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Lower prediagnostic serum 25‐hydroxyvitamin D concentration is associated with increased incidence of type 1 diabetes in the U. S. military: a nested case‐control study
Author(s) -
Gorham Edward Doerr,
Garland Cedric Frank,
Burgi Alina,
Mohr Sharif Burgette,
Zeng Kenneth,
Hofflich Heather,
Ricordi Camillo
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.41.3
Subject(s) - type 2 diabetes , vitamin d and neurology , medicine , diabetes mellitus , incidence (geometry) , odds ratio , nested case control study , gastroenterology , logistic regression , endocrinology , vitamin d deficiency , case control study , mathematics , geometry
Low serum 25‐hydroxyvitamin D (25(OH)D) concentration may increase risk of Type 1 diabetes. This is the first study to describe an inverse association of 25(OH)D with Type 1 diabetes incidence, using serum collected before diagnosis. A nested case‐control study was done using serum collected during 2002–2008 from service members. 1000 subjects subsequently developed Type 1 diabetes. A healthy control was individually matched to each case on blood draw date (± 2 days), age (± 3 months), length of service (± 30 days), and gender. Matched pairs and conditional logistic regression were performed. Odds ratios for Type 1 diabetes by quintile of serum 25(OH)D, from lowest to highest, were 3.5 (95% CI, 2.0–6.0), 2.5 (1.5–4.2), 0.8 (0.4–1.4), 1.1 (0.6–2.8) and 1.0 (reference) ( p trend < 0.001). The quintiles of serum 25(OH)D in nmol/L, were < 43 (mean 28), 43–61 (mean 52), 62–77 (mean 69), 78–99 (mean 87), and ≥ 100 (mean 125). 3.5‐fold greater risk was associated with serum 25(OH)D < 43 nmol/L, compared to ≥ 70 nmol/L. Maintaining > 70 nmol/L is consistent with 4,000 IU/d tolerable intake of vitamin D at ages ≥ 9 years, according to a 2011 National Academy of Sciences monograph. A proposed model is outlined that could explain the inverse association of 25(OH)D with Type 1 diabetes, the DIAB epithelial barrier model. Supported by NHRC Work Unit 60126. Thanks to Dr. Angelee Eick, AFHSC.