Vitamin D deficiency associated with risk of prediabetes among older adults: Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2012

Diabetes Metab Res Rev. 2022 Mar;38(3):e3499. doi: 10.1002/dmrr.3499. Epub 2021 Oct 11.


Aim: To examine the association between vitamin D (25(OH)D) deficiency and risk of prediabetes in Americans 50+ years of age.

Materials and methods: This was a cross-sectional analysis of NHANES (2007-2012) subjects aged 50+ years, free of kidney/liver diseases and diabetes. Prediabetes was defined as: HbA1c level 5.7%-6.4%, or fasting plasma glucose level 100-125 mg/dL, or Oral Glucose Tolerance Test result 140-199 mg/dL, with no laboratory value in the diabetic range. The comparison group had normal glucose tolerance (NGT) with no marker in the prediabetes/diabetes range. Total serum 25(OH)D levels were deficient at <50 nmol/L, insufficient 50-75 nmol/L, and sufficient >75 nmol/L. Logistic regression included strata, cluster and weight variables. Models were adjusted for body mass index (BMI), ethnicity, age and gender.

Results: The final sample was 2286 adults, predominantly White (80.4%) and female (56.6%), with a mean age of 62.3 years. Within the sample, 1387 had prediabetes (59.1%) and 899 were NGT (40.9%). Individuals classified within a lower serum vitamin D category were more likely to have prediabetes (p = 0.03). Those with 25(OH)D deficiency were more likely to have prediabetes compared to 25(OH)D sufficient individuals (crude OR = 1.48, 95% CI 1.15-1.91), and this association remained significant after adjustment for ethnicity, BMI, age and gender (aOR = 1.39, 95% CI 1.02-1.89). There was no effect modification by BMI, gender or ethnicity.

Conclusions: Vitamin D status was associated with risk of prediabetes in this sample of Americans 50+ years of age. Future research should seek to understand the potential mechanistic relationship between vitamin D and prediabetes.

Keywords: 25-hydroxy-vitamin D; NHANES; insulin resistance; type 2 diabetes.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Middle Aged
  • Nutrition Surveys
  • Prediabetic State*
  • Vitamin D
  • Vitamin D Deficiency* / complications
  • Vitamin D Deficiency* / epidemiology


  • Vitamin D