Skip to main content Accessibility help
×
Home

Inverse relationship between vitamin D status and insulin resistance and the risk of impaired fasting glucose in Korean children and adolescents: the Korean National Health and Nutrition Examination Survey (KNHANES) 2009–2010

  • Seung Joon Chung (a1), Young Ah Lee (a1), Hyunsook Hong (a2), Min Jae Kang (a1), Hyun Jin Kwon (a3), Choong Ho Shin (a1) and Sei Won Yang (a1)...

Abstract

Objective

To investigate whether low vitamin D status was related to insulin resistance (IR) or impaired fasting glucose (IFG) in Korean adolescents, after adjusting for total body fat mass (FM).

Design

A cross-sectional study.

Setting

Korea National Health and Nutrition Examination Survey (KNAHNES) 2009–2010.

Subjects

In total, 1466 participants (769 males) aged 10–19 years were assessed for serum 25-hydroxyvitamin D (25(OH)D) levels, for FM by whole-body dual-energy X-ray absorptiometry and for IR by homeostasis model assessment (HOMA-IR) after an 8 h fast.

Results

Age-, sex-, season- and physical-activity-adjusted regression models showed that serum 25(OH)D levels were significantly related to markers of adiposity (P = 0·016 for FM (g), P = 0·023 for FM (%) and P = 0·035 for fat mass index). When the participants were stratified into three 25(OH)D categories (<37·5 nmol/l (n 553), 37·5 to < 50 nmol/l (n 543) and ≥ 50 nmol/l (n 370)), significantly decreasing trends were observed for fasting insulin (all P < 0·001), HOMA-IR (all P < 0·001) and the odds ratios for IFG (all P for trend < 0·05) from the lowest to the highest 25(OH)D category, after adjustments for age, sex, physical activity and all markers of adiposity. In the multivariate logistic regression analysis, the likelihood of participants in the lowest serum 25(OH)D category having IFG was 2·96–3·15 compared with those in the highest 25(OH)D category (all P < 0·05).

Conclusions

There was a significant inverse relationship between vitamin D status and IR and the risk of IFG, independent of adiposity, in Korean adolescents.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Inverse relationship between vitamin D status and insulin resistance and the risk of impaired fasting glucose in Korean children and adolescents: the Korean National Health and Nutrition Examination Survey (KNHANES) 2009–2010
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Inverse relationship between vitamin D status and insulin resistance and the risk of impaired fasting glucose in Korean children and adolescents: the Korean National Health and Nutrition Examination Survey (KNHANES) 2009–2010
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Inverse relationship between vitamin D status and insulin resistance and the risk of impaired fasting glucose in Korean children and adolescents: the Korean National Health and Nutrition Examination Survey (KNHANES) 2009–2010
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Email nina337@snu.ac.kr

