Vitamin D and Diabetes in Koreans: Analyses Based on the Fourth Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2009

Diabet Med. 2012 Aug;29(8):1003-10. doi: 10.1111/j.1464-5491.2012.03575.x.


Aims: A causal relationship between vitamin D deficiency and the incidence of diabetes mellitus has been suggested, but little research has been conducted on the Korean population.

Methods: We analysed the glucose tolerance status and serum 25-hydroxyvitamin D concentrations in 12263 subjects >19 years old who were registered for the Korea National Health and Nutrition Examination Survey, 2008-2009.

Results: Various demographic variables such as gender, age, season, resident area, physical activity, smoking, alcohol, marital status, education and occupation were associated with serum 25-hydroxyvitamin D concentrations. After adjusting for these variables as confounders, 25-hydroxyvitamin D concentrations in subjects with diabetes were significantly lower than those in subjects with normal glucose tolerance and those with impaired fasting glucose (P=0.005). Compared with the ≥ 75 nmol/l subgroup of serum 25-hydroxyvitamin D concentration, the odds ratios and 95% confidence intervals for diabetes mellitus were 1.206 (95%CI 0.948-1.534) in the 50- to 74-nmol/l subgroup, 1.339 (1.051-1.707) in the 25-to 49-nmol/l subgroup and 1.759 (1.267-2.443) in the <25-nmol/l subgroup. Compared with the serum ≥ 75-nmol/l 25-hydroxyvitamin D subgroup, serum insulin and homeostasis model assessment 2%B, a marker of insulin secretory capacity, were significantly higher, and homeostasis model assessment 2%S, a marker of insulin sensitivity, was significantly lower in the <25- and 25- to 49-nmol/l serum 25-hydroxyvitamin D subgroups than those in the other subgroups (P<0.001).

Conclusions: The findings suggest that vitamin D deficiency, possibly involving altered insulin sensitivity, is associated with an increased risk for diabetes mellitus in the Korean population.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / epidemiology*
  • Fasting / blood
  • Female
  • Glucose Intolerance / blood
  • Glucose Intolerance / epidemiology
  • Humans
  • Insulin / metabolism
  • Insulin Resistance / physiology
  • Insulin Secretion
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Republic of Korea / epidemiology
  • Risk Factors
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / epidemiology*
  • Young Adult


  • Insulin
  • Vitamin D
  • 25-hydroxyvitamin D