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Meilina A, Anjani G, Djamiatun K. The effect of fortified Dadih (fermented buffalo milk) with vitamin D3 on caecum cholesterol concentration and high sensitivity c-reactive protein (hs-CRP) level in type 2 diabetes mellitus rat model. POTRAVINARSTVO 2020. [DOI: 10.5219/1446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) may be developed by a cardiovascular complication. T2DM and its complications associated with a decrease in levels of 25 hydroxyvitamin D below normal. The level of 25-OH-D can increase and it can be gained by probiotics supplementation. Dadih is a probiotic useful as antidiabetic, antiatherosclerotic, and it can reduce serum cholesterol. Vitamin D is beneficial for T2DM since it improves insulin production, acts as an anti-inflammatory and prevents dyslipidemia thereby preventing cardiovascular disease. This research aims to investigate the effects of giving dadih-fortified-vitamin-D3 toward caecum-cholesterol-concentration and hs-CRP-levels to T2DM-induced-rats. This study used a randomized pre-post test with control group design in 30 Wistar rats divided into 5 groups, namely T1, T2, and T3-treatment-groups. T3-group was given dadih-fortified-vitamin-D3, while T1 and T2-groups were given vitamin-D3 and dadih, respectively. The control groups were healthy-control (C1), and T2DM (C2). The intervention was given through oral sonde for 28days. The variables analyzed were caecal-cholesterol-concentrations using a spectrophotometer and hs-CRP using the ELISA method. The statistical tests were used for the caecum-cholesterol-concentration and hs-CRP levels. The mean of caecum-cholesterol-concentration in the T3-group (83.68 ±1.93mg.100g-1), was higher than T1 (77.99 ±1.70; p = 0.004) and C2-control (24.39 ±1.47; p = 0.0001). The mean of hs-CRP-level post-intervention in the T3-group (4.21 ±0.41 ng.mL-1), was lower than C2 (17.15 ±0.85;p = 0.0001), T1 (6.59 ±0.27; p = 0.0001) and T2 (5.43 ±0.39; p = 0.004). There is a very strong inverse correlation between the concentration of cholesterol and hs-CRP ( r = -0.979, p = 0.0001). The conclusion is dadih-fortified-vitamin-D3 –intervention is better than its single intervention as an anti-inflammation which might relate to the increased caecum-cholesterol-concentration.
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The Molecular Mechanisms by Which Vitamin D Prevents Insulin Resistance and Associated Disorders. Int J Mol Sci 2020; 21:ijms21186644. [PMID: 32932777 PMCID: PMC7554927 DOI: 10.3390/ijms21186644] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
Numerous studies have shown that vitamin D deficiency is very common in modern societies and is perceived as an important risk factor in the development of insulin resistance and related diseases such as obesity and type 2 diabetes (T2DM). While it is generally accepted that vitamin D is a regulator of bone homeostasis, its ability to counteract insulin resistance is subject to debate. The goal of this communication is to review the molecular mechanism by which vitamin D reduces insulin resistance and related complications. The university library, PUBMED, and Google Scholar were searched to find relevant studies to be summarized in this review article. Insulin resistance is accompanied by chronic hyperglycaemia and inflammation. Recent studies have shown that vitamin D exhibits indirect antioxidative properties and participates in the maintenance of normal resting ROS level. Appealingly, vitamin D reduces inflammation and regulates Ca2+ level in many cell types. Therefore, the beneficial actions of vitamin D include diminished insulin resistance which is observed as an improvement of glucose and lipid metabolism in insulin-sensitive tissues.
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Nimitphong H, Park E, Lee MJ. Vitamin D regulation of adipogenesis and adipose tissue functions. Nutr Res Pract 2020; 14:553-567. [PMID: 33282119 PMCID: PMC7683208 DOI: 10.4162/nrp.2020.14.6.553] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/03/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Vitamin D insufficiency is associated with obesity and its related metabolic diseases. Adipose tissues store and metabolize vitamin D and expression levels of vitamin D metabolizing enzymes are known to be altered in obesity. Sequestration of vitamin D in large amount of adipose tissues and low vitamin D metabolism may contribute to the vitamin D inadequacy in obesity. Vitamin D receptor is expressed in adipose tissues and vitamin D regulates multiple aspects of adipose biology including adipogenesis as well as metabolic and endocrine function of adipose tissues that can contribute to the high risk of metabolic diseases in vitamin D insufficiency. We will review current understanding of vitamin D regulation of adipose biology focusing on vitamin D modulation of adiposity and adipose tissue functions as well as the molecular mechanisms through which vitamin D regulates adipose biology. The effects of supplementation or maintenance of vitamin D on obesity and metabolic diseases are also discussed.
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Affiliation(s)
- Hataikarn Nimitphong
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon 34430, Korea
| | - Mi-Jeong Lee
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii, Honolulu, HI 96822, USA
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Dall’Agnol A, Brondani LDA, Cancelier VDA, Camargo EG, Silveiro SP. Lower serum 25-hydroxyvitamin D levels are associated with impaired glomerular filtration rate in type 2 diabetes patients. Ther Adv Endocrinol Metab 2020; 11:2042018820930904. [PMID: 32782774 PMCID: PMC7385831 DOI: 10.1177/2042018820930904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND 25-Hydroxyvitamin D [25(OH)D] deficiency has been implicated as a possible risk factor for the onset and progression of diabetes kidney disease (DKD). The aim of this study was to evaluate the interaction between levels of 25(OH)D and DKD in type 2 diabetes mellitus (DM) patients. METHODS Cross-sectional design, outpatient type 2 DM. Glomerular filtration rate (GFR) was measured by 51Cr-EDTA and estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), urinary albumin excretion (UAE) by immunoturbidimetry, and 25(OH)D by chemiluminescence. Receiver operating characteristic (ROC) curve analysis and generalized linear model (Poisson robust regression estimator) were used to assess the interaction between 25(OH)D levels and renal function. RESULTS A total of 114 type 2 DM patients aged 60 ± 10 years, 49 males (43%), DM duration 22 ± 10 years, with GFR > 60 ml/min/1.73 m2 were evaluated. Patients with GFRs 60-90 (n = 50) had significantly lower 25(OH)D levels than individuals with GFRs > 90 ml/min/1.73 m2 (n = 64), respectively 40 ± 20 versus 48 ± 20 nmol/l, p = 0.027. This difference was more pronounced for older individuals (39 ± 20 versus 54 ± 23 nmol/l, respectively), and Poisson robust regression disclosed that lower 25(OH)D [Poisson regression (PR) = 0.989, confidence interval (CI): 0.978-0.999, p = 0.034], and advanced age (PR = 1.050, CI: 1.007-1.096, p = 0.023) were significantly associated with the lower GFR category, adjusted for seasons. ROC curve analysis showed that the cutoff point of 25(OH)D of 41 nmol/l was associated with lower GFR [area under the curve (AUC) = 0.694, p = 0.009]. CKD-EPI estimated GFR (eGFR) was not associated with 25(OH)D in any analysis. There was no difference in 25(OH)D levels between patients with elevated UAE as compared with normoalbuminuric ones (44 ± 21 versus 46 ± 19 nmol/l, p = 0.587). CONCLUSION Lower levels of 25(OH)D are associated with decreased GFR in patients with type 2 DM, especially in older patients, with no evidence of interaction with UAE levels.
