions Institutional Review Board, and written consent was obtained from all study participants.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92(6):2017–29.  https://doi.org/10.1210/jc.2007-0298.CrossRefGoogle Scholar
  2. 2.
    Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr. 2011;65(9):1005–15.  https://doi.org/10.1038/ejcn.2011.118.CrossRefGoogle Scholar
  3. 3.
    Mathieu C. Vitamin D and diabetes: where do we stand? Diabetes Res Clin Prac. 2015;108(2):201–9.  https://doi.org/10.1016/j.diabres.2015.01.036.CrossRefGoogle Scholar
  4. 4.
    Karnchanasorn R, Ou HY, Chiu KC. Plasma 25-hydroxyvitamin D levels are favorably associated with β-cell function. Pancreas. 2012;41(6):863–8.  https://doi.org/10.1097/MPA.0b013e31823c947c.CrossRefGoogle Scholar
  5. 5.
    Ozfirat Z, Chowdhury TA. Vitamin D deficiency and type 2 diabetes. Postgrad Med J. 2010;86(1011):18–25.  https://doi.org/10.1136/pgmj.2009.078626.CrossRefGoogle Scholar
  6. 6.
    Guadarrama-López AL, Valdés-Ramos R, Martínez-Carrillo BE. Type 2 diabetes, PUFAs, and vitamin D: their relation to inflammation. J Immunol Res. 2014;2014:860703.  https://doi.org/10.1155/2014/860703.CrossRefGoogle Scholar
  7. 7.
    Quan W, Jo EK, Lee MS. Role of pancreatic β-cell death and inflammation in diabetes. Diabetes Obes Metab. 2013;15(suppl 3):141–51.  https://doi.org/10.1111/dom.12153.CrossRefGoogle Scholar
  8. 8.
    Hewison M. Vitamin D and immune function: autocrine, paracrine or endocrine? Scand J Clin Lab Invest. 2012;72(suppl 243):92–102.Google Scholar
  9. 9.
    Calton EK, Keane KN, Newsholme P, Soares MJ. The impact of vitamin D levels on inflammatory status: a systematic review of immune cell studies. PLoS ONE. 2015;10(11):e0141770.  https://doi.org/10.1371/journal.pone.0141770.CrossRefGoogle Scholar
  10. 10.
    Mattila C, Knekt P, Männistö S, et al. Serum 25-hydroxyvitamin D concentration and subsequent risk of type 2 diabetes. Diabetes Care. 2007;30(10):2569–70.  https://doi.org/10.2337/dc07-0292.CrossRefGoogle Scholar
  11. 11.
    Knekt P, Laaksonen M, Mattila C, et al. Serum vitamin D and subsequent occurrence of type 2 diabetes. Epidemiology. 2008;19(5):666–71.  https://doi.org/10.1097/EDE.0b013e318176b8ad.CrossRefGoogle Scholar
  12. 12.
    Liu E, Meigs JB, Pittas AG, et al. Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study. Am J Clin Nutr. 2010;91(6):1627–33.  https://doi.org/10.3945/ajcn.2009.28441.CrossRefGoogle Scholar
  13. 13.
    Pittas AG, Dawson-Hughes B, Li T, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;29(3):650–6.  https://doi.org/10.2337/diacare.29.03.06.dc05-1961.CrossRefGoogle Scholar
  14. 14.
    Kositsawat J, Freeman VL, Gerber BS, Geraci S. Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey. Diabetes Care. 2010;33(6):1236–8.  https://doi.org/10.2337/dc09-2150.CrossRefGoogle Scholar
  15. 15.
    Kabadi SM, Lee BK, Liu L. Joint effects of obesity and vitamin D insufficiency on insulin resistance and type 2 diabetes: results from the NHANES 2001–2006. Diabetes Care. 2012;35(10):2048–54.  https://doi.org/10.2337/dc12-0235.CrossRefGoogle Scholar
  16. 16.
    Mangin M, Sinha R, Fincher K. Inflammation and vitamin D: the infection connection. Inflamm Res. 2014;63(10):803–19.  https://doi.org/10.1007/s00011-014-0755-z.CrossRefGoogle Scholar
  17. 17.
    Ye Z, Sharp SJ, Burgess S, et al. Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: a Mendelian randomisation study. Lancet Diabetes Endocrinol. 2015;3(1):35–42.  https://doi.org/10.1016/S2213-8587(14)70184-6.CrossRefGoogle Scholar
  18. 18.
