Korean J Fam Pract. 2018; 8(1): 136-141  https://doi.org/10.21215/kjfp.2018.8.1.136
Association between Niacin and Type 2 Diabetes Mellitus in Korean: Korean National Health and Nutrition Examination Survey 2012-2015
Ji Yun Jeong, Jin Young Kim, Hee Jeong Kim, Yu Ri Choe*
Department of Family Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
Yu Ri Choe
Tel: +82-61-379-7290, Fax: +82-61-379-7289
E-mail: hiyuriya@naver.com
ORCID: http://orcid.org/0000-0002-4557-2323
Received: March 7, 2017; Revised: August 8, 2017; Accepted: October 8, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Diabetes mellitus (DM) is one of the most common chronic diseases worldwide, and its prevalence has increased rapidly with economic growth. Although many researchers have previously examined the association between niacin intake and diabetes prevalence, only a few studies have evaluated the association between dietary niacin overdose and the prevalence of diabetes. Moreover, studies involving Korean subjects are scarce. The aim of this study was to determine the effect of over-consumption of niacin on the prevalence of DM.
Methods: We analyzed data derived from the 2012–2015 Korean National Health and Nutrition Survey, which included 6,548 respondents aged >45 years, who had accurately completed a questionnaire on the frequency of their food intake. Niacin overdose was defined as an intake of ≥30 mg of niacin equivalent (NE) per day and diabetes was defined as fasting blood glucose levels of ≥126 mg/dL or hemoglobin Alc of >6.5%, or based on the diagnosis made by a physician. Propensity score-matching was used for sensitivity analysis. Multivariate logistic regression analysis was performed with significant variables, adjusted to analyze the association between the prevalence of diabetes and niacin overdose.
Results: Overall, 70 individuals (64.1 weighted %) had excessive intake of niacin of ≥30 mg NE/day. Multiple logistic regression analysis after propensity score-matching revealed that inadequate niacin intake was associated with an increased prevalence of DM. The odds ratio for diabetes with inadequate niacin intake was statistically significant at 4.995 (95% confidence interval, 1.298–19.218).
Conclusion: The prevalence of DM correlated significantly with niacin overdose.
Keywords: Dietary Supplement; Niacin; Diabetes Mellitus; Prevalence
  1. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey [Internet]. Seoul: Korea Centers for Disease Control and Prevention; 2015 [cited 2016 Dec 21].
    Available from: http://www.cdc.go.kr
  2. Ha KH, Kim DJ. Trends in the diabetes epidemic in Korea. Endocrinol Metab (Seoul) 2015; 30: 142-6.
    Pubmed KoreaMed CrossRef
  3. Lee YH, Bang H, Kim HC, Kim HM, Park SW, Kim DJ. A simple screening score for diabetes for the Korean population: development, validation, and comparison with other scores. Diabetes Care 2012; 35: 1723-30.
    Pubmed KoreaMed CrossRef
  4. Valdés-Ramos R, Guadarrama-López AL, Martínez-Carrillo BE, BenítezArciniega AD. Vitamins and type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets 2015; 15: 54-63.
    Pubmed KoreaMed CrossRef
  5. O’Connell BS. Select vitamins and minerals in the management of diabetes. Diabetes Spectrum 2001; 14: 133-48.
  6. Batuca JR, Amaral MC, Favas C, Paula FS, Ames PRJ, Papoila AL, et al. Extendedrelease niacin increases anti-apolipoprotein A-I antibodies that block the antioxidant effect of high-density lipoprotein-cholesterol: the EXPLORE clinical trial. Br J Clin Pharmacol 2017; 83: 1002-10.
    Pubmed CrossRef
  7. Pang J, Chan DC, Hamilton SJ, Tenneti VS, Watts GF, Barrett PH. Effect of niacin on high-density lipoprotein apolipoprotein A-I kinetics in statintreated patients with type 2 diabetes mellitus. Arterioscler Thromb Vasc Biol 2014; 34: 427-32.
    Pubmed CrossRef
  8. Elam MB, Hunninghake DB, Davis KB, Garg R, Johnson C, Egan D, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease: the ADMIT study: A randomized trial. Arterial Disease Multiple Intervention Trial. JAMA 2000; 284:1263-70.
    Pubmed CrossRef
  9. Ooi EM, Watts GF, Chan DC, Pang J, Tenneti VS, Hamilton SJ, et al. Effects of extended-release niacin on the postprandial metabolism of Lp(a) and ApoB-100-containing lipoproteins in statin-treated men with type 2 diabetes mellitus. Arterioscler Thromb Vasc Biol 2015; 35: 2686-93.
    Pubmed CrossRef
  10. Brinton EA, Triscari J, Brudi P, Chen E, Johnson-Levonas AO, Sisk CM, et al. Effects of extended-release niacin/laropiprant on correlations between apolipoprotein B, LDL-cholesterol and non-HDL-cholesterol in patients with type 2 diabetes. Lipids Health Dis 2016; 15: 116.