References

Hide All
1. Kumar, J, Muntner, P, Kaskel, FJ et al. (2009) Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics 124, e362e370.
2. Choi, HS, Oh, HJ, Choi, H et al. (2011) Vitamin D insufficiency in Korea – a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 96, 643651.
3. Bouillon, R, Carmeliet, G, Verlinden, L et al. (2008) Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 29, 726776.
4. Gagnon, C, Lu, ZX, Magliano, DJ et al. (2012) Low serum 25-hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study (The Australian Diabetes, Obesity and Lifestyle Study: AusDiab). J Clin Endocrinol Metab 97, 19531961.
5. Lu, L, Yu, Z, Pan, A et al. (2009) Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 32, 12781283.
6. Choi, HS, Kim, KA, Lim, CY et al. (2011) Low serum vitamin D is associated with high risk of diabetes in Korean adults. J Nutr 141, 15241528.
7. Kayaniyil, S, Retnakaran, R, Harris, SB et al. (2011) Prospective associations of vitamin D with β-cell function and glycemia: the PROspective Metabolism and ISlet cell Evaluation (PROMISE) cohort study. Diabetes 60, 29472953.
8. Gagnon, C, Lu, ZX, Magliano, DJ et al. (2011) Serum 25-hydroxyvitamin D, calcium intake, and risk of type 2 diabetes after 5 years: results from a national, population-based prospective study (the Australian Diabetes, Obesity and Lifestyle Study). Diabetes Care 34, 11331138.
9. Reis, JP, von Muhlen, D, Miller, ER et al. (2009) Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics 124, e371e379.
10. Ganji, V, Zhang, X, Shaikh, N et al. (2011) Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted serum 25-hydroxyvitamin D data from NHANES 2001–2006. Am J Clin Nutr 94, 225233.
11. Maestro, B, Davila, N, Carranza, MC et al. (2003) Identification of a vitamin D response element in the human insulin receptor gene promoter. J Steroid Biochem Mol Biol 84, 223230.
12. Maestro, B, Campion, J, Davila, N et al. (2000) Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 47, 383391.
13. Pittas, AG, Lau, J, Hu, FB et al. (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92, 20172029.
14. Johnson, JA, Grande, JP, Roche, PC et al. (1994) Immunohistochemical localization of the 1,25(OH)2D3 receptor and calbindin D28k in human and rat pancreas. Am J Physiol 267, E356E360.
15. Bland, R, Markovic, D, Hills, CE et al. (2004) Expression of 25-hydroxyvitamin D3–1α-hydroxylase in pancreatic islets. J Steroid Biochem Mol Biol 89–90, 121125.
16. Alvarez, JA & Ashraf, A (2010) Role of vitamin D in insulin secretion and insulin sensitivity for glucose homeostasis. Int J Endocrinol 2010, 351385.
17. Korea Centers for Disease Control and Prevention, The Korean Pediatric Society, The Committee for the Development of Growth Standard for Korean Children and Adolescents (2008) 2007 Korean Children and Adolescents Growth Standard. http://www.cdc.go.kr/CDC/cms/cmsFileDownload.jsp?fid=28&cid=1235&fieldName=attach1&index=1 (accessed November 2012).
18. US Department of Health and Human Services (2011) 2008 Physical activity guidelines for Americans: be active, healthy, and happy! http://www.health.gov/paguidelines (accessed February 2013).
19. Korea Centers for Disease Control and Prevention (2009) The Statistics of 5th Korea Youth Risk Behavior Web-based Survey (KYRBWS) in 2009. http://yhs.cdc.go.kr/ (accessed November 2012).
20. Sempos, CT, Vesper, HW, Phinney, KW et al. (2012) Vitamin D status as an international issue: national surveys and the problem of standardization. Scand J Clin Lab Invest Suppl 243, 3240.
21. Matthews, DR, Hosker, JP, Rudenski, AS et al. (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412419.
22. Katz, A, Nambi, SS, Mather, K et al. (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85, 24022410.
23. Wells, JC (2001) A critique of the expression of paediatric body composition data. Arch Dis Child 85, 6772.
24. Cole, TJ & Green, PJ (1992) Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 11, 13051319.
25. Del Gobbo, LC, Song, Y, Dannenbaum, DA et al. (2011) Serum 25-hydroxyvitamin D is not associated with insulin resistance or β cell function in Canadian Cree. J Nutr 141, 290295.
26. Rajakumar, K, de las Heras, J, Lee, S et al. (2012) 25-Hydroxyvitamin D concentrations and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity in black and white youth. Diabetes Care 35, 627633.
27. Pacifico, L, Anania, C, Osborn, JF et al. (2011) Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol 165, 603611.
28. Rajakumar, K, de las Heras, J, Chen, TC et al. (2011) Vitamin D status, adiposity, and lipids in black American and Caucasian children. J Clin Endocrinol Metab 96, 15601567.
29. Golden, SH, Brown, A, Cauley, JA et al. (2012) Health disparities in endocrine disorders: biological, clinical, and nonclinical factors – an Endocrine Society scientific statement. J Clin Endocrinol Metab 97, e1579e1639.
30. Chan, JC, Malik, V, Jia, W et al. (2009) Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA 301, 21292140.
31. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA et al. (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96, 19111930.
32. Kremer, R, Campbell, PP, Reinhardt, T et al. (2009) Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab 94, 6773.
33. Hatun, S, Islam, O, Cizmecioglu, F et al. (2005) Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr 135, 218222.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed