Association of Diabetes Mellitus with a Combination of Vitamin D Deficiency and Arsenic Exposure in the Korean General Population: Analysis of 2008–2009 Korean National Health and Nutrition Examination Survey Data

OBJECTIVES: We present data from the Korean National Health and Nutritional Examination Survey (KNHANES) 2008-2009 on the combination of vitamin D deficiency and arsenic exposure on diabetes mellitus (DM) in a representative sample of the adult Korean population. METHODS: This study was based on data obtained from the KNHANES 2008-2009, which was conducted for 3 years (2007-2009) using a rolling sampling design that involved a complex, stratified, multistage, probability-cluster survey of a representative sample of the non-institutionalized civilian population in South Korea. RESULTS: Data analysis revealed that subjects who showed both vitamin D levels in the 1st quartile (Q) and urinary arsenic levels in the 4th Q, had a 302% increased risk of having DM, as compared with those whose vitamin D and urinary arsenic levels were in the 4th Q and 1st Q, respectively. CONCLUSION: The present study reconfirmed an association of DM with low vitamin D levels and arsenic exposure, and further showed a combination of vitamin D deficiency and arsenic exposure on DM in the general Korean population. To the best of our knowledge, this is the first report describing a combination of vitamin D deficiency and arsenic exposure on DM. The present findings have important public health implications.