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Affiliation(s)
- Angélica Dall’Agnol
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Letícia de Almeida Brondani
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vítor da Agostim Cancelier
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo Guimarães Camargo
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra Pinho Silveiro
- Endocrine Division, HCPA, Rua Ramiro Barcelos, Porto Alegre, RS Brazil
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, 2350, 4° andar, Porto Alegre, RS 90035-003, Brazil
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Cho J, Scragg R, Pandol SJ, Petrov MS. Exocrine Pancreatic Dysfunction Increases the Risk of New-Onset Diabetes Mellitus: Results of a Nationwide Cohort Study. Clin Transl Sci 2020; 14:170-178. [PMID: 32692901 PMCID: PMC7877819 DOI: 10.1111/cts.12837] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 12/11/2022] Open
Abstract
It is well established that individuals with diabetes mellitus (DM) may develop exocrine pancreatic dysfunction (EPD) requiring pancreatic enzyme replacement therapy, whereas the converse relationship has been poorly studied. Pancreatitis is a disease that is well suited to investigate the latter as it is often characterized by the development of EPD and/or new‐onset DM. The aim was to investigate the association between EPD and the risk of new‐onset DM in individuals after the first attack of pancreatitis. Using nationwide pharmaceutical dispensing data and hospital discharge data, this cohort study included a total of 9,124 post‐pancreatitis individuals. EPD was defined as having two or more dispensing records of pancreatic enzymes. Considering EPD as a time‐dependent variable, multivariable Cox regression analysis was conducted. A 1‐year lag period between EPD and DM was introduced to minimize reverse causality. Age, sex, ethnicity, alcohol consumption, tobacco smoking, social deprivation index, Charlson comorbidity index, and use of proton pump inhibitors were adjusted for. In the overall cohort, EPD was associated with a significantly higher risk for new‐onset DM (adjusted hazard ratio, 3.83; 95% confidence interval, 2.37–6.18). The association remained statistically significant when a 1‐year lag period was applied (adjusted hazard ratio, 2.51; 95% confidence interval, 1.38–4.58), as well as when the analysis was constrained to mild acute pancreatitis (4.65; 2.18–9.93). The findings suggest that individuals with EPD, even those without extensive mechanistic destruction of the pancreas, are at an increased risk for new‐onset DM. Purposely designed studies are warranted to investigate mechanisms behind the association and if the mechanisms could be targeted therapeutically.
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Affiliation(s)
- Jaelim Cho
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Stephen J Pandol
- Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Maxim S Petrov
- School of Medicine, University of Auckland, Auckland, New Zealand
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Pramono A, Jocken JWE, Blaak EE, van Baak MA. The Effect of Vitamin D Supplementation on Insulin Sensitivity: A Systematic Review and Meta-analysis. Diabetes Care 2020; 43:1659-1669. [PMID: 33534727 DOI: 10.2337/dc19-2265] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/02/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Vitamin D has been suggested to affect peripheral insulin sensitivity. Evidence regarding the effect of vitamin D supplementation on insulin sensitivity is still conflicting. PURPOSE This meta-analysis aimed to assess the effect of vitamin D supplementation on insulin sensitivity in humans with or at risk for insulin resistance. DATA SOURCES AND STUDY SELECTION PubMed, Web of Science, Embase, CINAHL, and Cochrane Library were systematically searched for randomized controlled trials (RCTs) from 1980 until 31 December 2018 reporting treatment effects of vitamin D supplementation on insulin sensitivity. DATA EXTRACTION The main outcome of interest was the change in insulin sensitivity, derived from the gold standard hyperinsulinemic-euglycemic clamp or the Matsuda index derived from the oral glucose tolerance test and insulin sensitivity index from intravenous glucose tolerance test. We extracted data on the standardized mean difference between the vitamin D treatment and placebo groups in change from baseline insulin sensitivity. DATA SYNTHESIS Eighteen RCTs were included in this meta-analysis comparing vitamin D supplementation (n = 612) with placebo (n = 608). Vitamin D supplementation had no effect on insulin sensitivity (standardized mean difference -0.01, 95% CI -0.12, 0.10; P = 0.87, I 2 = 0%). Visual inspection of funnel plot symmetry did not suggest potential publication bias. LIMITATIONS The number of individuals who participated in the included studies was relatively small, possibly due to the invasive character of the measurement (e.g., clamp). CONCLUSIONS This meta-analysis provides no evidence that vitamin D supplementation has a beneficial effect on peripheral insulin sensitivity in people with or at risk for insulin resistance.
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Affiliation(s)
- Adriyan Pramono
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.,Department of Nutrition, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Johan W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Marleen A van Baak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
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Al Thani M, Sadoun E, Sofroniou A, Jayyousi A, Baagar KAM, Al Hammaq A, Vinodson B, Akram H, Bhatti ZS, Nasser HS, Leventakou V. The effect of vitamin D supplementation on the glycemic control of pre-diabetic Qatari patients in a randomized control trial. BMC Nutr 2020; 5:46. [PMID: 32153959 PMCID: PMC7050821 DOI: 10.1186/s40795-019-0311-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/24/2019] [Indexed: 01/12/2023] Open
Abstract
Background Vitamin D deficiency is associated with indicators of pre-diabetes including, insulin resistance, β-cell dysfunction and elevated plasma glucose with controversial findings from current trials. This study aims to investigate the long-term effect of vitamin D on glucose metabolism and insulin sensitivity in pre-diabetic and highly vitamin-deficient subjects. Methods One hundred thirty-two participants were randomized to 30,000 IU vitamin D weekly for 6 months. Participants underwent oral glucose tolerance test (OGTT) at 3-month intervals to determine the change in plasma glucose concentration at 2 h after 75 g OGTT (2hPCG). Secondary measurements included glycated hemoglobin, fasting plasma glucose and insulin, post-prandial insulin, indices of insulin sensitivity (HOMA-IR, Matsuda Index), β-cell function (HOMA-β, glucose and insulin area under the curve (AUC), disposition and insulinogenic indices), and lipid profile. Results A total of 57 (vitamin D) and 75 (placebo) subjects completed the study. Mean baseline serum 25(OH) D levels were 17.0 ng/ml and 14.9 ng/ml for placebo and vitamin D group, respectively. No significant differences were observed for 2hPC glucose or insulin sensitivity indices between groups. HOMA-β significantly decreased in the vitamin D group, while area under curve for glucose and insulin showed a significant reduction in β-cell function in both groups. Additionally, HOMA-β was found to be significantly different between control and treatment group and significance persisted after adjusting for confounding factors. Conclusion Vitamin D supplementation in a pre-diabetic and severely vitamin-deficient population had no effect on glucose tolerance or insulin sensitivity. The observed reduction in β-cell function in both placebo and vitamin D groups could be attributed to factors other than supplementation. Trial registration NCT02098980, 28/03/2014 (www.clinicaltrials.gov).
