nach oben

Diabetologia

Erschienen in:

01.08.2008 | Article

The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide

verfasst von: S. B. Mohr, C. F. Garland, E. D. Gorham, F. C. Garland

Erschienen in: Diabetologia | Ausgabe 8/2008

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

This study is an analysis of the relationship between ultraviolet B (UVB) irradiance, the primary source of circulating vitamin D in humans, and age-standardised incidence rates of type 1 diabetes mellitus in children, according to region of the world.

Methods

The association of UVB irradiance adjusted for cloud cover to incidence rates of type 1 diabetes in children aged <14 years during 1990–1994 in 51 regions worldwide was assessed using multiple regression. Incidence data were obtained from the Diabetes Mondial Project Group.

Results

Incidence rates were generally higher at higher latitudes (R ² = 0.25, p < 0.001). According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p < 0.05), while per capita health expenditure (p < 0.004) was positively associated (overall R ² = 0.42, p < 0.0001).

Conclusions/interpretation

An association was found between low UVB irradiance and high incidence rates of type 1 childhood diabetes after controlling for per capita health expenditure. Incidence rates of type 1 diabetes approached zero in regions worldwide with high UVB irradiance, adding new support to the concept of a role of vitamin D in reducing the risk of the disease.

Eiselein L, Schwartz HJ, Rutledge JC (2004) The challenge of type 1 diabetes mellitus. ILAR J 45:231–236PubMed

Jahromi MM, Eisenbarth GS (2007) Cellular and molecular pathogenesis of type I diabetes. Cell Mol Life Sci 64:865–872PubMedCrossRef

Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526PubMedCrossRef

Adams JS, Clemens TL, Parrish JA, Holick MF (1982) Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects. N Engl J Med 306:722–725PubMed

Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC (2007) Is ultraviolet B irradiance inversely associated with incidence rates of endometrial cancer: an ecological study of 107 countries. Prev Med 45:327–331PubMedCrossRef

Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM (2001) Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358:1500–1503PubMedCrossRef

EURODIAB Substudy 2 Study Group (1999) Vitamin D supplement in early childhood and risk for Type I (insulin-dependent) diabetes mellitus. Diabetologia 42:51–54CrossRef

Stene LC, Joner G (2003) Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 78:1128–1134PubMed

Dahlquist GG, Patterson C, Soltesz G (1999) Perinatal risk factors for childhood type 1 diabetes in Europe. The EURODIAB Substudy 2 Study Group. Diabetes Care 22:1698–1702PubMedCrossRef

10.

Stene LC, Barriga K, Norris JM et al (2004) Perinatal factors and development of islet autoimmunity in early childhood: the diabetes autoimmunity study in the young. Am J Epidemiol 160:3–10PubMedCrossRef

11.

Fronczak CM, Baron AE, Chase HP et al (2003) In utero dietary exposures and risk of islet autoimmunity in children. Diabetes Care 26:3237–3242PubMedCrossRef

12.

Stene LC, Ulriksen E, Magnus P, Joner G (2000) Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring. Diabetologia 43:1093–1098PubMedCrossRef

13.

Staples JA, Ponsonby AL, Lim LL, McMichael AJ (2003) Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence. Environ Health Perspect 111:518–523PubMed

14.

Ponsonby AL, Lucas RM, van der Mei IA (2005) UVR, vitamin D and three autoimmune diseases–multiple sclerosis, type 1 diabetes, rheumatoid arthritis. Photochem Photobiol 81:1267–1275PubMedCrossRef

15.

Akerblom HK, Reunanen A (1985) The epidemiology of insulin-dependent diabetes mellitus (IDDM) in Finland and in northern Europe. Diabetes Care 8:10–16PubMed

16.

Burgaz A, Akesson A, Oster A, Michaelsson K, Wolk A (2007) Associations of diet, supplement use, and ultraviolet B radiation exposure with vitamin D status in Swedish women during winter. Am J Clin Nutr 86:1399–1404PubMed

17.

Brustad M, Edvardsen K, Wilsgaard T, Engelsen O, Aksnes L, Lund E (2007) Seasonality of UV-radiation and vitamin D status at 69 degrees north. Photochem Photobiol Sci 6:903–908PubMedCrossRef

18.

Brustad M, Alsaker E, Engelsen O, Aksnes L, Lund E (2004) Vitamin D status of middle-aged women at 65–71 degrees N in relation to dietary intake and exposure to ultraviolet radiation. Public Health Nutr 7:327–335PubMed

19.

Kokkonen J, Koivisto M, Kirkinen P (1983) Seasonal variation in serum-25-OH-D₃ in mothers and newborn infants in northern Finland. Acta Paediatr Scand 72:93–96PubMedCrossRef

20.

Nystrom L, Dahlquist G, Ostman J et al (1992) Risk of developing insulin-dependent diabetes mellitus (IDDM) before 35 years of age: indications of climatological determinants for age at onset. Int J Epidemiol 21:352–358PubMedCrossRef

21.

Adorini L (2002) Immunomodulatory effects of vitamin D receptor ligands in autoimmune diseases. Int Immunopharmacol 2:1017–1028PubMedCrossRef

22.

Kent SC, Chen Y, Bregoli L et al (2005) Expanded T cells from pancreatic lymph nodes of type 1 diabetic subjects recognize an insulin epitope. Nature 435:224–228PubMedCrossRef

23.

Penna G, Amuchastegui S, Giarratana N et al (2007) 1,25-Dihydroxyvitamin D₃ selectively modulates tolerogenic properties in myeloid but not plasmacytoid dendritic cells. J Immunol 178:145–153PubMed

24.

