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Prediabetes and Prehypertension in Healthy Adults Are Associated with Low Vitamin D Levels

This study strengthens the plausibility that low serum vitamin D levels elevate the risk for early-stage diabetes and hypertension….

The objective of the study was to determine whether modest elevations of fasting serum glucose (FSG) and resting blood pressure (BP) in healthy adults are associated with differential serum vitamin D concentrations.  

Disease-free adults in the National Health and Nutrition Examination Survey 2001-2006 were assessed. Prediabetes (PreDM) and prehypertension (PreHTN) were diagnosed using American Diabetes Association and Seventh Report of the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure criteria: FSG 100-125 mg/dL and systolic BP 120-139 and/or diastolic BP 80-89 mmHg. Logistic regression was used to assess the effects of low vitamin D levels on the odds for PreDM and PreHTN in asymptomatic adults (n = 1,711).

The results showed the odds ratio for comorbid PreDM and PreHTN in Caucasian men (n = 898) and women (n = 813) was 2.41 (P < 0.0001) with vitamin D levels ≤76.3 versus less than 76.3 nmol/L after adjusting for age, sex, and BMI.

This study alludes to the merits of serum vitamin D testing in seemingly healthy adults at risk for (or exhibiting) PreDM, PreHTN, or coexisting PreDM and PreHTN. These healthy disease-free men and women also tended to have a substantially larger waist circumference, higher serum triglycerides, and lower high-density lipoprotein cholesterol concentrations (all appropriately more than or less than the desirable range) attesting to an increased cardiovascular disease risk. Although in this cross sectional study, the mechanistic sequence of events leading to low vitamin D in healthy Caucasian men and women with aging and increasing BMI, or in the development of PreDM and PreHTN cannot be identified, low vitamin D levels in otherwise healthy Caucasian men and women are associated with PreDM, PreHTN, and coexisting PreDM and PreHTN. Both the unadjusted and adjusted odds ratios were significantly greater than unity for PreDM, PreHTN, and coexisting PreDM and PreHTN with serum vitamin D concentrations, 75th percentile. It is therefore plausible that among those with the above conditions and low serum vitamin D concentrations, exogenous vitamin D supplementation and increasing the serum 25-hydroxy vitamin D concentration may reverse subtle changes in FSG and resting BP. Disease-free adults with PreDM, PreHTN, and coexisting PreDM and PreHTN are on an accelerated pathway for adverse cardiovascular events. This simple measure, combined with individually tailored interventions targeted toward the reduction of other risk factors, may then also prevent subsequent conversion from PreDM to diabetes and PreHTN to hypertension.

Diabetes Care January 31, 2011 DC_101829