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Affiliation(s)
| | - Eman Sadoun
- 2Biomedical Research Department, Ministry of Public Health, P.O. Box 42, Al Khaleej Str, Al Rumaila, Doha, Qatar
| | | | - Amin Jayyousi
- 3Diabetes and Endocrine Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Hammad Akram
- 1Public Health Department, Ministry of Public Health, Doha, Qatar
| | - Zaid Shakoor Bhatti
- 2Biomedical Research Department, Ministry of Public Health, P.O. Box 42, Al Khaleej Str, Al Rumaila, Doha, Qatar
| | | | - Vasiliki Leventakou
- 2Biomedical Research Department, Ministry of Public Health, P.O. Box 42, Al Khaleej Str, Al Rumaila, Doha, Qatar
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58
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Vitamin D Supplementation Improves Adipose Tissue Inflammation and Reduces Hepatic Steatosis in Obese C57BL/6J Mice. Nutrients 2020; 12:nu12020342. [PMID: 32012987 PMCID: PMC7071313 DOI: 10.3390/nu12020342] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 02/07/2023] Open
Abstract
The beneficial effect of vitamin D (VD) supplementation on body weight gain limitation and inflammation has been highlighted in primary prevention mice models, but the long-term effect of VD supplementation in tertiary prevention has never been reported in obesity models. The curative effect of VD supplementation on obesity and associated disorders was evaluated in high-fat- and high-sucrose (HFS)-fed mice. Morphological, histological, and molecular phenotype were characterized. The increased body mass and adiposity caused by HFS diet as well as fat cell hypertrophy and glucose homeostasis were not improved by VD supplementation. However, VD supplementation led to a decrease of HFS-induced inflammation in inguinal adipose tissue, characterized by a decreased expression of chemokine mRNA levels. Moreover, a protective effect of VD on HFS-induced hepatic steatosis was highlighted by a decrease of lipid droplets and a reduction of triglyceride accumulation in the liver. This result was associated with a significant decrease of gene expression coding for key enzymes involved in hepatic de novo lipogenesis and fatty acid oxidation. Altogether, our results show that VD supplementation could be of interest to blunt the adipose tissue inflammation and hepatic steatosis and could represent an interesting nutritional strategy to fight obesity-associated comorbidities.
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59
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Li J, Li X, Gathirua-Mwangi W, Song Y. Prevalence and trends in dietary supplement use among US adults with diabetes: the National Health and Nutrition Examination Surveys, 1999-2014. BMJ Open Diabetes Res Care 2020; 8:8/1/e000925. [PMID: 31958304 PMCID: PMC7039581 DOI: 10.1136/bmjdrc-2019-000925] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/22/2019] [Accepted: 12/03/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate overall prevalence and trends of use of any supplements, multivitamins/multiminerals (MVMM), individual vitamins, minerals, and non-vitamin, non-mineral (NVNM) supplements among adults with diabetes in the USA. RESEARCH DESIGN AND METHODS We used a nationally representative sample from the National Health and Nutrition Examination Survey collected between 1999 and 2014. Information on supplement use in the preceding 30 days was collected during interview over 8 continuous 2-year waves. To account for the complex sampling design, weighted analyses were conducted among 6688 US adults with diabetes aged 20-85 years and also stratified by age, sex, race/ethnicity, education, comorbidity status, and diabetes duration. RESULTS Overall, the prevalence of any supplement use (52%-58%; P for trend=0.08) and that of any mineral use (47%-51%; P for trend=0.23) seemed stable over the years studied. Reported use of MVMM slightly decreased from 36% to 32% (P for trend=0.006). Use of any vitamin products significantly increased from 47% to 52% (P for trend=0.03). Use of some individual supplements, especially vitamin D, choline, lycopene, and fish oil supplements, significantly increased, while some vitamins, minerals and NVNM supplements decreased over the years. In addition, the trend of any supplement use varied by age, sex, race/ethnicity, or education, but not by diabetes duration or diabetic comorbidities. CONCLUSIONS Among US patients with diabetes, use of any dietary supplements or any minerals remained stable, while MVMM use slightly decreased and use of any vitamins increased. Additionally, use of several individual supplements varied significantly over the 16-year period studied.
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Affiliation(s)
- Jing Li
- Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Xinli Li
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University Medical College, Suzhou, Jiangsu, China
| | | | - Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
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Jang H, Lee Y, Park K. Obesity and Vitamin D Insufficiency among Adolescent Girls and Young Adult Women from Korea. Nutrients 2019; 11:nu11123049. [PMID: 31847208 PMCID: PMC6950463 DOI: 10.3390/nu11123049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/05/2019] [Accepted: 12/11/2019] [Indexed: 01/21/2023] Open
Abstract
Although there is evidence of the biological mechanisms by which obesity may induce vitamin D insufficiency or deficiency, limited epidemiological studies have been conducted, especially among Asian adolescent girls and young adult women who are at a high risk of vitamin D deficiency. This study aimed to examine the cross-sectional association between obesity and vitamin D insufficiency among adolescent girls and young adult women in Korea. We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2014, and 3623 girls and young adult women aged 12–29 years were included. Demographic and lifestyle data were collected using a self-administered questionnaire from the health interview survey. Serum 25-hydroxyvitamin D (25(OH)D) level, body mass index (BMI), and body fat percentage (BF%) were measured during health examinations. Multivariable logistic regression was used considering the complex, multistage probability sample design of KNHANES. In the multivariable-adjusted analyses, obese girls and women, defined by BMI, were more likely to have a higher prevalence of vitamin D insufficiency (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.03–2.17). This association was also evident for BF%. Participants with ≥30% BF% had a significantly higher prevalence of vitamin D insufficiency (OR: 1.52, 95% CI: 1.07–2.16). Obesity may worsen vitamin D insufficiency among adolescents and young women because of the fat-soluble characteristics of vitamin D and related health behaviors, such as a lack of outdoor activity. Further large-scale prospective cohort studies or randomized controlled trials are warranted to confirm this causality.
