title: Vitamin D deficiency is associated with high prevalence of diabetes in Kuwaiti adults: results from a national survey.
abstract: BACKGROUND
  Vitamin D homeostasis may play a critical role in glucose metabolism. Little is known on vitamin D deficiency and its association with diabetes in countries of the Arabia Gulf where the population is experiencing a rapid increase in the incidence of diabetes.
  
  
  METHODS
  In a cross-sectional study of 960 adults enrolled in the first National Nutrition Survey of the State of Kuwait (NNSSK), we examined vitamin D status in association with the prevalence of diabetes and prediabetes. Vitamin D status was measured by serum levels of 25-hydroxyvitami D (25(OH)D). Prevalences of diabetes and prediabetes were determined based on fasting glucose and HbA1C levels.
  
  
  RESULTS
  The median level of serum 25(OH)D in Kuwaiti adults was 13.8 ng/ml. Approximately 56 % of the Kuwaiti adults had vitamin D inadequacy (25(OH)D = 12-19.9 ng/ml), and 27 % had vitamin D deficiency (25(OH)D < 12 ng/ml). The prevalences of prediabetes and diabetes were 40 and 27 %, respectively. Vitamin D inadequacy (OR = 1.7, 95 % CI: 1.0-2.9) and deficiency (OR =2.0, 95 % CI: 1.1-3.3) was each associated with about two-fold increased odds of prediabetes compared to sufficient vitamin D status (25(OH)D ≥ 20 ng/ml). Vitamin D inadequacy (OR =2.1, 95 % CI: 1.2-3.7) and deficiency (OR =2.0, 95 % CI: 1.1-3.9) were also associated with two-fold increased odds of diabetes.
  
  
  CONCLUSIONS
  Data from Kuwaiti's first nutrition nutritional survey suggests a very high prevalence of vitamin D deficiency in Kuwaiti adults. Associations of low vitamin D status and high prevalence of diabetes point to the need of continuous monitoring of vitamin D status and further evaluating potential health consequences in this high-risk population.
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA. fang_fang.zhang@tufts.edu.
authors.forename: Fang Fang
authors.initials: FF
authors.lastname: Zhang
authors.affiliation: Kuwait Institute for Scientific Research, PO Box 24885, Safat, 13109, Kuwait.
authors.forename: Suad
authors.initials: S
authors.lastname: Al Hooti
authors.affiliation: Kuwait Institute for Scientific Research, PO Box 24885, Safat, 13109, Kuwait.
authors.forename: Sameer
authors.initials: S
authors.lastname: Al Zenki
authors.affiliation: Kuwait Institute for Scientific Research, PO Box 24885, Safat, 13109, Kuwait.
authors.forename: Husam
authors.initials: H
authors.lastname: Alomirah
authors.affiliation: Kuwait Institute for Scientific Research, PO Box 24885, Safat, 13109, Kuwait.
authors.forename: Kazi M
authors.initials: KM
authors.lastname: Jamil
authors.affiliation: Ministry of Health, Medical Laboratories Services, Sabah Hospital Laboratories, PO Box 24225, Safat, 13103, Kuwait.
authors.forename: Aravinda
authors.initials: A
authors.lastname: Rao
authors.affiliation: Ministry of Health, Medical Laboratories Services, Sabah Hospital Laboratories, PO Box 24225, Safat, 13103, Kuwait.
authors.forename: Nasser
authors.initials: N
authors.lastname: Al Jahmah
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Saltzman
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Ausman
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009752:Nutritional Status; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
references.citation: J Clin Endocrinol Metab. 2007 Jun;92(6):2017-29
references.pmid: 17389701
references.citation: Diabetes Care. 2012 Jan;35 Suppl 1:S11-63
references.pmid: 22187469
references.citation: N Engl J Med. 2007 Jul 19;357(3):266-81
references.pmid: 17634462
references.citation: Public Health Nutr. 2013 Apr;16(4):596-607
references.pmid: 22974508
references.citation: Am J Clin Nutr. 2008 Dec;88(6):1519-27
references.pmid: 19064511
references.citation: Diabetes Care. 2008 Apr;31(4):701-7
references.pmid: 18235052
references.citation: Endocrinol Metab Clin North Am. 2010 Jun;39(2):365-79, table of contents
references.pmid: 20511058
references.citation: Age Ageing. 2009 Sep;38(5):606-9
references.pmid: 19617604
references.citation: Dis Markers. 2015;2015:580474
references.pmid: 26576069
references.citation: J Immigr Minor Health. 2012 Dec;14(6):926-32
references.pmid: 22588624
references.citation: Med Princ Pract. 2003 Jul-Sep;12(3):160-3
references.pmid: 12766333
references.citation: Diabetologia. 2012 Aug;55(8):2173-82
references.pmid: 22526608
references.citation: Endocr J. 2000 Aug;47(4):383-91
references.pmid: 11075718
references.citation: Int J Clin Pract. 2003 May;57(4):258-61
references.pmid: 12800453
references.citation: J Clin Endocrinol Metab. 2012 Apr;97(4):1146-52
references.pmid: 22442278
references.citation: Am J Clin Nutr. 1994 May;59(5):1083-7
references.pmid: 8172095
references.citation: Diabetes Care. 2006 Mar;29(3):722-4
references.pmid: 16505539
references.citation: Diabetologia. 2005 Jun;48(6):1038-50
references.pmid: 15864529
references.citation: Am J Clin Nutr. 2004 May;79(5):820-5
references.pmid: 15113720
references.citation: Nutr Metab Cardiovasc Dis. 2012 Feb;22(2):81-7
references.pmid: 22265795
references.citation: J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30
references.pmid: 21646368
references.citation: Cancer Epidemiol Biomarkers Prev. 2010 Apr;19(4):927-31
references.pmid: 20332255
references.citation: Diabetes Care. 2007 Apr;30(4):980-6
references.pmid: 17277040
references.citation: J Diabetes Res. 2014;2014:869307
references.pmid: 25371907
references.citation: Eur J Clin Nutr. 1996 May;50(5):315-8
references.pmid: 8735313
references.citation: Nutrition. 2012 Sep;28(9):917-23
references.pmid: 22459551
references.citation: Diabetes Res Clin Pract. 2015 Jun;108(3):e71-5
references.pmid: 25836943
references.citation: Maedica (Buchar). 2013 Sep;8(3):231-6
references.pmid: 24371490
references.citation: Bone Miner. 1986 Jun;1(3):187-92
references.pmid: 3334207
references.citation: Diabetologia. 1997 Mar;40(3):344-7
references.pmid: 9084975
references.citation: Diabetologia. 1967 Mar;3(1):47-9
references.pmid: 4903553
references.citation: Nutrition. 2011 Sep;27(9):868-79
references.pmid: 21704500
references.citation: J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):121-5
references.pmid: 15225758
references.citation: Int J Environ Res Public Health. 2012 May;9(5):1984-96
references.pmid: 22754486
references.citation: Diabetologia. 2010 Oct;53(10):2112-9
references.pmid: 20596692
references.citation: Diabet Med. 2012 Aug;29(8):e142-50
references.pmid: 22486204
references.citation: JAMA. 2011 Apr 6;305(13):1348-9
references.pmid: 21467288
references.citation: Diabetes Care. 2004 Dec;27(12):2813-8
references.pmid: 15562190
references.citation: Horm Res. 1990;34(1):39-44
references.pmid: 2074090
references.citation: FASEB J. 2003 Mar;17(3):509-11
references.pmid: 12551842
references.citation: Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):268-80
references.pmid: 19398913
references.citation: BMC Public Health. 2014;14:153
references.pmid: 24517121