保健医学研究与实践2025，Vol.22Issue(7)：6-12,7.DOI:10.11986/j.issn.1673-873X.2025.07.02
非糖尿病人群维生素D与胰岛素抵抗的关系:基于NHANES的横断面分析
Relationship between vitamin D and insulin resistance in a non-diabetic population:a cross-sectional analysis based on NHANES
摘要
Abstract
Objective To investigate the relationship between vitamin D and insulin resistance(IR)in a non-diabetic population.Methods Using data from the 2021-2023 National Health and Nutrition Examination Survey(NHANES)of the United States,we included non-pregnant adults meeting the study criteria.IR was defined as a Homeostasis Model Assessment of In-sulin Resistance(HOMA-IR)≥ 2.5.Serum vitamin D nutritional status was categorized as deficient,insufficient,or normal.Weighted logistic regression was used to analyze the association between vitamin D and IR,adjusting for age,sex,body mass index(BMI),C-reactive protein(CRP),and season of examination.Trend analyses and sex-stratified analyses were performed to further assess dose-response relationships and sex differences;BMI-stratified analyses were conducted to assess the modif-ying effect of obesity.Results A total of 1,621 participants were included,which after weighting represented 57,560,867 U.S.non-diabetic,non-pregnant adults.Compared with the non-IR group,the IR group had a higher BMI(32.44±7.20 kg/m2 vs.25.70±4.75 kg/m2,P＜0.001);higher CRP(4.47±7.96 mg/L vs.2.70±8.97 mg/L,P=0.003);and lower vitamin D(66.85±29.31 nmol/L vs.76.47±30.15 nmol/L,P＜0.001).Multivariable weighted logistic regression(adjusted for age,sex,BMI,CRP,and season)showed that,compared with the vitamin D normal group,the vitamin D deficient group had a significantly increased risk of IR(OR=2.56,95％CI:1.49-4.39,P=0.009).In addition,each 1 kg/m2 increase in BMI was associated with a 25％higher risk of IR(OR=1.25,95％CI:1.19-1.30,P＜0.001);females had a 49％lower risk of IR compared with males(OR=0.51,95％CI:0.39-0.68,P=0.002).Trend analysis indicated that each one-level im-provement in vitamin D nutritional status(deficient → insufficient → normal)was associated with a significant reduction in IR risk(OR=0.64,95％CI:0.53-0.76,P＜0.001);each 1 nmol/L increase in vitamin D was associated with a 2％reduction in IR risk(OR=0.98,95％CI:0.97-0.99,P＜0.001).Sex-stratified analyses showed a negative association between vita-min D and IR,with a stronger protective effect in women(female OR=0.98,95％CI:0.98-0.99,P=0.009;male OR=0.99,95％CI:0.99-1.00,P=0.070).BMI-lstratified analyses indicated the strongest effect of vitamin D deficiency in the obese subgroup(OR=3.48,95％CI:2.22-5.44,P＜0.001).Conclusion Vitamin D deficiency is significantly associated with increased risk of IR,and this association is amplified by obesity;vitamin D shows a stronger protective association in women.These findings suggest that correcting vitamin D deficiency may help improve insulin resistance.关键词
维生素D/胰岛素抵抗/横断面研究/身体质量指数Key words
Vitamin D/Insulin resistance/Cross-sectional study/Body mass index分类
预防医学引用本文复制引用
李元美,吴艳,付彩雯,黄秀丽,李钰艳,刘芸廷,喻荷淋..非糖尿病人群维生素D与胰岛素抵抗的关系:基于NHANES的横断面分析[J].保健医学研究与实践,2025,22(7):6-12,7.基金项目
四川省中医药管理局科学技术研究专项课题(2020LC0215). （2020LC0215）
