Korean J Fam Pract. 2016; 6(6): 623-628  https://doi.org/10.21215/kjfp.2016.6.6.623
The Effect of Vitamin D Deficiency on the Homeostasis Model Assessment-Insulin Resistance: Using the Propensity Score Matching
Eun-Kyung Kim, Jung-Hun Kim, Min-gyu Park, Je-Won Lee, Chung-Hwan Cho*, Jin-Hee Lee, Jae-sung Lee
Department of Family Medicine, Presbyterian Medical Center, Jeonju, Korea
Chung-Hwan Cho
Tel: +82-63-230-1512, Fax: +82-63-230-1519
E-mail: lightgod@cholian.com
Received: May 23, 2016; Revised: September 28, 2016; Accepted: October 2, 2016; Published online: December 20, 2016.
© 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.
Abstract
Background: A low serum vitamin D level is reportedly associated with an increased risk of diabetes mellitus. Insulin resistance has been identified as a fundamental feature of diabetes mellitus. The homeostasis model assessment (HOMA) is based on fasting plasma glucose and insulin levels and has been validated and applied for quantifying insulin resistance and secretion. The purpose of this study was to investigate the association between 25-hydroxyvitamin D (25(OH)D) level and insulin resistance using propensity score matching (PSM).
Methods: We used the data from the 5th Korea National Health and Nutrition Examination Survey, 2010. Basic information was obtained from the physical examination, interview, and self-completed questionnaire. Serum 25(OH)D and insulin levels were determined. HOMA-insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin levels.
Results: Except for body mass index (BMI), there were significant differences in all covariates before and after PSM. Univariable analysis of the effects on insulin resistance after PSM showed higher correlations in younger individuals, those with higher BMI and larger waist circumference, and non-smokers. Logistic regression analysis of the effects on insulin resistance after PSM showed higher correlations in the vitamin D deficiency group, younger individuals, those with higher BMI and larger waist circumference, and non-smokers.
Conclusion: Vitamin D deficiency is highly correlated with insulin resistance.
Keywords: Vitamin D; Homeostasis Model Assessment-Insulin Resistance; Propensity Score Matching; Korea National Health and Nutrition Examination Survey
References
  1. Lemire JM. Immunomodulatory actions of 1,25-dihydroxyvitamin D3. J Steroid Biochem Mol Biol 1995; 53: 599-602.
    CrossRef
  2. Walters MR. Newly identified actions of the vitamin D endocrine system. Endocr Rev 1992; 13: 719-64.
    Pubmed
  3. Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, Reynolds J, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89: 1196-9.
    Pubmed CrossRef
  4. Snijder MB, van Dam RM, Visser M, Deeg DJ, Dekker JM, Bouter LM, et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119-23.
    Pubmed CrossRef
  5. Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care 2005; 28:1228-30.
    Pubmed CrossRef
  6. Scragg R, Sowers M, Bell C; Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004; 27: 2813-8.
    Pubmed CrossRef
  7. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 2007; 92: 2017-29.
    Pubmed KoreaMed CrossRef
  8. Looker AC. Body fat and vitamin D status in black versus white women. J Clin Endocrinol Metab 2005; 90: 635-40.
    Pubmed CrossRef
  9. Choi HJ. New Insight into the action of vitamin D. Korean J Fam Med 2011;32: 89-96.
    CrossRef
  10. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004; 79: 820-5.
    Pubmed
  11. Choi HS, Kim KA, Lim CY, Rhee SY, Hwang YC, Kim KM, et al. Low serum vitamin D is associated with high risk of diabetes in Korean adults. J Nutr 2011; 141: 1524-8.
    Pubmed CrossRef
  12. Ministry of Health and Welfare, Center of Disease Control and Preventation. the 3th Korea National Health and Nutrition Examination Survey (KNHANES) 2006. Seoul: Ministry of Health and Welfare; 2005.
  13. Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, et al. Epidemic obesity and type 2 diabetes in Asia. Lancet 2006; 368: 1681-8.
    CrossRef
  14. Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia 2003; 46:3-19.
    Pubmed CrossRef
  15. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, DawsonHughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84: 18-28.
    Pubmed
  16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-9.
    Pubmed CrossRef
  17. Choi ES, Rhee EJ, Kim JH, Won JC, Park CY, Lee WY, et al. Insulin sensitivity and insulin secretion determined by homeostasis model assessment and future risk of diabetes mellitus in Korean men. Korean Diabetes J 2008; 32:498-505.
    CrossRef
  18. Morrissey RL, Bucci TJ, Richard B, Empson N, Lufkin EG. Calcium-binding protein: its cellular localization in jejunum, kidney and pancreas. Proc Soc Exp Biol Med 1975; 149: 56-60.
    Pubmed CrossRef
  19. Ishida H, Norman AW. Demonstration of a high affinity receptor for 1,25-dihydroxyvitamin D3 in rat pancreas. Mol Cell Endocrinol 1988; 60:109-17.
    CrossRef
  20. Zeitz U, Weber K, Soegiarto DW, Wolf E, Balling R, Erben RG. Impaired insulin secretory capacity in mice lacking a functional vitamin D receptor. FASEB J 2003; 17: 509-11.
    CrossRef


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