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61
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López-Baena MT, Pérez-Roncero GR, Pérez-López FR, Mezones-Holguín E, Chedraui P. Vitamin D, menopause, and aging: quo vadis? Climacteric 2019; 23:123-129. [PMID: 31736391 DOI: 10.1080/13697137.2019.1682543] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Menopause and aging are associated with changes in circulating gonadal steroid hormones, insulin sensitivity, body composition, and also lifestyle and social coordinates. Vitamin D status influences different metabolic adjustments, aside from calcium-phosphorus and bone metabolism. The main blood marker used to measure endogenous vitamin D status is 25-hydroxyvitamin D. Aging is associated with increases in serum parathyroid hormone and alkaline phosphatase, and a decrease of serum calcium, phosphorus, and vitamin D metabolites. 25-Hydroxyvitamin D status is also influenced by the circannual rhythm of sun irradiation. Results of clinical association studies have not correlated with intervention trials, experimental studies, and/or meta-analyses regarding the role of vitamin D on different outcomes in women during their second half of life and the vitamin D supplementation dose needed to improve clinical endpoints. Discordant results have been related to the method used to measure vitamin D, the studied population (i.e., sociodemographics and ethnicity), study designs, and biases of analyses. Vitamin D supplementation with cholecalciferol or calcifediol may improve some metabolic variables and clinical outcomes in young postmenopausal and older women. Studies seem to suggest that calcifediol may have some advantages over other forms of vitamin D supplementation. Further studies are needed to define interventions with supplements and effective food fortification.
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Affiliation(s)
- M T López-Baena
- Red de Investigación de Ginecología, Obstetricia y Reproducción, Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
| | - G R Pérez-Roncero
- Red de Investigación de Ginecología, Obstetricia y Reproducción, Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
| | - F R Pérez-López
- Red de Investigación de Ginecología, Obstetricia y Reproducción, Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
| | - E Mezones-Holguín
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Perú.,Epi-gnosis Solutions, Piura, Perú
| | - P Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Facultad de Ciencias de la Salud, Universidad Católica 'Nuestra Señora de la Asunción', Asunción, Paraguay
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62
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Liu JM, Zhu DL, Mu YM, Xia WB. Management of fracture risk in patients with diabetes-Chinese Expert Consensus. J Diabetes 2019; 11:906-919. [PMID: 31219236 DOI: 10.1111/1753-0407.12962] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/20/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jian-Min Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai, China
| | - Da-Long Zhu
- Department of Endocrinology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Yi-Ming Mu
- Department of Endocrinology, The General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Wei-Bo Xia
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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Bouillon R, Marcocci C, Carmeliet G, Bikle D, White JH, Dawson-Hughes B, Lips P, Munns CF, Lazaretti-Castro M, Giustina A, Bilezikian J. Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions. Endocr Rev 2019; 40:1109-1151. [PMID: 30321335 PMCID: PMC6626501 DOI: 10.1210/er.2018-00126] [Citation(s) in RCA: 563] [Impact Index Per Article: 112.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/17/2018] [Indexed: 02/06/2023]
Abstract
The etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D-deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.
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Affiliation(s)
- Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Geert Carmeliet
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium
| | - Daniel Bikle
- Veterans Affairs Medical Center and University of California San Francisco, San Francisco, California
| | - John H White
- Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, HV Amsterdam, Netherlands
| | - Craig F Munns
- Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Andrea Giustina
- Chair of Endocrinology, Vita-Salute San Raffaele University, Milan, Italy
| | - John Bilezikian
- Department of Endocrinology, Columbia University College of Physicians and Surgeons, New York, New York
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Leung PS. The Modulatory Action of Vitamin D on the Renin-Angiotensin System and the Determination of Hepatic Insulin Resistance. Molecules 2019; 24:molecules24132479. [PMID: 31284538 PMCID: PMC6651371 DOI: 10.3390/molecules24132479] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/16/2022] Open
Abstract
Vitamin D deficiency or hypovitaminosis D is associated with increased risks of insulin resistance, type 2 diabetes mellitus (T2DM) and its related non-alcoholic fatty liver disease (NAFLD). Meanwhile, inappropriate over-activation of the renin–angiotensin system (RAS) in the liver leads to the hepatic dysfunction and increased risk of T2DM, such as abnormalities in lipid and glucose metabolism. Our previous findings have shown that calcitriol, an active metabolite of vitamin D, reduces hepatic triglyceride accumulation and glucose output in diabetic db/db mice and human hepatocellular cell HepG2 cells under insulin-resistant conditions. Notwithstanding the existence of this evidence, the protective action of vitamin D in the modulation of overexpressed RAS-induced metabolic abnormalities in the liver under insulin resistance remains to be elusive and investigated. Herein, we have reported the potential interaction between vitamin D and RAS; and its beneficial effects on the expression and function of the RAS components in HepG2 cells and primary hepatocytes under insulin-resistance states. Our study findings suggest that hormonal vitamin D (calcitriol) has modulatory action on the inappropriate upregulation of the hepatic RAS under insulin-resistant conditions. If confirmed, vitamin D supplementation might provide a nutraceutical potential as a cost-effective approach for the management of hepatic metabolic dysfunction as observed in T2DM and related NAFLD.
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Affiliation(s)
- Po Sing Leung
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Pramono A, Jocken JWE, Blaak EE. Vitamin D deficiency in the aetiology of obesity-related insulin resistance. Diabetes Metab Res Rev 2019; 35:e3146. [PMID: 30801902 DOI: 10.1002/dmrr.3146] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/08/2019] [Accepted: 02/19/2019] [Indexed: 12/11/2022]
Abstract
The obese insulin-resistant state is often associated with low circulating concentration of vitamin D 25-hydroxyvitamin D3 [25(OH)D3 ]. Fat sequestration of vitamin D in the expanded obese adipose tissue mass has been pointed out as a plausible explanation for this circulating vitamin D deficiency. However, the putative mechanisms behind this hypovitaminosis D remain to be elucidated. The presence of vitamin D receptor and vitamin D-metabolizing enzymes in insulin-sensitive organs suggests that vitamin D may be involved in glucose and lipid metabolism and may be related to insulin sensitivity. Indeed, mainly in vitro studies support a role of vitamin D in regulating glucose and lipid metabolism in several insulin-sensitive tissues including adipose tissue, skeletal muscle, liver, as well as pancreatic insulin secretion. A potential role of vitamin D in gut barrier function and metabolism has also been suggested. This review summarizes recent knowledge on vitamin D deficiency in the aetiology of obesity-related insulin resistance and discusses potential underlying mechanisms. Finally, the role of vitamin D supplementation on insulin sensitivity and glycaemic control is discussed.
