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Nutrients 2014, 6(12), 5806-5818; doi:10.3390/nu6125806

Urban-Rural Differences Explain the Association between Serum 25-Hydroxyvitamin D Level and Insulin Resistance in Korea

1
Department of Public Health, Yonsei University Graduate School, Seoul 120-752, Korea
2
Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul 120-752, Korea
3
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
4
Department of Sociology, Yonsei University College of Social Sciences, Seoul 120-752, Korea
5
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea
6
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
*
Author to whom correspondence should be addressed.
Received: 30 July 2014 / Revised: 9 October 2014 / Accepted: 24 November 2014 / Published: 11 December 2014
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Abstract

An increasing number of studies report associations between low serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance; however, whether low vitamin D levels directly contribute to increased insulin resistance is unclear. We investigated the impact of residential area on the association between 25(OH)D and insulin resistance in elderly Koreans. Using data from the Korean Urban Rural Elderly study, we conducted cross-sectional analyses in 1628 participants (505 men and 1123 women). Serum 25(OH)D was analyzed as both continuous and categorized variables. Homeostasis model assessment for insulin resistance (HOMA-IR) was calculated using fasting blood glucose and insulin levels. In men, 25(OH)D level was inversely associated with HOMA-IR (standardized β = −0.133, p < 0.001) after adjustment for age, body mass index, waist circumference, smoking, alcohol intake, exercise, and study year. However, we noted significant urban-rural differences in 25(OH)D level (43.4 versus 65.6 nmol/L; p < 0.001) and HOMA-IR (1.2 versus 0.8 mmol·pmol/L2; p < 0.001). When we additionally adjusted for residential area, the association between 25(OH)D and HOMA-IR was attenuated (standardized β = −0.063, p = 0.115). In women, the association between 25(OH)D and HOMA-IR was not significant before or after adjustment for residential area. Environmental or lifestyle differences in urban and rural areas may largely explain the inverse association between serum 25(OH)D and insulin resistance. View Full-Text
Keywords: vitamin D; insulin resistance; elderly; Korean; residential area vitamin D; insulin resistance; elderly; Korean; residential area
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Song, B.M.; Rhee, Y.; Kim, C.O.; Youm, Y.; Kim, K.M.; Lee, E.Y.; Lee, J.-M.; Yoon, Y.M.; Kim, H.C. Urban-Rural Differences Explain the Association between Serum 25-Hydroxyvitamin D Level and Insulin Resistance in Korea. Nutrients 2014, 6, 5806-5818.

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