Vitamin D, type 2 diabetes and other metabolic outcomes: a systematic review and meta-analysis of prospective studies

Abstract

Vitamin D status may influence the risk of developing metabolic diseases such as Type 2 diabetes (T2D), metabolic syndrome (MetS) and insulin resistance (IR). Several studies have assessed vitamin D in relationship with metabolic outcomes; however, results remain inconsistent. A systematic review and meta-analysis using multiple databases (MEDLINE, Web of Science and EMBASE), was performed up to 10 August 2012. Prospective studies reporting association of circulating or dietary vitamin D with incident T2D, MetS and IR outcomes were included. Relative risks (RR) were pooled using random effects and subgroup analysis by pertinent study-level characteristics was performed. A total of seventeen articles based on eighteen unique prospective studies, and comprising 210 107 participants with 15 899 metabolic events, collected during a median follow up of 10 years (range 3-22 years), were included. RR for individuals in top v. bottom thirds of baseline vitamin D were 0 . 81 (95 % CI 0 . 71, 0 . 92); 0 . 86 (95 % CI 0 . 80, 0 . 92); and 0 . 84 (95 % CI 0 . 64, 1 . 12) for T2D, MetS and IR outcomes, respectively. Moderate heterogeneity was found between fourteen studies (I 2 = 67 %, P < 0 . 001) reporting on T2D. Findings were generally consistent across various study-level characteristics. In conclusion, vitamin D status at baseline in apparently healthy adults is inversely associated with future risks of T2D and MetS. Interventions aimed at maintaining adequate levels of vitamin D in addition to preventing deficiency may be a useful preventive measure for metabolic diseases. However, reliable evidence from carefully designed intervention studies, particularly those based on healthy populations, is needed to confirm observational findings.

Vitamin D status and metabolic syndrome in the elderly: the Rotterdam Study

“…Other previous studies have found an inverse association between vitamin D status and MetS (4,7,8,11) and our estimates fall within the range reported. However, the majority of the associations reported elsewhere were observed in younger populations (7,8), such as the findings from a longitudinal study conducted among Australian adults by Gagnon et al (11).…”

“…However, the majority of the associations reported elsewhere were observed in younger populations (7,8), such as the findings from a longitudinal study conducted among Australian adults by Gagnon et al (11). They found that lower concentrations of serum vitamin D status were associated with increased risk of MetS (11).…”

“…The association between vitamin D status and MetS has previously been studied in different populations (7,8). Animal models and in vitro studies provide an insight into mechanisms (9,10) of vitamin D metabolic actions, while meta-analyses of epidemiological studies confirm inverse associations between serum vitamin D status and MetS (7,8).…”

“…Animal models and in vitro studies provide an insight into mechanisms (9,10) of vitamin D metabolic actions, while meta-analyses of epidemiological studies confirm inverse associations between serum vitamin D status and MetS (7,8). However, the most of the studies published on this topic were conducted in younger populations (11), and subgroup analyses of data from the elderly (aged 65 years and older) are not conclusive and two of the studies focusing on this age group yielded contradictory results (12,13).…”

Global vitamin D status problems: causes, pathogenetic mechanisms, treatment, prevention measures

“…До недавнего времени дефицит витамина D был связан главным образом с риском развития рахита, деминерализацией костной структуры [30]. В исследо-ваниях последних лет отмечено, что снижение концен-трации витамина D -потенциальный значимый фактор риска для таких заболеваний, как рак, сердечно-сосуди-стые заболевания [31][32][33], сахарный диабет [34][35][36], артериальная гипертензия [37][38][39], аутоиммунные заболевания [40][41][42], нарушения обмена веществ [43,44], инфекционные заболевания, вызванные снижени-ем иммунитета [45], и некоторые психоневрологиче-ские расстройства [46]. Дефицит витамина D увеличива-ет частоту преждевременных родов, снижение веса при рождении и гипертонической болезни во время бере-менности [47][48][49][50][51][52].…”