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United States Department of Agriculture

Agricultural Research Service

Research Project: MUSCULOSKELETAL HEALTH IN THE ELDERLY

Location: Human Nutrition Research Center on Aging

Title: Plasma 25-hydroxyvitamin D and progression to diabetes in patients at risk for diabetes: an ancillary analysis in the diabetes prevention program

Authors
item Pittas, Anastassios -
item Nelson, Jason -
item Mitri, Joanna -
item Hillmann, William -
item Garganta, Cheryl -
item Nathan, David -
item Hu, Frank -
item Dawson-Hughes, Bess -

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: January 17, 2012
Publication Date: February 1, 2012
Citation: Pittas, A.G., Nelson, J., Mitri, J., Hillmann, W., Garganta, C., Nathan, D.M., Hu, F.B., Dawson-Hughes, B. 2012. Plasma 25-hydroxyvitamin D and progression to diabetes in patients at risk for diabetes: an ancillary analysis in the diabetes prevention program. Diabetes Care. 35(3):565-573.

Interpretive Summary: The goal of this research was to investigate the association between vitamin D status, assessed by plasma 25-hydroxyvitamin D, and risk of incident diabetes. We concluded that higher plasma 25-hydroxyvitamin D, assessed repeatedly, was associated with lower risk of incident diabetes in high risk patients, after adjusting for lifestyle interventions (dietary changes, increased physical activity and weight loss) known to decrease diabetes risk. Because of the observational nature of the study, the potential association between vitamin D and diabetes needs to be confirmed in intervention studies.

Technical Abstract: We investigated the association between vitamin D status, assessed by plasma 25-hydroxyvitamin D, and risk of incident diabetes. The research design and methods were a prospective observational study with a mean follow-up of 2.7 years in the Diabetes Prevention Program (DPP), a multi-center trial comparing different strategies for prevention of diabetes in patients with pre-diabetes. We assessed the association between plasma 25-hydroxyvitamin D, measured repeatedly during follow-up, and incident diabetes in the combined placebo (n=1,022) and intensive lifestyle (n=1,017) randomized arms of the DPP. Variables measured at multiple study time points (25-hydroxyvitamin D, body mass index and physical activity) entered the analyses as time-varying “lagged” covariates, as the mean of the previous and current visit at which diabetes status was assessed. After multivariate adjustment, including for the DPP intervention, participants in the highest tertile of 25-hydroxyvitamin D (median concentration 30.1 ng/mL) had a hazard ratio of 0.72 (95%CI, 0.56 to 0.90) for developing diabetes compared to participants in the lowest tertile (median concentration 12.8 ng/mL). The association was in the same direction in placebo (0.70; 95%CI 0.52, 0.94) vs. lifestyle arm (0.80; 95%CI 0.54, 1.17). We concluded that a higher plasma 25-hydroxyvitamin D, assessed repeatedly, was associated with lower risk of incident diabetes in high risk patients, after adjusting for lifestyle interventions (dietary changes, increased physical activity and weight loss) known to decrease diabetes risk. Because of the observational nature of the study, the potential association between vitamin D and diabetes needs to be confirmed in intervention studies.

Last Modified: 9/22/2014
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