title: Association of vitamin D levels with type 2 diabetes in older working adults.
abstract: OBJECTIVE
  Increasing evidence suggests that vitamin D plays a role in the development of chronic diseases including type 2 diabetes (DM). Aim of the study was to explore the association of vitamin D levels with prevalent DM in a sample of predominantly healthy working adults older than 45 years.
  
  
  METHODS
  This cross-sectional study (2009-2011) involved 1821 employees of a German engineering company (83.1% male, mean age 51.9 ±5.6 years). Sociodemographics and medical history were assessed by self-report. Clinical characteristics were obtained including blood samples to determine vitamin D levels and diabetes status by fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c). Vitamin D was grouped into one of four categories (<10 ng/ml, 10-19.9 ng/ml, 20-29.9 ng/ml, ≥30 ng/ml). Bivariate associations between vitamin D categories and a composite indicator for DM (FPG ≥126 mg/dl or HbA1c ≥6.5% or self-reported diagnosis) were calculated; multivariable models tested this association further, controlling for potential confounders.
  
  
  RESULTS
  Severe vitamin D deficiency (<10 ng/ml) was associated with increasing FPG (β 3.13; 95% CI: 0.78, 5.47; p≤0.01) and HbA1c (β 0.15; 95% CI: 0.08, 0.23; p≤0.001) values in adjusted linear regression models. In multivariable models, severe vitamin D deficiency was associated with DM (OR 2.55; 95%CI 1.16, 5.62; p≤0.05) after controlling for potential confounders.
  
  
  CONCLUSIONS
  Vitamin D deficiency is associated with prevalent DM in working older adults. The findings highlight that the workplace may be a unique location for conducting large-scale health screening to identify those at risk of DM using vitamin D.
authors.affiliation: 1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mauss
authors.affiliation: 1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Jarczok
authors.affiliation: 1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Hoffmann
authors.affiliation: 1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. ; 2. Department of Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, United Kingdom.
authors.forename: G Neil
authors.initials: GN
authors.lastname: Thomas
authors.affiliation: 1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Fischer
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25-hydroxyvitamin D; cardiovascular disease; diabetes mellitus; employees; work health check