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Affiliation(s)
- Adriyan Pramono
- Department of Human Biology, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Johan W E Jocken
- Department of Human Biology, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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66
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Vitamin D Supplementation Reduces Both Oxidative DNA Damage and Insulin Resistance in the Elderly with Metabolic Disorders. Int J Mol Sci 2019; 20:ijms20122891. [PMID: 31200560 PMCID: PMC6628266 DOI: 10.3390/ijms20122891] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/31/2019] [Accepted: 06/10/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Research evidence indicates that vitamin D deficiency is involved in the pathogenesis of insulin resistance (IR) and associated metabolic disorders including hyperglycemia and dyslipidemia. It also suggested that vitamin D deficiency is associated with elevated levels of oxidative stress and its complications. Therefore, the aim of our study was to determine the effect of vitamin D supplementation on DNA damage and metabolic parameters in vitamin D deficient individuals aged >45 with metabolic disorders. Material and Methods: Of 98 initially screened participants, 92 subjects deficient in vitamin D were included in the study. They were randomly assigned to the following group: with vitamin D supplementation (intervention group, n = 48) and without supplementation (comparative group, n = 44). The patients from both groups were divided into two subgroups according to the presence or absence of type 2 diabetes (T2DM). The intervention group was treated with 2000 International Unit (IU) cholecalciferol/day between October and March for three months. At baseline and after three-month supplementation vitamin D concentration (25-OH)D3 and endogenous and oxidative DNA damage were determined. In addition, fast plasma glucose (FPG), fasting insulin, HbA1c and lipid fraction (total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglyceride (TG)), as well as anthropometric measurements (weight, height) were gathered. The following IR-related parameters were calculated Homeostatic Model Assesment – Insulin Resistance (HOMA-IR) and TG/HDL ratio. Results: Three-month vitamin D supplementation increased the mean vitamin D concentration to generally accepted physiological level independently of T2DM presence. Importantly, vitamin D exposure decreased the level of oxidative DNA damage in lymphocytes of patients of intervention group. Among studied metabolic parameters, vitamin D markedly increased HDL level, decreased HOMA-IR, TG/HDL ratio. Furthermore, we found that HbA1c percentage diminished about 0.5% in T2DM patients supplemented with vitamin D. Conclusion: The current study demonstrated that daily 2000I U intake of vitamin D for three months decreased the level of oxidative DNA damage, a marker of oxidative stress, independently on T2DM presence. Furthermore, vitamin D reduced metabolic parameters connected with IR and improved glucose and lipid metabolism. Therefore, our results support the assertion that vitamin D, by reducing oxidative stress and improving of metabolic profile, may decrease IR and related diseases.
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Contreras-Manzano A, Villalpando S, García-Díaz C, Flores-Aldana M. Cardiovascular Risk Factors and Their Association with Vitamin D Deficiency in Mexican Women of Reproductive Age. Nutrients 2019; 11:nu11061211. [PMID: 31141980 PMCID: PMC6627884 DOI: 10.3390/nu11061211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/04/2019] [Accepted: 05/08/2019] [Indexed: 02/08/2023] Open
Abstract
Based on a nationally representative sample of young Mexican women aged 20 to 49 years (n = 3260), we sought to explore whether cardiovascular risk factors and acute myocardial infarction (AMI) were associated with vitamin D deficiency (VDD, defined as 25-OH-D <50 nmol/L). To this end, we obtained sociodemographic, serum and anthropometric data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). Analyses were developed through logistic regression models adjusted for potential confounders. The prevalence of VDD was significantly higher in obese women (42.5%, 95% CI; 37.3–47.9) compared to women with a normal body mass index (29.9%, 95% CI; 23.5–37.1, p = 0.05), in those with high total cholesterol (TC) (45.6% 95% CI; 39.4–51.9) compared to those with normal TC levels (33.9%, 95% CI 30–38.1, p = 0.03), and in those with insulin resistance (IR) (44%, 95% CI; 36.9–51.7) or type 2 diabetes mellitus (T2DM) (58.6%, 95% CI 46.9–69.4) compared to those with normal glycemia (no insulin resistance: 34.7%, 95% CI; 30.9–38.8, p = 0.04 and no T2DM: 34.9%, 95% CI 31.4–38.6, p < 0.001). Utilizing individual models to estimate cardiovascular risk according to VDD, we found that the odds of being obese (odds ratio, OR: 1.53, 95% CI 1.02–2.32, p = 0.05), or having high TC levels (OR: 1.43, 95% CI; 1.05–2.01, p = 0.03), T2DM (OR: 2.64, 95% CI; 1.65–4.03, p < 0.001), or IR (OR: 1.48, 95% CI 1.04–2.10, p = 0.026) were significantly higher in women with VDD (p < 0.05). Odds were not statistically significant for overweight, high blood pressure, sedentarism, AMI, high serum concentration of triglycerides, homocysteine, or C-reactive protein models. In conclusion, our results indicate that young Mexican women with VDD show a higher prevalence of cardiovascular risk factors.
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Affiliation(s)
| | - Salvador Villalpando
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - Claudia García-Díaz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - Mario Flores-Aldana
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico.
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Ostadmohammadi V, Milajerdi A, Ghayour-Mobarhan M, Ferns G, Taghizadeh M, Badehnoosh B, Mirzaei H, Asemi Z. The Effects of Vitamin D Supplementation on Glycemic Control, Lipid Profiles and C-Reactive Protein Among Patients with Cardiovascular Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Curr Pharm Des 2019; 25:201-210. [DOI: 10.2174/1381612825666190308152943] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/04/2019] [Indexed: 12/21/2022]
Abstract
Background:
Insulin resistance, dyslipidemia and chronic inflammation are important risk factors for
cardiovascular diseases (CVD). Hence, vitamin D supplementation might be an appropriate approach to decrease
the complications of CVD. This systematic review and meta-analysis aimed to determine the effects of vitamin D
supplementation on glycemic control, lipid profiles, and C-reactive protein among patients with coronary artery
disease.
Methods:
Two independent authors systematically searched online databases including EMBASE, Scopus, Pub-
Med, Cochrane Library, and Web of Science until 20th September 2018. Cochrane Collaboration risk of bias tool
was applied to assess the methodological quality of included trials. The heterogeneity among the included studies
was assessed using Cochran’s Q test and I-square (I2) statistic. Data were pooled using a random-effects model
and weighted mean difference (WMD) was considered as the overall effect size.
Results:
A total of eight trials (305 participants in the intervention group and 325 in placebo group) were included
in the current meta-analysis. Pooling effect sizes from studies revealed a significant reduction in fasting glucose
(WMD): -15.67; 95% CI: -29.32, -2.03), insulin concentrations (WMD: -3.53; 95% CI: -4.59, -2.46) and homeostatic
model assessment of insulin resistance (WMD: -1.07; 95% CI: -1.49, -0.66), and significant increase in the
quantitative insulin-sensitivity check index (WMD: 0.02; 95% CI: 0.01, 0.03) following the administration of
vitamin D. In addition, pooled analysis revealed a significant increase in serum HDL-cholesterol concentrations
following vitamin D therapy (WMD: 3.08; 95% CI: 1.42, 4.73). Additionally, vitamin D supplementation significantly
reduced C-reactive protein (CRP) levels (WMD: -0.75; 95% CI: -1.28, -0.23).
Conclusion:
This meta-analysis demonstrated the beneficial effects of vitamin D supplementation on improving
glycemic control, HDL-cholesterol and CRP levels among patients with CVD, though it did not affect triglycerides,
total- and LDL-cholesterol levels.