    Brouwer-Brolsma EM, Bischoff-Ferrari HA, Bouillon R, et al. Vitamin D: do we get enough? A discussion between vitamin D experts in order to make a step towards the harmonisation of dietary reference intakes for vitamin D across Europe. Osteoporos Int. 2013;24(5):1567–77.  https://doi.org/10.1007/s00198-012-2231-3.CrossRefGoogle Scholar
  19. 19.
    Kim MT, Han HR, Song HJ, et al. A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. Diabetes Educ. 2009;35(6):986–94.  https://doi.org/10.1177/0145721709345774.CrossRefGoogle Scholar
  20. 20.
    Kim MT, Kim KB, Huh B, et al. The effect of a community-based self-help intervention: Korean Americans with type 2 diabetes. Am J Prev Med. 2015;49(5):726–37.  https://doi.org/10.1016/j.amepre.2015.04.033.CrossRefGoogle Scholar
  21. 21.
    Centers for Disease Control and Prevention, National Center for Health Statistics. Analytical note for 25-hydroxyvitamin D data analysis using NHANES III (1988–1994), NHANES 2001–2006, and NHANES 2007–2010 (October 2015). https://wwwn.cdc.gov/nchs/nhanes/vitamind/analyticalnote.aspx.
  22. 22.
    Tutuncu Y, Satman I, Celik S, et al. A comparison of hs-CRP levels in new diabetes groups diagnosed based on FPG, 2-hPG, or HbA1c criteria. J Diabetes Res. 2016;2016:5827041.  https://doi.org/10.1155/2016/5827041.CrossRefGoogle Scholar
  23. 23.
    Institute of Medicine (US). Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press; 2011.Google Scholar
  24. 24.
    Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab. 2012;97(4):1153–8.  https://doi.org/10.1210/jc.2011-2601.CrossRefGoogle Scholar
  25. 25.
    Shin J, Park SY, Cho S, et al. Validation of Patient Health Questionnaire-9 Korean Version (PHQ-9K) scale for screening depression among Korean Americans in community settings. J Theory Constr Test. 2010;14(2):45–50.  https://doi.org/10.1177/1043659607305191.Google Scholar
  26. 26.
    Barba C, Cavalli-Sforza T, Cutter J, et al. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363:157–63.  https://doi.org/10.1016/S0140-6736(03)15268-3.CrossRefGoogle Scholar
  27. 27.
    Ford ES, Ajani UA, McBuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005;28(5):1228–30.  https://doi.org/10.2337/diacare.28.5.1228.CrossRefGoogle Scholar
  28. 28.
    Schroeder SA. We can do better—improving the health of the American people. N Engl J Med. 2007;357(12):1221–8.  https://doi.org/10.1056/NEJMsa073350.CrossRefGoogle Scholar
  29. 29.
    Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444(7121):840–6.  https://doi.org/10.1038/nature05482.CrossRefGoogle Scholar
  30. 30.
    Sung KC, Jeong WS, Wild SH, Byrne CD. Combined influence of insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes. Diabetes Care. 2012;35(4):717–22.  https://doi.org/10.2337/dc11-1853.CrossRefGoogle Scholar
  31. 31.
    Lee DH, Jung KY, Park KS, et al. Characterization of patients with type 2 diabetes according to body mass index: Korea National Health and Nutrition Examination Survey from 2007 to 2011. Endocrinol Metab. 2015;30(4):514–21.  https://doi.org/10.3803/EnM.2015.30.4.514.CrossRefGoogle Scholar
  32. 32.
    Mitri J, Pittas AG. Vitamin D and diabetes. Endocrin Metabol Clin North Am. 2014;43(1):205–32.  https://doi.org/10.1016/j.ecl.2013.09.010.CrossRefGoogle Scholar
  33. 33.
    Buijsse B. Vitamin D for prevention of type 2 diabetes: a clouded forecast for the sunshine vitamin. Lancet Diabetes Endocrinol. 2015;3(1):5–6.  https://doi.org/10.1016/S2213-8587(14)70202-5.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of NursingThe University of Texas at AustinAustinUSA
  2. 2.Korean Resource CenterEllicott CityUSA
  3. 3.School of NursingUT Health Science San AntonioSan AntonioUSA
  4. 4.School of MedicineJohns Hopkins UniversityBaltimoreUSA
  5. 5.College of NursingThe Catholic University of KoreaSeoulSouth Korea

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