Multimarker Approach as More Reliable Method Than Single Vitamin D in Relationship with Type 2 Diabetes Mellitus in Montenegrin Postmenopausal Women

Aleksandra Klisic; Milena Cojic; Dimitrios Patoulias; Ana Ninic

doi:10.3390/biomedicines11102610

Multimarker Approach as More Reliable Method Than Single Vitamin D in Relationship with Type 2 Diabetes Mellitus in Montenegrin Postmenopausal Women

Biomedicines. 2023 Sep 23;11(10):2610. doi: 10.3390/biomedicines11102610.

Authors

Aleksandra Klisic^{1

2}, Milena Cojic^{1

2}, Dimitrios Patoulias³, Ana Ninic⁴

Affiliations

¹ Primary Health Care Center, 81000 Podgorica, Montenegro.
² Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro.
³ Outpatient Department of Cardiometabolic Medicine, Second Department of Cardiology, Aristotle University of Thessaloniki, General Hospital "Hippokration", 54642 Thessaloniki, Greece.
⁴ Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia.

Abstract

Objective: Previous studies suggested that ethnic differences, sex and obesity could modify the relationship between 25-hydroxyvitamin D [25(OH)D], glycometabolic markers and/or type 2 diabetes mellitus (T2D). We aimed to examine the potential relationship between [25(OH)D] and T2D in postmenopausal women in Montenegro. In addition, we aimed to explore if a set of biomarkers, rather than [25(OH)D] as a single biomarker, could better explain its potential association with T2D.

Patients and methods: A total of 116 postmenopausal, otherwise healthy women and 48 postmenopausal women with T2D were included. Univariable and multivariable binary logistic regression analysis, along with principal component analysis (PCA), were applied to test the associations between examined biomarkers/set of biomarkers with T2D.

Results: Women with T2D had lower serum [25(OH)D] levels than healthy controls (p = 0.024). No independent relationship between [25(OH)D] and T2D was found. PCA extracted three significant factors that were associated with T2D, i.e., age-glycometabolic-related factor (i.e., with positive loadings of age, glucose and insulin; OR = 11.321, p < 0.001), obesity-inflammation- related factor (i.e., with positive loadings of hsCRP and WC, and negative loading of [25(OH)D]; (OR = 2.079, p < 0.001)) and lipid-related factor (i.e., with positive loadings of TG and LDL-c, and negative loading of HDL-c; OR = 1.423, p = 0.044).

Conclusions: The relationship between [25(OH)D] and T2D is modulated by central obesity (as measured by WC) and inflammation (as measured with hsCRP) in postmenopausal women. Their joint measurement, rather than [25(OH)D] itself, could provide better information for the risk assessment for T2D in postmenopausal women.

Keywords: cardiometabolic risk; inflammation; obesity; postmenopausal; vitamin D deficiency.

Grants and funding

This work was financially supported in part by a grant from the Ministry of Science and Technological Development, Montenegro, and the Ministry of Education, Science and Technological Development, Republic of Serbia (project number 451-03-68/2020-14/200161).