Griffin MD, Dong X, Kumar R (2007) Vitamin D receptor-mediated suppression of Re1B in antigen presenting cells: a paradigm for ligand-augmented negative transcriptional regulation. Arch Biochem Biophys 460:218–226PubMedCrossRef

25.

Adorini L, Giarratana N, Penna G (2004) Pharmacological induction of tolerogenic dendritic cells and regulatory T cells. Semin Immunol 16:127–134PubMedCrossRef

26.

Chailurkit LO, Rajatanavin R, Teerarungsikul K, Ongphiphadhanakul B, Puavilai G (1996) Serum vitamin D, parathyroid hormone and biochemical markers of bone turnover in normal Thai subjects. J Med Assoc Thai 79:499–504PubMed

27.

Haddad JG, Chyu KJ (1971) Competitive protein-binding radioassay for 25-hydroxycholecalciferol. J Clin Endocrinol Metab 33:992–995PubMedCrossRef

28.

National Academy of Sciences–Institute of Medicine–Food and Nutrition Board–Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. National Academy Press, Washington DC

29.

Chen TC, Chimeh F, Lu Z et al (2007) Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Arch Biochem Biophys 460:213–217PubMedCrossRef

30.

Vieth R (1999) Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 69:842–856PubMed

31.

Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D₃: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D₃ synthesis in human skin. J Clin Endocrinol Metab 67:373–378PubMed

32.

Hathcock JN, Shao A, Vieth R, Heaney R (2007) Risk assessment for vitamin D. Am J Clin Nutr 85:6–18PubMed

33.

Ainsleigh G (1993) Beneficial effects of sun exposure on cancer mortality. Prev Med 22:132–140PubMedCrossRef

34.

Berwick M, Armstrong BK, Ben-Porat L et al (2005) Sun exposure and mortality from melanoma. J Natl Cancer Inst 97:195–199PubMedCrossRef

35.

World Health Organization (2004) World Health Report 2004 Statistical Annex. Available from: http://www.who.int/whr/2004/annex/en/index.html, accessed 11 July 2007

36.

Menon RK, Sperling MA (2003) Pediatric diabetes. Kluwer, Boston, MA

37.

Chaturvedi N, Stephenson JM, Fuller JH (1996) The relationship between socioeconomic status and diabetes control and complications in the EURODIAB IDDM Complications Study. Diabetes Care 19:423–430PubMedCrossRef

38.

Rothman KS (1998) Modern epidemiology. Lippincott-Raven, Philadelphia, PA

39.

Romanescu G, Pleceas M (1968) Inactivating action of ultraviolet rays on influenza virus and Coxsackie virus. Stud Cercet Inframicrobiol 19:105–112 (in Romanian)PubMed

40.

Barrett-Connor E (1985) Is insulin-dependent diabetes mellitus caused by Coxsackie virus B infection? A review of the epidemiologic evidence. Rev Infect Dis 7:207–215PubMed

41.

Riley RL (1977) Ultraviolet air disinfection for protection against influenza. Johns Hopkins Med J 141:29–30PubMed

42.

Jun HS, Yoon JW (2003) A new look at viruses in type 1 diabetes. Diabetes Metab Res Rev 19:8–31PubMedCrossRef

43.

Suminski RR, Poston WC, Market P, Hyder M, Sara PA (2008) Meteorological conditions are associated with physical activities performed in open-air settings. Int J Biometeorol 52:189–197PubMedCrossRef

44.

Molla AM, Al Badawi M, Hammoud MS et al (2005) Vitamin D status of mothers and their neonates in Kuwait. Pediatr Int 47:649–652PubMedCrossRef

45.

Mathieu C, Waer M, Laureys J, Rutgeerts O, Bouillon R (1994) Prevention of autoimmune diabetes in NOD mice by 1,25 dihydroxyvitamin D₃. Diabetologia 37:552–558PubMedCrossRef

46.

Zella JB, McCary LC, DeLuca HF (2003) Oral administration of 1,25-dihydroxyvitamin D₃ completely protects NOD mice from insulin-dependent diabetes mellitus. Arch Biochem Biophys 417:77–80PubMedCrossRef

47.

Columbia University, Center for International Earth Science Information Network, Gridded Population of the World Database, Version 3 (2000). Available from http://www.ciesin.columbia.edu/eidata/resource.jsp, accessed 11 May 2008

48.

World Health Organization (2001) The World Health Report 2001 statistical annex. WHO publication no. 1242001. WHO, Geneva, p 160 [Table 5. Selected national health accounts indicators for all member states, estimates for 1997 and 1998]. Available from http://www.who.int/whr/2001/en/annex5_en.pdf, accessed 11 May 2008

Titel: The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide
verfasst von: S. B. Mohr
C. F. Garland
E. D. Gorham
F. C. Garland
Publikationsdatum: 01.08.2008
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 8/2008
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-008-1061-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2008

Functional significance of repressor element 1 silencing transcription factor (REST) target genes in pancreatic beta cells

Mannose-binding lectin plays a critical role in myocardial ischaemia and reperfusion injury in a mouse model of diabetes

No REST for healthy beta cells

The association of intensity and overall level of physical activity energy expenditure with a marker of insulin resistance

Variation in the FTO gene locus is associated with cerebrocortical insulin resistance in humans

Fuel metabolism during exercise in euglycaemia and hyperglycaemia in patients with type 1 diabetes mellitus—a prospective single-blinded randomised crossover trial