UCSD: An epidemiological study conducted by researchers at University of
California San Diego School of Medicine and Seoul National University
suggests that persons deficient in vitamin D may be at much greater risk
of developing diabetes.
The findings are reported in the April 19, 2018 online issue of PLOS One. The scientists studied a cohort of 903 healthy adults (mean age: 74)
with no indications of either pre-diabetes or diabetes during clinic
visits from 1997 to 1999, and then followed the participants through
2009. Vitamin D levels in blood were measured during these visits, along
with fasting plasma glucose and oral glucose tolerance.
Over the course of time, there were 47 new cases of diabetes and 337
new cases of pre-diabetes, in which blood sugar levels are higher than
normal but not yet high enough to be categorized as type 2 diabetes.
For the study, the researchers identified the minimum healthy level
of 25-hydroxyvitamin D in blood plasma to be 30 nanograms per
milliliter. This is 10 ng/ml above the level recommended in 2010 by the
Institute of Medicine, now part of The National Academies, a health
advisory group to the federal government. Many groups, however, have
argued for higher blood serum levels of vitamin D, as much as 50 ng/ml.
The matter remains hotly debated.
"We found that participants with blood levels of 25-hydroxyvitamin D
that were above 30 ng/ml had one-third of the risk of diabetes and those
with levels above 50 ng/ml had one-fifth of the risk of developing
diabetes," said first author Sue K. Park, MD, in the Department of
Preventive Medicine at Seoul National University College of Medicine in
South Korea.
Study co-author Cedric F. Garland, DrPH, adjunct professor in the UC
San Diego School of Medicine Department of Family Medicine and Public
Health, said persons with 25-hydroxyvitamin D levels below 30 ng/ml were
considered vitamin D deficient. These persons, the researchers found,
were up to five times at greater risk for developing diabetes than
people with levels above 50 ng/ml.
Garland, who has previously investigated connections between vitamin D
levels and various types of cancer, said the study builds upon previous
epidemiological research linking vitamin D deficiency to a higher risk
of diabetes. Epidemiological studies analyze the distribution and
determinants of health and disease conditions. They do not necessarily
prove cause-and-effect.
"Further research is needed on whether high 25-hydroxyvitamin D
levels might prevent type 2 diabetes or the transition from pre-diabetes
to diabetes," said Garland. "But this paper and past research indicate
there is a strong association."
Garland and others have long advocated the health benefits of vitamin
D. In 1980, he and his late brother Frank C. Garland, also an
epidemiologist, published an influential paper that posited vitamin D
(produced by the body through exposure to sunshine) and calcium (which
vitamin D helps the body absorb) together reduced the risk of colon
cancer. The Garlands and colleagues subsequently found associations with
breast, lung and bladder cancers.
To reach 25-hydroxyvitamin D levels of 30 ng/ml, Garland said would
require dietary supplements of 3,000 to 5,000 international units (IU)
per day, less with the addition of moderate daily sun exposure with
minimal clothing (approximately 10-15 minutes per day outdoors at noon).
The current recommended average daily amount of vitamin D is 400 IU
for children up to 1 year; 600 IU for ages 1 to 70 years (less for
pregnant or breastfeeding women) and 800 IU for persons over 70,
according to the National Institutes of Health. Higher daily amounts of
vitamin D are generally considered safe, but blood serum levels
exceeding 125 ng/ml have been linked to adverse side effects, such as
nausea, constipation, weight loss, heart rhythm problems and kidney
damage.
Co-authors include Edward D. Gorham, Luke BuDoff and Elizabeth Barrett-Connor, all at UC San Diego.
Funding for this research came, in part, from National Institute on
Aging (grants AG07181 and AG028507) and National Institute of Diabetes
and Digestive and Kidney Diseases (grant DK31801).
Full study: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193070