Abstract

BackgroundThe prevalence of type 2 diabetes is higher among African Americans (AA) vs European Americans (EA), independent of obesity and other known confounders. Although the reason for this disparity is not known, it is possible that relatively low levels of vitamin D among AA may contribute, as vitamin D has been positively associated with insulin sensitivity in some studies. The objective of this study was to test the hypothesis that dietary vitamin D would be associated with a robust measure of insulin sensitivity in AA and EA women.MethodsSubjects were 115 African American (AA) and 137 European American (EA) healthy, premenopausal women. Dietary intake was determined with 4-day food records; the insulin sensitivity index (SI) with a frequently-sampled intravenous glucose tolerance test and minimal modeling; the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) with fasting insulin and glucose; and body composition with dual-energy X-ray absorptiometry.ResultsVitamin D intake was positively associated with SI (standardized β = 0.18, P = 0.05) and inversely associated with HOMA-IR (standardized β = -0.26, P = 0.007) in AA, and the relationships were independent of age, total body fat, energy intake, and % kcal from fat. Vitamin D intake was not significantly associated with indices of insulin sensitivity/resistance in EA (standardized β = 0.03, P = 0.74 and standardized β = 0.02, P = 0.85 for SI and HOMA-IR, respectively). Similar to vitamin D, dietary calcium was associated with SI and HOMA-IR among AA but not EA.ConclusionsThis study provides novel findings that dietary vitamin D and calcium were independently associated with insulin sensitivity in AA, but not EA. Promotion of these nutrients in the diet may reduce health disparities in type 2 diabetes risk among AA, although longitudinal and intervention studies are required.

Highlights

  • The prevalence of type 2 diabetes is higher among African Americans (AA) vs European Americans (EA), independent of obesity and other known confounders

  • Dietary vitamin D was significantly, positively associated with sensitivity index (SI) (P = 0.01), and there was a trend towards a significant inverse association between vitamin D intake and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and fasting insulin (P = 0.08 for both)

  • If both dietary vitamin D and calcium were added to the models as independent variables, neither nutrient was significantly associated with SI (P = 0.25 and 0.34, respectively) or HOMA-IR (P = 0.18 and 0.25, respectively)

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Summary

Introduction

The prevalence of type 2 diabetes is higher among African Americans (AA) vs European Americans (EA), independent of obesity and other known confounders. The reason for this disparity is not known, it is possible that relatively low levels of vitamin D among AA may contribute, as vitamin D has been positively associated with insulin sensitivity in some studies. Epidemiological research suggests that low vitamin D intake is associated with greater risk of type 2 diabetes [1]. No previous study has African Americans (AA) have lower insulin sensitivity and, subsequently, a greater risk of type 2 diabetes compared to European Americans (EA) [5], the cause of this disparity is multi-factorial and not completely understood. Whether ethnic differences in vitamin D status contribute to the ethnic disparities in type 2 diabetes is not clear

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