Prediabetes and Prehypertension in Healthy Adults Are Associated With Low Vitamin D Levels Full Text
Diabetes Care, 02/04/2011
Exclusive author commentary
Gupta AK et al. – This study strengthens the plausibility that low serum vitamin D levels elevate the risk for early–stage diabetes (PreDM) and hypertension (PreHTN).
Alok K. Gupta (02/07/2011) comments:
The link between low serum vitamin D (Vit D) concentrations and abnormal bone and calcium metabolism has been known. The adverse associations between low Vit D concentrations and the metabolic syndrome, diabetes mellitus (DM), hypertension (HTN), cardiovascular health, cardiovascular and all cause mortality, have also been identified. The relationship between serum Vit D and the precursor states for DM and HTN: prediabetes (PreDM) and prehypertension (PreHTN) is unknown. In previous analyses of otherwise healthy adults, we had found significant increases in the prevalence over time of PreDM, PreHTN, and coexisting PreDM and PreHTN (Co-PreDM & PreHTN). One in three, four and ten, respectively, of the seemingly healthy US adults had PreHTN, PreDM and Co-PreDM & PreHTN and were found to be on an accelerated pathway leading to early cardiovascular adverse events (Hypertens Res. 2010;33(9):905-10; Hypertens Res. 2011 Jan 13. [Epub ahead of print]). PreDM was found to be associated with circadian blood pressure variability and endothelial function abnormalities (J Hum Hypertens. 2008.22(9):627-33, Cardiovasc Diabetol. 2010. 24;9:58-http://www.cardiab.com/content/9/1/58). PreDM and PreHTN were associated with exacerbated systemic inflammation (J Inflamm (Lond). 2010. 26;7:36-http://www.journal-inflammation.com/content/7/1/36) illustrating the many interrelated mechanisms that lead to this increase in cardiovascular morbidity and mortality. The present study was undertaken 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. PreDM and 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 odds ratio for co morbid 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 >76.3 nmol/L after adjusting for age, sex, and BMI. This study strengthens the plausibility that low serum vitamin D levels elevate the risk for early-stage diabetes (PreDM) and hypertension (PreHTN.