Diabetes Care：循环25（OH）D与2型糖尿病风险呈负相关

为了量化评估血液25羟维生素D[25(OH)D]水平与2型糖尿病发生风险之间相关性的强度和模型。来自美国马萨诸塞州波士顿市哈佛大学预防医学系的Yiqing Song博士及其团队进行了一项研究，该研究发现循环25（OH）D水平与2型糖尿病风险之间呈显著负相关。该研究结果发表在2013年4月的美国《糖尿病治疗》（Diabetes Care）杂志上。
该研究中，在2012年10月31前系统性检索MEDLINE和Embase数据库，并手工检索原始报告的参考文献。对评估血液25（OH）D水平与2型糖尿病发生风险关系的前瞻性观察性研究进行荟萃分析。使用DerSimonian和Laird′s随机效应模型。使用二元曲线回归分析检验这个用广义的最小二乘趋势检验进行量效关系的相关模型。
该研究结果表明，共有21项前瞻性研究，包括76220例参与者和4996例2型糖尿病病例选入荟萃分析。最高范畴与最低范畴的25（OH）D水平相比，2型糖尿病总的相对风险为0.62（95%CI 0.54–0.70）。曲线回归模型显示较高的25（OH）D水平与较低的糖尿病风险单调相关。这个负相关不因性别、随访时间、研究样本量、糖尿病诊断标准或是25（OH）D检测方法而有差异。线性趋势分析显示25（OH）D水平每增加10nmol/l，与2型糖尿病风险降低4%有关（95%CI 3–6；线性趋势的P值＜0.0001）。
该研究发现，在不同人群的血液25（OH）D水平宽大范围中，循环25（OH）D水平与2型糖尿病风险之间呈显著负相关。
与糖尿病相关的拓展阅读：

• GLP-1类糖尿病药物的胰腺炎风险引起监管机构重视
• Diabetes Care：糖尿病视网膜病和微量白蛋白尿可预测T2DM患者大量白蛋白尿和肾功能减退
• NEJM：糖尿病治疗领域的进展与不足
• JAMA：研究支持对糖尿病患者进行更强力的抗血小板治疗
• Obes Surg：减重手术可能不能“治愈”糖尿病
• Cell Metab:新的血清标志物提前数年预测糖尿病风险
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Blood 25-Hydroxy Vitamin D Levels and Incident Type 2 Diabetes: A meta-analysis of prospective studies.
OBJECTIVE
To quantitatively assess the strength and shape of the association between blood 25-hydroxy vitamin D [25(OH)D] levels and incident risk of type 2 diabetes.
RESEARCH DESIGN AND METHODS
A systematic search of the MEDLINE and Embase databases and a hand search of references from original reports were conducted up to 31 October 2012. Prospective observational studies that assessed the association between blood levels of 25(OH)D and risk of incident type 2 diabetes were included for meta-analysis. DerSimonian and Laird's random-effects model was used. A quadratic spline regression analysis was used to examine the shape of the association with a generalized least-squares trend test performed for the dose-response relation.
RESULTS
A total of 21 prospective studies involving 76,220 participants and 4,996 incident type 2 diabetes cases were included for meta-analysis. Comparing the highest to the lowest category of 25(OH)D levels, the summary relative risk for type 2 diabetes was 0.62 (95% CI 0.54-0.70). A spline regression model showed that higher 25(OH)D levels were monotonically associated with a lower diabetes risk. This inverse association did not differ by sex, duration of follow-up, study sample size, diabetes diagnostic criteria, or 25(OH)D assay method. A linear trend analysis showed that each 10 nmol/L increment in 25(OH)D levels was associated with a 4% lower risk of type 2 diabetes (95% CI 3-6; P for linear trend < 0.0001).
CONCLUSIONS
Our meta-analysis showed an inverse and significant association between circulating 25(OH)D levels and risk of type 2 diabetes across a broad range of blood 25(OH)D levels in diverse populations.