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Affiliation(s)
- Vahidreza Ostadmohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, United Kingdom
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Bita Badehnoosh
- Department of Gynecology and Obstetrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Vitamin D supplementation after the second year of life: joint position of the Committee on Nutrition, German Society for Pediatric and Adolescent Medicine (DGKJ e.V.), and the German Society for Pediatric Endocrinology and Diabetology (DGKED e.V.). Mol Cell Pediatr 2019; 6:3. [PMID: 31062205 PMCID: PMC6502918 DOI: 10.1186/s40348-019-0090-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 04/11/2019] [Indexed: 12/16/2022] Open
Abstract
Background Low vitamin D serum concentrations have been associated with rickets and other disorders in observational studies. Since vitamin D serum concentrations in children and adolescents are frequently below reference values, it is debated whether vitamin D should be supplemented after infancy. Methods The effects of vitamin D supplementation in children > 2 years of age are analyzed based on a literature review of randomized controlled trials (RCTs). Results Vitamin D supplementation can potentially reduce the risk for influenza infections and improve asthma bronchiale exacerbation; however, it has no impact on asthma bronchiale severity. Vitamin D supplementation has no relevant effect on attention-deficit/hyperactivity disorders, cardiac failure, hypertension, or incidence of type II diabetes mellitus. Vitamin D supplementation has no effect on the rate of multiple sclerosis relapses, but on the number of new lesions detected by MRI. For other endpoints, RCTs are lacking. Conclusion Based on currently available studies, routine vitamin D supplementation is not be recommended for children aged > 2 years, even when they have serum concentrations below reference values. Routine vitamin D supplementation is not recommended in children who do not have risk factors and chronic diseases which are associated with calcium or vitamin D resorption disorders.
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Szymczak-Pajor I, Śliwińska A. Analysis of Association between Vitamin D Deficiency and Insulin Resistance. Nutrients 2019; 11:E794. [PMID: 30959886 PMCID: PMC6520736 DOI: 10.3390/nu11040794] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
Recent evidence revealed extra skeleton activity of vitamin D, including prevention from cardiometabolic diseases and cancer development as well as anti-inflammatory properties. It is worth noting that vitamin D deficiency is very common and may be associated with the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes. This review aims to provide molecular mechanisms showing how vitamin D deficiency may be involved in the insulin resistance formation. The PUBMED database and published reference lists were searched to find studies published between 1980 and 2019. It was identified that molecular action of vitamin D is involved in maintaining the normal resting levels of ROS and Ca2+, not only in pancreatic β-cells, but also in insulin responsive tissues. Both genomic and non-genomic action of vitamin D is directed towards insulin signaling. Thereby, vitamin D reduces the extent of pathologies associated with insulin resistance such as oxidative stress and inflammation. More recently, it was also shown that vitamin D prevents epigenetic alterations associated with insulin resistance and diabetes. In conclusion, vitamin D deficiency is one of the factors accelerating insulin resistance formation. The results of basic and clinical research support beneficial action of vitamin D in the reduction of insulin resistance and related pathologies.
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Affiliation(s)
- Izabela Szymczak-Pajor
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland.
| | - Agnieszka Śliwińska
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland.
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Moore LW, Suki WN, Lunsford KE, Sabek OM, Knight RJ, Gaber AO. Cross-sectional evaluation of the relationship between vitamin D status and supplement use across levels of kidney function in adults. BMJ Open 2019; 9:e022471. [PMID: 30798303 PMCID: PMC6398648 DOI: 10.1136/bmjopen-2018-022471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess vitamin D status of US non-pregnant adults using a standardised assay across 15 mL/min/1.73 m2 increments of kidney function, report the use of dietary supplements containing vitamin D and assess relationships between vitamin D and markers of bone resorption. DESIGN This study is a cross-sectional evaluation. SETTING The study is from the US National Health and Nutrition Evaluation Survey in 2001-2012. PARTICIPANTS The participants were non-institutionalised, non-pregnant adults, age ≥20 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was serum 25OHD evaluated using liquid chromatography-tandem mass spectroscopy traceable to international reference standards. Secondary outcome measures were use of dietary supplements containing vitamin D and the serum intact parathyroid hormone and bone-specific alkaline phosphatase in a subset of participants. RESULTS The median 25OHD concentration in 27 543 US non-pregnant adults was 25.7 ng/mL (range, 2.2-150.0 ng/mL). Vitamin D supplements were used by 38.0%; mean (SE)=757 (43) international units/day. The range of 25OHD concentration across groups, stratified by kidney function, was 23.0-28.1 ng/mL. The lowest concentration of 25OHD observed was in people with higher kidney function (23.0 ng/mL for estimated glomerular filtration rate >105 mL/min/1.73 m2). Only 24% of people not taking a dietary supplement had a 25OHD concentration >30 ng/mL. Serum intact parathyroid hormone inversely correlated with 25OHD within all kidney function groups. Bone-specific alkaline phosphatase was also negatively associated with 25OHD concentration. CONCLUSIONS These data indicate that 25OHD concentrations and supplement use may be suboptimal in a significant proportion of the population, across all kidney function levels. The response of bone resorption markers further suggests that 25OHD levels could be improved. Together, these data support a re-evaluation of the 25OHD concentration associated with health in adults.
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Affiliation(s)
- Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Wadi N Suki
- Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Keri E Lunsford
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Omaima M Sabek
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Richard J Knight
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - A Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
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Wang Y, Yang S, Zhou Q, Zhang H, Yi B. Effects of Vitamin D Supplementation on Renal Function, Inflammation and Glycemic Control in Patients with Diabetic Nephropathy: a Systematic Review and Meta-Analysis. Kidney Blood Press Res 2019; 44:72-87. [PMID: 30808855 DOI: 10.1159/000498838] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Vitamin D (VD) is widely recognized as renal protective. However, whether VD supplementation provides benefit to patients with diabetic nephropathy (DN) remains controversial. Here, we performed a meta-analysis to systematically evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN patients, and to explore the potential renal protective mechanism of VD. METHODS We searched Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) for randomized controlled trials (RCTs) examining the effects of VD or its analogs in DN patients, published between September 2007 and July 2018. Quality assessment and data extraction were performed independently by two authors, according to the Cochrane systematic review methods. Meta-analysis based on the extracted results were performed via Revman 5.2 software. RESULTS We included 20 RCTs representing 1,464 patients with DN in this meta-analysis. VD supplementation significantly reduced 24-hour urine protein [MD = -0.26; 95% CI (-0.34, -0.17); P < 0.00001; I2 = 95%], UAER [MD = -67.36; 95% CI (-91.96, -42.76); P < 0.00001; I2 = 97%], hs-CRP [MD = -0.69; 95% CI (-0.86,-0.53); P < 0.00001; I2 = 0%], TNF-α [MD = -56.79; 95% CI (-77.05, -36.52); P < 0.00001; I2 = 89%] and IL-6 [MD = -0.73; 95% CI(-1.03, -0.44); P < 0.00001; I2 = 0%]. However, VD supplementation failed to decrease SCr [MD = -0.83; 95% CI (-3.67,2.02); P = 0.57; I2 = 0%] or increase eGFR [MD = 2.13; 95% CI (-2.06, 6.32); P = 0.32; I2 = 0%]. In addition, VD supplementation showed no impact on indexes of glycemic control, such as HbA1c [MD = 0.01; 95% CI (-0.09, 0.11); P = 0.84; I2 = 0%] and FBG [MD = -0.05; 95% CI (-0.29, 0.20); P = 0.70; I2 = 0%]. Analysis of 24-hour urine protein, SCr, eGFR, hs-CRP or HbA1c revealed no difference between subgroups based on the type of VD supplementation, including calcitriol, alfacalcidol and vitamin D3, and the dose or duration of calcitriol usage. CONCLUSION In patients with DN, VD supplementation provides beneficial effects on 24-hour urine protein and inflammation indexes, but not on SCr, eGFR or glycemic control indexes. More RCTs that comprehensively evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN atients are required in order to reach conclusive results.
