Joint Effects of Obesity and Vitamin D Insufficiency on Insulin Resistance and Type 2 Diabetes: Results from the NHANES 2001-2006
Diabetes Care, 07/11/2012
Kabadi SM et al. – Within a cross–sectional, nationally representative sample, abdominal obesity and insufficient 25(OH)D interact to synergistically influence the risk of insulin resistance.Methods
- The analytic sample for the type 2 diabetes analysis (n = 12,900) was limited to participants from the National Health and Nutrition Examination Survey (NHANES) 2001–2006 over 20 years of age.
- Participants >20 years of age assigned to the morning session and free of diabetes were limited to the insulin resistance analysis (n = 5,806).
- Multiplicative interaction was assessed through a cross–product interaction term in a multiple logistic regression model.
- The presence of additive interaction between insufficient 25(OH)D and obesity (indicated by BMI or waist circumference) was evaluated by calculation of the relative excess risk due to interaction (RERI) and attributable proportion due to interaction (AP).
- There was no multiplicative interaction of insufficient 25(OH)D and obesity on type 2 diabetes or insulin resistance.
- Furthermore, none of the RERI or AP values were statistically significant in the diabetes analysis.
- However, there was strong additive interaction between abdominal obesity and insufficient 25(OH)D (RERI 6.45 [95% CI 1.03–11.52]) in regard to insulin resistance.
- In addition, 47% of the increased odds of insulin resistance can be explained by interaction between insufficient 25(OH)D and high BMI (AP 0.47 [95% CI 0.08–0.87]).