title: Inverse Association between Vitamin D Status and Diabetes in a Clinic Based Sample of Hispanic Adults in Puerto Rico.
abstract: BACKGROUND
  Vitamin D deficiency is a public health problem around the world. Diabetes has been associated with vitamin D deficiency. We aimed to examine the association between the vitamin D status and diabetes in a clinic based sample of Hispanic adults in Puerto Rico.
  
  
  METHODS
  Demographics and laboratory test results for serum 25(OH)D, Fasting Blood Glucose (FBG), and Haemoglobin A1C (HbAlc) were extracted from medical records. Vitamin D status was classified as deficient (<12 ng/ml); inadequate (12-20 ng/ml); insufficient (21-29 ng/ml) and optimal (≥30 ng/ml) using serum 25(OH)D levels.
  
  
  RESULTS
  A total of 716 records were included in the analyses. Most were females (63.3%), with mean age of 54.1±14.9 y, mean BMI 30.1±6.3 kg/m2 and mean serum 25(OH)D levels of 24.3±8.6 ng/ml. Most were classified as diabetics (41.1%). Those with diabetes had lower 25(OH)D levels compared to pre-diabetic and normal glucose status (p<0.05). Serum 25(OH) D levels were inversely correlated to FBG and HbA1c in the total sample and in men (p<0.05). After adjusting for age, gender, BMI and seasonality, there was a greater risk of diabetes, but not prediabetes, in those with serum 25(OH)D levels <30 ng/ml. This risk increased from 1.8 times in those with vitamin D insufficiency to 4.2 times in those with vitamin D deficiency (<12 ng/ml).
  
  
  CONCLUSIONS
  Diabetes risk significantly increased as serum 25(OH)D levels decreased in this group of Hispanic adults, underscoring the importance of routinely screening high risk individuals for vitamin D deficiency and offer supplementation to normalize serum levels.
authors.affiliation: Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Grisel
authors.initials: G
authors.lastname: Ramos-Trautmann
authors.affiliation: Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Lilliana
authors.initials: L
authors.lastname: González
authors.affiliation: Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Giselle
authors.initials: G
authors.lastname: Díaz-Luquis
authors.affiliation: Epidemiology Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.affiliation: Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Cristina
authors.initials: C
authors.lastname: Palacios
keywords: 25(OH)D levels; Diabetes; Glucose parameters; Vitamin D status