    Pubmed KoreaMed CrossRef
  11. Sorrentino SA, Besler C, Rohrer L, Meyer M, Heinrich K, Bahlmann FH, et al. Endothelial-vasoprotective effects of high-density lipoprotein are impaired in patients with type 2 diabetes mellitus but are improved after extendedrelease niacin therapy. Circulation 2010; 121: 110-22.
    Pubmed CrossRef
  12. Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, et al. Role of niacin in current clinical practice: a systematic review. Am J Med 2017; 130: 173-87.
    Pubmed CrossRef
  13. Bays HE, Brinton EA, Triscari J, Chen E, Maccubbin D, MacLean AA, et al. Extended-release niacin/laropiprant significantly improves lipid levels in type 2 diabetes mellitus irrespective of baseline glycemic control. Vasc Health Risk Manag 2015; 11: 165-72.
    Pubmed KoreaMed
  14. Goldie C, Taylor AJ, Nguyen P, McCoy C, Zhao XQ, Preiss D. Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomised controlled trials. Heart 2016; 102: 198-203.
    Pubmed KoreaMed CrossRef
  15. Liu M, Li L, Chu J, Zhu B, Zhang Q, Yin X, et al. Serum N(1)-methylnicotin amide is associated with obesity and diabetes in Chinese. J Clin Endocrinol Metab 2015; 100: 3112-7.
    Pubmed KoreaMed CrossRef
  16. Kannt A, Pfenninger A, Teichert L, Tönjes A, Dietrich A, Schön MR, et al. Association of nicotinamide-N-methyltransferase mRNA expression in human adipose tissue and the plasma concentration of its product, 1-methylnicotinamide, with insulin resistance. Diabetologia 2015; 58: 799-808.
    Pubmed KoreaMed CrossRef
  17. Zhou SS, Li D, Sun WP, Guo M, Lun YZ, Zhou YM, et al. Nicotinamide overload may play a role in the development of type 2 diabetes. World J Gastroenterol 2009; 15: 5674-84.
    Pubmed KoreaMed CrossRef
  18. Collins PD, Sattar N. Glycaemic effects of non-statin lipid-lowering therapies. Curr Cardiol Rep 2016; 18: 133.
    Pubmed KoreaMed CrossRef
  19. Sazonov V, Maccubbin D, Sisk CM, Canner PL. Effects of niacin on the incidence of new onset diabetes and cardiovascular events in patients with normoglycaemia and impaired fasting glucose. Int J Clin Pract 2013; 67: 297302.
    Pubmed CrossRef
  20. Ministry of Health and Welfare. The Korean Nutrition Society. Dietary Reference Intakes for Koreans [Internet]. Sejong: Ministry of Health and Welfare. The Korean Nutrition Society; 2015 [cited 2016 Nov 15].
    Available from: http://www.kns.or.kr
  21. Park SH, Lee HM, Yoon EK, Min CS, Kim HJ, Jun EA, et al. Niacin upper level recommendation and exposure assessment of foods and multivitamin drugs. Journal of Food Hygiene and Safety 2005; 20: 77-82.
  22. McCormick DB, Shills ME, Young VR, et al. Modern nutrition in health and disease. Philadelphia: Lea & Felbiger; 1988. p. 370-5.
  23. Scientific Committee on Food of European Commission. Opinion of the Scientific Committee on Food on the tolerable upper intake levels of nicotinic acid and nicotinamide (niacin). European Commission 2002; 1-20.
  24. HPS2-THRIVE Collaborative Group, Landray MJ, Haynes R, Hopewell JC, Parish S, Aung T, et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med 2014; 371: 203-12.
    Pubmed CrossRef
  25. Guyton JR, Fazio S, Adewale AJ, Jensen E, Tomassini JE, Shah A, et al. Effect of extended-release niacin on new-onset diabetes among hyperlipidemic patients treated with ezetimibe/simvastatin in a randomized controlled trial. Diabetes Care 2012; 35: 857-60.
    Pubmed KoreaMed CrossRef
  26. Kei A, Elisaf MS. Nicotinic acid: clinical considerations. Expert Opin Drug Saf 2012; 11: 551-64.
    Pubmed CrossRef
  27. Wang N, Guo DY, Tian X, Lin HP, Li YP, Chen SJ, et al. Niacin receptor GPR109A inhibits insulin secretion and is down-regulated in type 2 diabetic islet beta-cells. Gen Comp Endocrinol 2016; 237: 98-108.
    Pubmed CrossRef
  28. Zhou SS, Li D, Zhou YM, Sun WP, Liu QG. B-vitamin consumption and the prevalence of diabetes and obesity among the US adults: population based ecological study. BMC Public Health 2010; 10: 746.
    Pubmed KoreaMed CrossRef
  29. Backes JM, Padley RJ, Moriarty PM. Important considerations for treatment with dietary supplement versus prescription niacin products. Postgrad Med 2011; 123: 70-83.
    Pubmed CrossRef

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