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Relations of vitamin D status, gender and type 2 diabetes in middle-aged Caucasians

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Abstract

Vitamin D (Vit D) deficiency may be linked to the development of obesity-associated complications such as insulin resistance and type 2 diabetes. We therefore evaluated the relationship of Vit D serum concentrations with metabolic parameters and type 2 diabetes in middle-aged Caucasian men and women. One thousand six hundred and thirty-one Caucasians (832 males, 58.8 ± 9.7 years; 799 females, 59.7 ± 10.7 years) were evaluated in a cross-sectional study. Vit D status was assessed by measuring the serum concentration of 25-hydroxyvitamin D3 [25(OH)D3]. Type 2 diabetes prevalence was ascertained by medical history, fasting plasma glucose concentrations, oral glucose tolerance testing and/or glycosylated hemoglobin. Men displayed higher crude or seasonally adjusted 25(OH)D3 serum concentrations than women (24.64 ± 10.98 vs. 22.88 ± 11.6 ng/ml; P < 0.001). Strong associations between body mass index (BMI) and 25(OH)D3 were observed in both genders (P < 0.001). Seasonally adjusted levels of 25(OH)D3 revealed stronger associations with type 2 diabetes in women than men (P < 0.001). However, adjustment for BMI and other confounding variables revealed an independent inverse association of 25(OH)D3 with diabetes only in women (P < 0.001), whereas the association was abrogated in men. Using a 15 ng/ml 25(OH)D3 cutoff for binary comparison, adjusted odds ratios for having newly diagnosed or known type 2 diabetes more than doubled (2.95 [95 % CI 1.37–4.89] and 3.26 [1.59–6.68], respectively), in women below the cutoff. We conclude that in women, but not in men, low 25(OH)D3 serum levels are independently associated with type 2 diabetes. These findings suggest sex-specific effects of Vit D in the pathogenesis of type 2 diabetes.

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Acknowledgments

We gratefully acknowledge laboratory technical support by Elke Albrecht, Monika Ratkowitsch, Carmen Winkler, Oberndorf Hospital; Angela Eich, First Department of Medicine, Paracelsus Medical University Salzburg; Silke Winkler, Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Germany and support from SPAR Austria to Christian Datz is gratefully acknowledged.

Conflicts of interest

None of the authors have any potential conflicts of interest to declare with regard to this investigation.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Internal Medicine, Oberndorf Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Paracelsusstraße 37, Oberndorf, 5110, Austria

    Andreas Stadlmayr, Ursula Huber-Schönauer, David Niederseer & Christian Datz

  2. Department of Internal Medicine 1, Paracelsus Medical University Salzburg, Salzburg, Austria

    Elmar Aigner

  3. 1st Medical Department, AUVA Trauma Center Meidling, Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna, Austria

    Jochen Zwerina & Emma Husar-Memmer

  4. Department of Internal Medicine 3, Paracelsus Medical University Salzburg, Salzburg, Austria

    Florian Hohla

  5. Department of Internal Medicine 3, Institute for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany

    Georg Schett

  6. Department of Pharmacology and Toxicology, Paracelsus Medical University, Salzburg, Austria

    Wolfgang Patsch

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  1. Andreas Stadlmayr
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Correspondence to Christian Datz.

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Managed by Massimo Porta.

Wolfgang Patsch and Christian Datz have contributed equally to this manuscript.

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Stadlmayr, A., Aigner, E., Huber-Schönauer, U. et al. Relations of vitamin D status, gender and type 2 diabetes in middle-aged Caucasians. Acta Diabetol 52, 39–46 (2015). https://doi.org/10.1007/s00592-014-0596-9

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