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Yerin Hwang 1 Article
Associations of fasting glucose and glycated hemoglobin with vitamin D levels according to diabetes mellitus status in Korean adults
Yerin Hwang, Jiyoung Jang, Myung-Hee Shin
Epidemiol Health. 2022;44:e2022025.   Published online February 21, 2022
DOI: https://doi.org/10.4178/epih.e2022025
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to previous studies, vitamin D deficiency might increase the risk of type 2 diabetes mellitus (DM). However, few studies have examined whether vitamin D continues to affect glucose control after DM diagnosis. Therefore, we examined the association between vitamin D and glucose levels in individuals with and without DM.
METHODS
We analyzed data for 32,943 adults aged 19 years and older from the 2008 to 2014 Korea National Health and Nutrition Examination Survey. Patients were classified into 3 groups according to the 25-hydroxyvitamin D concentration. DM was defined as a fasting glucose level ≥126 mg/dL, current use of DM medications or insulin injections, or a self-reported diagnosis of DM by a doctor.
RESULTS
In male DM patients, the hemoglobin A1c (HbA1c) level increased significantly as vitamin D levels became severely deficient. In male and postmenopausal female with abnormal HbA1c, those with severe vitamin D deficiency had significantly higher HbA1c levels (p for trend=0.004 and 0.022 for male and postmenopausal female, respectively). Significant differences were found between participants with normal and abnormal HbA1c levels in both male and female. However, regardless of sex or menopausal status, there was no significant association between vitamin D and fasting glucose in any of the fasting glucose subgroups.
CONCLUSIONS
Male and female with abnormal HbA1c levels showed markedly elevated blood glucose when they also had vitamin D deficiency. A more distinct difference was observed in the HbA1c subgroups than in the fasting glucose subgroups.
Summary
Korean summary
당화혈색소 비정상군에서 비타민 D가 부족할수록 혈당의 상승을 보였다. 현재까지 비타민 D와 혈당 조절과 관련하여 한국인을 대상으로 한 연구는 매우 미비한 상황이며, 한국인을 대상으로 한 연구 결과를 반영한 당뇨병 환자들의 혈당 조절 관리 지침 마련이 필요하다.
Key Message
Guidelines are needed for managing glucose control in DM patients that reflect the results of this research performed among Koreans. Additional large-scale longitudinal studies should be conducted to clarify the causal relationships underlying this association.

Epidemiol Health : Epidemiology and Health