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Affiliation(s)
- Yangyang Wang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shikun Yang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qianying Zhou
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao Zhang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Bin Yi
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China,
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Pramono A, Jocken JWE, Essers YPG, Goossens GH, Blaak EE. Vitamin D and Tissue-Specific Insulin Sensitivity in Humans With Overweight/Obesity. J Clin Endocrinol Metab 2019; 104:49-56. [PMID: 30137362 DOI: 10.1210/jc.2018-00995] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/15/2018] [Indexed: 02/06/2023]
Abstract
CONTEXT Vitamin D deficiency in obesity has been linked to insulin resistance. However, studies that examined the association between plasma 25-hydroxyvitamin D3 [25(OH)D3] as well as plasma 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and tissue-specific insulin sensitivity are scarce. Furthermore, vitamin D receptor (VDR) and vitamin D-metabolizing enzymes [cytochrome 450 (CYP)] expression in adipose tissue (AT) might affect AT insulin sensitivity. OBJECTIVE To investigate the association between body mass index (BMI) and plasma 25(OH)D3 and 1,25(OH)2D3, AT VDR; between plasma 25(OH)D3, 1,25(OH)2D3, AT VDR, and tissue-specific insulin sensitivity in individuals with overweight/obesity. DESIGN AND PATIENTS This analysis included 92 adult individuals (BMI, >25 kg/m2). A two-step hyperinsulinemic-euglycemic clamp with a [6,6-2H2]-glucose tracer was performed to assess tissue-specific insulin sensitivity. Abdominal subcutaneous AT (SAT) mRNA expression of VDR and CYP was determined by using quantitative RT-PCR. SETTING University medical center. MAIN OUTCOME MEASURES Plasma 25(OH)D3, 1,25(OH)2D3, 1,25(OH)2D3/25(OH)D3 ratio, SAT VDR and CYPs mRNA, and tissue-specific insulin sensitivity. RESULTS BMI was inversely associated with plasma 25(OH)D3 (β = -0.274; P = 0.011) but not with plasma 1,25(OH)2D3. Plasma 25(OH)D3 was not related to CYPs or VDR expression in SAT. Plasma 1,25(OH)2D3 and 25(OH)D3 were not related to tissue-specific insulin sensitivity. Interestingly, SAT VDR mRNA was negatively associated with AT insulin sensitivity (β = -0.207; P = 0.025). CONCLUSIONS BMI was inversely associated with 25(OH)D3 concentrations, which could not be explained by alterations in SAT VDR and CYP enzymes. Plasma vitamin D metabolites were not related to tissue-specific insulin sensitivity. However, VDR expression in SAT was negatively associated with AT insulin sensitivity.
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Affiliation(s)
- Adriyan Pramono
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Johan W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Yvonne P G Essers
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
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Bellan M, Marzullo P. New Insights on Low Vitamin D Plasma Concentration as a Potential Cardiovascular Risk Factor. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The role of Vitamin D hormone in human health and disease is still debated. Recently, growing attention has been paid to its putative role in cardiovascular system homeostasis with several studies that suggested a correlation between low vitamin D levels and increased cardiovascular risk. Several mechanisms are involved in the development of cardiovascular diseases: systemic inflammation, endothelial dysfunction, arterial hypertension and insulin resistance. In the present paper, we have revised the current literature supporting a role for vitamin D in the development of these pathogenetic processes. Finally, we have evaluated the current evidence linking vitamin D to atherosclerosis and its natural consequence, cardiovascular diseases.
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Nwosu BU, Kum-Nji P. Tobacco smoke exposure is an independent predictor of vitamin D deficiency in US children. PLoS One 2018; 13:e0205342. [PMID: 30296288 PMCID: PMC6175516 DOI: 10.1371/journal.pone.0205342] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children. METHODS Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke exposure on vitamin D status after controlling for key sociodemographic confounders. Vitamin D deficiency was defined as 25(OH)D <20 ng/mL, insufficiency as 25(OH)D of 20-29.9 ng/mL, and sufficiency as 25(OH)D of ≥30 ng/mL. Tobacco smoke exposure status was defined by serum cotinine concentration as follows: unexposed and non-smoking (<0.05 ng/mL) and exposed (passive and active smokers combined) (≥0.05ng/mL). Specifically, passive and active smoking were defined as cotinine of 0.05-10 ng/mL, and ≥10ng/mL respectively. RESULTS The prevalence of second-hand smoke exposure was 42.0% (95%CI, 36.7%-47.5%); while the prevalence of active smoking among teenagers was 9.0% (95%CI, 6.2%-12.5%). Vitamin D deficiency occurred at a frequency of 15.1% in children unexposed to tobacco smoke, 20.9% in children exposed to passive tobacco smoke, and 18.0% among actively smoking youth (p<0.001). Tobacco smoke exposure independently predicted vitamin D deficiency after controlling for age, sex, race, BMI, maternal education, and family socio-economic status (OR:1.50; 95%CI, 1.14-1.85, p = 0.002). CONCLUSIONS This analysis of a nationwide database reports that tobacco smoke exposure is an independent predictor of vitamin D deficiency in US children.
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Affiliation(s)
- Benjamin Udoka Nwosu
- Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Philip Kum-Nji
- Department of General Pediatrics, Children’s Hospital of Richmond, Virginia Commonwealth University School of Medicine, Richmond, Virginia, United States of America
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Abstract
Severe vitamin D deficiency can be defined as the dose of vitamin D or serum 25OHD concentrations needed to prevent nutritional rickets or osteomalacia. There is large international consensus that these diseases can be prevented by 400 IU of vitamin D/d and 25OHD above 30 nmol/l (12 ng/ml). Vitamin D deficiency can also accelerate the risk of fractures and probably also of falls in elderly subjects but there is no consensus on the required daily doses or minimal 25OHD threshold for these endpoints. The majority of experts consider 800 IU/d and serum 25OHD above 50 nmol/l (20 ng/ml) as sufficient, with a minority opinion aiming for 75 nmol/l or even higher. For other extra-skeletal endpoints, no hard evidence is available to define whether or not this is causally related to vitamin D status. Therefore, for these endpoints no minimal dosage or 25OHD threshold can be defined.
