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Meta-Analysis
. 2013 May;36(5):1422-8.
doi: 10.2337/dc12-0962.

Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies

Yiqing Song  1 , Lu Wang, Anastassios G Pittas, Liana C Del Gobbo, Cuilin Zhang, Joann E Manson, Frank B Hu
Affiliations
Meta-Analysis

Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies

Yiqing Song et al. Diabetes Care. 2013 May.

Abstract

Objective: To quantitatively assess the strength and shape of the association between blood 25-hydroxy vitamin D [25(OH)D] levels and incident risk of type 2 diabetes.

Research design and methods: A systematic search of the MEDLINE and Embase databases and a hand search of references from original reports were conducted up to 31 October 2012. Prospective observational studies that assessed the association between blood levels of 25(OH)D and risk of incident type 2 diabetes were included for meta-analysis. DerSimonian and Laird's random-effects model was used. A quadratic spline regression analysis was used to examine the shape of the association with a generalized least-squares trend test performed for the dose-response relation.

Results: A total of 21 prospective studies involving 76,220 participants and 4,996 incident type 2 diabetes cases were included for meta-analysis. Comparing the highest to the lowest category of 25(OH)D levels, the summary relative risk for type 2 diabetes was 0.62 (95% CI 0.54-0.70). A spline regression model showed that higher 25(OH)D levels were monotonically associated with a lower diabetes risk. This inverse association did not differ by sex, duration of follow-up, study sample size, diabetes diagnostic criteria, or 25(OH)D assay method. A linear trend analysis showed that each 10 nmol/L increment in 25(OH)D levels was associated with a 4% lower risk of type 2 diabetes (95% CI 3-6; P for linear trend < 0.0001).

Conclusions: Our meta-analysis showed an inverse and significant association between circulating 25(OH)D levels and risk of type 2 diabetes across a broad range of blood 25(OH)D levels in diverse populations.

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Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
A random-effects meta-analysis of 21 independent prospective studies with adjusted RR and 95% CI of type 2 diabetes in relation to serum 25(OH)D levels (the highest category versus the lowest category). AusDiab, Australian Diabetes, Obesity and Lifestyle Study; DPP, Diabetes Prevention Program; Ely, Medical Research Council Ely Study; EPIC, European Prospective Investigation into Cancer-Norfolk Study; FMC, Finnish Mobile Clinic Health Examination Survey; Hoorn, Hoorn Study; Inter99, Inter99 Study; MFH, Mini-Finland Health Survey; MONICA1, Danish MONICA1 survey; MONICA/KORA, Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg Study; NHS, Nurses’ Health Study; PS, Pizarra Study; SDPP, Stockholm Diabetes Prevention Program.
Figure 3
Figure 3
Relation between the risk of type 2 diabetes and baseline levels of 25(OH)D in 18 independent prospective studies included in the meta-analysis. The relation is modeled by the quadratic spline regression. Circles indicate RR in each study. The circle size is proportional to the precision of the RR (inverse of variance). The gray-shaded region shows the 95% CIs around the regression line.
See this image and copyright information in PMC

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