title: Decreased serum concentrations of 25-hydroxycholecalciferol are associated with increased risk of progression to impaired fasting glucose and diabetes.
abstract: OBJECTIVE
  To study the association between vitamin D status and the risk of incident impaired fasting glucose (IFG) and diabetes in a population-based cohort of diabetes-free subjects.
  
  
  METHODS
  In a historical prospective cohort study of subjects from the Clalit Health Services database, which includes information on nearly 4 million people, diabetes-free subjects aged 40-70 years with serum 25-hydroxycholecalciferol (25-OHD) measurements available were followed for 2 years to assess the development of IFG and diabetes in five 25-OHD subgroups: ≥25, 25.1-37.5, 37.6-50, 50.1-75, and >75 nmol/L.
  
  
  RESULTS
  The baseline cohort included 117,960 adults: 83,526 normoglycemic subjects and 34,434 subjects with IFG. During follow-up, 8,629 subjects (10.3% of the normoglycemic group) developed IFG, and 2,162 subjects (1.8% of the total cohort) progressed to diabetes. A multivariable model adjusted for age, sex, population group, immigrant status, BMI, season of vitamin D measurement, LDL and HDL cholesterol, triglycerides, estimated glomerular filtration rate, history of hypertension or cardiovascular disease, Charlson comorbidity index, smoking, and socioeconomic status revealed an inverse association between 25-OHD and the risk of progression to IFG and diabetes. The odds of transitioning from normoglycemia to IFG, from normoglycemia to diabetes, and from IFG to diabetes in subjects with a 25-OHD level ≤25 nmol/L were greater than those of subjects with a 25-OHD level >75 nmol/L [odds ratio 1.13 (95% CI 1.03-1.24), 1.77 (1.11-2.83), and 1.43 (1.16-1.76), respectively].
  
  
  CONCLUSIONS
  Vitamin D deficiency appears to be an independent risk factor for the development of IFG and diabetes.
authors: Clalit Health Services, Jerusalem, Israel. tsuranat@netvision.net.il
authors: Anat
authors: A
authors: Tsur
authors: Becca S
authors: BS
authors: Feldman
authors: Ilan
authors: I
authors: Feldhammer
authors: Moshe B
authors: MB
authors: Hoshen
authors: Gil
authors: G
authors: Leibowitz
authors: Ran D
authors: RD
authors: Balicer
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002112:Calcifediol / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism*; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D002112:Calcifediol
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