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Circulating 25-hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies.
Diabetologia. 2012 Aug; 55(8):2173-82.D

Abstract

AIMS/HYPOTHESIS

Epidemiological evidence is suggestive, but limited, for an association between circulating 25-hydroxyvitamin D (25[OH]D) and risk of type 2 diabetes. We conducted a systematic review and meta-analysis that included new data from previously unpublished studies.

METHODS

Using a nested case-cohort design in the European Prospective Investigation into Cancer (EPIC)-Norfolk study, we identified a random subcohort and incident type 2 diabetes cases occurring between baseline (1993-1997) and 2006. In the Ely prospective study we identified incident type 2 diabetes cases between 1990 and 2003. We conducted a systematic review of prospective studies on 25(OH)D and type 2 diabetes published in MEDLINE or EMBASE until 31 January 2012, and performed a random-effects meta-analysis combining available evidence with results from the EPIC-Norfolk and Ely studies.

RESULTS

In EPIC-Norfolk, baseline 25(OH)D was lower among incident type 2 diabetes cases (mean [SD] 61.6 [22.4] nmol/l; n=621) vs non-case subcohort participants (mean 65.3 [23.9] nmol/l; n=826). There was an inverse association between baseline 25(OH)D and incident type 2 diabetes in multivariable-adjusted analyses: HR (95% CI) 0.66 (0.45, 0.97), 0.53 (0.34, 0.82), 0.50 (0.32, 0.76), p trend <0.001, comparing consecutive increasing 25(OH)D quartiles with the lowest. In Ely, 37 incident type 2 diabetes cases were identified among 777 participants. In meta-analysis, the combined RR of type 2 diabetes comparing the highest with lowest quartile of 25(OH)D was 0.59 (0.52, 0.67), with little heterogeneity (I (2) =2.7%, p=0.42) between the 11 studies included (3,612 cases and 55,713 non-cases).

CONCLUSIONS/INTERPRETATION

These findings demonstrate an inverse association between circulating 25(OH)D and incident type 2 diabetes. However, causal inference should be addressed through adequately dosed randomised trials of vitamin D supplementation or genetic Mendelian randomisation experiments.

Authors+Show Affiliations

Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Box 285, Hills Road, Cambridge, CB2 0QQ, UK. nita.forouhi@mrc-epid.cam.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

22526608

Citation

Forouhi, N G., et al. "Circulating 25-hydroxyvitamin D Concentration and the Risk of Type 2 Diabetes: Results From the European Prospective Investigation Into Cancer (EPIC)-Norfolk Cohort and Updated Meta-analysis of Prospective Studies." Diabetologia, vol. 55, no. 8, 2012, pp. 2173-82.
Forouhi NG, Ye Z, Rickard AP, et al. Circulating 25-hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies. Diabetologia. 2012;55(8):2173-82.
Forouhi, N. G., Ye, Z., Rickard, A. P., Khaw, K. T., Luben, R., Langenberg, C., & Wareham, N. J. (2012). Circulating 25-hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies. Diabetologia, 55(8), 2173-82. https://doi.org/10.1007/s00125-012-2544-y
Forouhi NG, et al. Circulating 25-hydroxyvitamin D Concentration and the Risk of Type 2 Diabetes: Results From the European Prospective Investigation Into Cancer (EPIC)-Norfolk Cohort and Updated Meta-analysis of Prospective Studies. Diabetologia. 2012;55(8):2173-82. PubMed PMID: 22526608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulating 25-hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies. AU - Forouhi,N G, AU - Ye,Z, AU - Rickard,A P, AU - Khaw,K T, AU - Luben,R, AU - Langenberg,C, AU - Wareham,N J, Y1 - 2012/04/15/ PY - 2011/12/15/received PY - 2012/03/08/accepted PY - 2012/4/25/entrez PY - 2012/4/25/pubmed PY - 2012/12/10/medline SP - 2173 EP - 82 JF - Diabetologia JO - Diabetologia VL - 55 IS - 8 N2 - AIMS/HYPOTHESIS: Epidemiological evidence is suggestive, but limited, for an association between circulating 25-hydroxyvitamin D (25[OH]D) and risk of type 2 diabetes. We conducted a systematic review and meta-analysis that included new data from previously unpublished studies. METHODS: Using a nested case-cohort design in the European Prospective Investigation into Cancer (EPIC)-Norfolk study, we identified a random subcohort and incident type 2 diabetes cases occurring between baseline (1993-1997) and 2006. In the Ely prospective study we identified incident type 2 diabetes cases between 1990 and 2003. We conducted a systematic review of prospective studies on 25(OH)D and type 2 diabetes published in MEDLINE or EMBASE until 31 January 2012, and performed a random-effects meta-analysis combining available evidence with results from the EPIC-Norfolk and Ely studies. RESULTS: In EPIC-Norfolk, baseline 25(OH)D was lower among incident type 2 diabetes cases (mean [SD] 61.6 [22.4] nmol/l; n=621) vs non-case subcohort participants (mean 65.3 [23.9] nmol/l; n=826). There was an inverse association between baseline 25(OH)D and incident type 2 diabetes in multivariable-adjusted analyses: HR (95% CI) 0.66 (0.45, 0.97), 0.53 (0.34, 0.82), 0.50 (0.32, 0.76), p trend <0.001, comparing consecutive increasing 25(OH)D quartiles with the lowest. In Ely, 37 incident type 2 diabetes cases were identified among 777 participants. In meta-analysis, the combined RR of type 2 diabetes comparing the highest with lowest quartile of 25(OH)D was 0.59 (0.52, 0.67), with little heterogeneity (I (2) =2.7%, p=0.42) between the 11 studies included (3,612 cases and 55,713 non-cases). CONCLUSIONS/INTERPRETATION: These findings demonstrate an inverse association between circulating 25(OH)D and incident type 2 diabetes. However, causal inference should be addressed through adequately dosed randomised trials of vitamin D supplementation or genetic Mendelian randomisation experiments. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/22526608/Circulating_25_hydroxyvitamin_D_concentration_and_the_risk_of_type_2_diabetes:_results_from_the_European_Prospective_Investigation_into_Cancer__EPIC__Norfolk_cohort_and_updated_meta_analysis_of_prospective_studies_ L2 - https://doi.org/10.1007/s00125-012-2544-y DB - PRIME DP - Unbound Medicine ER -