TY - JOUR
T1 - Association of racial disparities in the prevalence of insulin resistance with racial disparities in vitamin D levels
T2 - National Health and Nutrition Examination Survey (2001-2006)
AU - Williams, Stephen K.
AU - Fiscella, Kevin
AU - Winters, Paul
AU - Martins, David
AU - Ogedegbe, Gbenga
N1 - Funding Information:
This work was supported by funding from the Agency for Healthcare Research and Quality ( T32 HS 000066 ); The National Heart Lung and Blood Institute ( R01 HL78566 , R01 HL081066 , and R01 HL087301 ); and The National Institute of Minority Health and Health Disparities ( P60MD003421 ).
PY - 2013/4
Y1 - 2013/4
N2 - We tested the hypothesis that racial differences in vitamin D levels are associated with racial disparities in insulin resistance between blacks and whites. Among 3628 non-Hispanic black and white adults in the National Health and Nutrition Examination Survey from 2001 to 2006, we examined the association between race and insulin resistance using the homeostasis assessment model for insulin resistance. We conducted analyses with and without serum 25-hydroxyvitamin D (25[OH]D). We adjusted for age, sex, educational level, body mass index, waist circumference, physical activity, alcohol intake, smoking, estimated glomerular filtration rate, and urinary albumin/creatinine ratio. Blacks had a lower mean serum 25(OH)D level compared with whites (14.6 [0.3] ng/mL vs 25.6 [0.4] ng/mL, respectively; P < .0001). Blacks had a higher odds ratio (OR) for insulin resistance without controlling for serum 25(OH)D levels (OR, 1.67; 95% confidence interval, 1.26-2.20). The association was not significant (OR, 1.28; 95% confidence interval, 0.90-1.82) after accounting for serum 25(OH)D levels. The higher burden of insulin resistance in blacks compared with whites may be partially mediated by the disparity in serum 25(OH)D levels.
AB - We tested the hypothesis that racial differences in vitamin D levels are associated with racial disparities in insulin resistance between blacks and whites. Among 3628 non-Hispanic black and white adults in the National Health and Nutrition Examination Survey from 2001 to 2006, we examined the association between race and insulin resistance using the homeostasis assessment model for insulin resistance. We conducted analyses with and without serum 25-hydroxyvitamin D (25[OH]D). We adjusted for age, sex, educational level, body mass index, waist circumference, physical activity, alcohol intake, smoking, estimated glomerular filtration rate, and urinary albumin/creatinine ratio. Blacks had a lower mean serum 25(OH)D level compared with whites (14.6 [0.3] ng/mL vs 25.6 [0.4] ng/mL, respectively; P < .0001). Blacks had a higher odds ratio (OR) for insulin resistance without controlling for serum 25(OH)D levels (OR, 1.67; 95% confidence interval, 1.26-2.20). The association was not significant (OR, 1.28; 95% confidence interval, 0.90-1.82) after accounting for serum 25(OH)D levels. The higher burden of insulin resistance in blacks compared with whites may be partially mediated by the disparity in serum 25(OH)D levels.
KW - African Americans
KW - Cohort studies
KW - Insulin resistance
KW - Minority health
KW - Vitamin D
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U2 - 10.1016/j.nutres.2013.02.002
DO - 10.1016/j.nutres.2013.02.002
M3 - Article
C2 - 23602243
AN - SCOPUS:84876720227
SN - 0271-5317
VL - 33
SP - 266
EP - 271
JO - Nutrition Research
JF - Nutrition Research
IS - 4
ER -