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Affiliation(s)
- Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium.
| | - Geert Carmeliet
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium
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Lakhani OJ, Kumar S, Tripathi S, Desai MA, Seth C. Correlation between Basal Insulin Glargine Dose Required in Achieving Target Fasting Blood Glucose and Various Clinical and Laboratory Parameters in Hospitalized Noncritical Patients. Indian J Endocrinol Metab 2018; 22:469-472. [PMID: 30148091 PMCID: PMC6085955 DOI: 10.4103/ijem.ijem_297_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
AIMS The primary objective was to study the interrelationship between the basal insulin glargine dose and baseline clinical and laboratory parameters in noncritically ill hospitalized patients who have achieved the stable fasting blood glucose in the target range of 100-140 mg/dl. PATIENTS AND METHODS This was retrospective, cross-sectional, observational study. Consenting, nonpregnant, adult patients on basal-bolus insulin who had fasting capillary blood glucose in the range of 100-140 mg/dl as measured by glucometer for 3 consecutive days were included in this study. Patient receiving any basal insulin other than insulin glargine were excluded from this study. The data collected for these patients included age, sex, glycated hemoglobin (HBA1c) at the time of admission, timing of basal insulin, basal insulin dose (BID), BID/kg, weight, and serum creatinine. BID/kg was correlated with other parameters using regression analysis (Pearson's). Comparison of BID/kg in various subgroups was analyzed using Student's t- test. Parametric data of more than three groups were compared using ANOVA. The P < 0.05 was considered as statistically significant. RESULTS A total of 180 patients were included in the study. On correlating the BID/kg with various parameters, we found statistically significant correlation between BID/kg and glycated hemoglobin (HbA1c) at the time of admission (P = 0.044). Patients with HbA1c ≥8.0% had higher BID/kg compared to those with HbA1c <8.0% (P = 0.004). The mean BID in patients with renal failure was significantly higher compared to those without renal failure. CONCLUSION HbA1c at the time of admission is the most important parameter for determining the appropriate BID in hospitalized patients. Patients with renal failure may require a higher dose of basal insulin than those not having renal failure.
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Affiliation(s)
- Om J. Lakhani
- Department of Endocrinology and Metabolism, Sir Ganga Ram Hospital, New Delhi, India
| | - Surender Kumar
- Department of Endocrinology and Metabolism, Sir Ganga Ram Hospital, New Delhi, India
| | - Sudhir Tripathi
- Department of Endocrinology and Metabolism, Sir Ganga Ram Hospital, New Delhi, India
| | - Mitali A. Desai
- Department of Endocrinology and Metabolism, Sir Ganga Ram Hospital, New Delhi, India
| | - Chandani Seth
- Department of Endocrinology and Metabolism, Sir Ganga Ram Hospital, New Delhi, India
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Jarrah MI, Mhaidat NM, Alzoubi KH, Alrabadi N, Alsatari E, Khader Y, Bataineh MF. The association between the serum level of vitamin D and ischemic heart disease: a study from Jordan. Vasc Health Risk Manag 2018; 14:119-127. [PMID: 29928126 PMCID: PMC6003285 DOI: 10.2147/vhrm.s167024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Decreased levels of vitamin D were associated with increased risk of multiple diseases, including cardiovascular diseases. However, there seem to be some discrepancies among the results obtained from different studies. The aim of the present study was to explore the importance of having sufficient serum levels of vitamin D in reducing the incidence and the progression of coronary artery stenosis and ischemic heart disease (IHD). Methods Serum levels of vitamin D were measured using radioimmunoassay in 186 Jordanian patients who underwent investigative coronary catheterization. Of these patients, 133 were suffering from coronary artery stenosis. The association between vitamin D levels, coronary stenosis and many risk factors was determined using SPSS software. Results and conclusions Interestingly, the current results did not show an association between vitamin D abnormalities and the incidence or the reoccurrence of coronary artery stenosis. Moreover, significant differences were detected in the prevalence of vitamin D abnormalities based on the patient’s gender, and there was a significant association between vitamin D abnormalities and both body mass index and dyslipidemia. However, current results did not show any significant association with other risk factors for IHD. For instance, no association was found with smoking, hypertension, diabetes mellitus, stable and unstable angina or with acute recent myocardial infarction.
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Affiliation(s)
- Mohamad I Jarrah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nizar M Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Enas Alsatari
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Moath F Bataineh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, Hashemite University, Zarqa, Jordan
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Raygan F, Ostadmohammadi V, Bahmani F, Asemi Z. The effects of vitamin D and probiotic co-supplementation on mental health parameters and metabolic status in type 2 diabetic patients with coronary heart disease: A randomized, double-blind, placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2018; 84:50-55. [PMID: 29432877 DOI: 10.1016/j.pnpbp.2018.02.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study was carried out to evaluate the effects of vitamin D and probiotic co-supplementation on mental health parameters and metabolic status in diabetic people with coronary heart disease (CHD). METHODS This randomized, double-blind, placebo-controlled trial was carried out among 60 diabetic people with CHD, aged 45-85 years old. Subjects were randomly allocated into two groups to receive either 50,000 IU vitamin D every 2 weeks plus 8 × 109 CFU/g probiotic of Lactocare Zisttakhmir Co (n = 30) or placebo (n = 30) for 12 weeks. Fasting blood samples were obtained at baseline and after the 12-week intervention to determine metabolic profiles. RESULTS After the 12-week intervention, compared with the placebo, vitamin D and probiotic co-supplementation resulted in significant improvements in beck depression inventory total score (-2.8 ± 3.8 vs. -0.9 ± 2.1, P = 0.01), beck anxiety inventory scores (-2.1 ± 2.3 vs. -0.8 ± 1.4, P = 0.009) and general health questionnaire scores (-3.9 ± 4.1 vs. -1.1 ± 3.4, P = 0.005). Compared with the placebo, vitamin D and probiotic co-supplementation resulted in significant reductions in serum insulin levels (-2.8 ± 3.8 vs. +0.2 ± 4.9 μIU/mL, P = 0.009), homeostasis model of assessment-estimated insulin resistance (-1.0 ± 1.6 vs. -0.1 ± 1.5, P = 0.02), and a significant increase in serum 25-OH-vitamin D (+11.8 ± 5.9 vs. +0.1 ± 1.4 ng/mL, P < 0.001), the quantitative insulin sensitivity check index (+0.03 ± 0.04 vs. -0.001 ± 0.01, P = 0.003) and serum HDL-cholesterol levels (+2.3 ± 3.5 vs. -0.5 ± 3.8 mg/dL, P = 0.004). In addition, changes in serum high sensitivity C-reactive protein (hs-CRP) (-950.0 ± 1811.2 vs. +260.5 ± 2298.2 ng/mL, P = 0.02), plasma nitric oxide (NO) (+1.7 ± 4.0 vs. -1.4 ± 6.7 μmol/L, P = 0.03) and plasma total antioxidant capacity (TAC) (+12.6 ± 41.6 vs. -116.9 ± 324.2 mmol/L, P = 0.03) in the supplemented group were significantly different from the changes in these indicators in the placebo group. CONCLUSIONS Overall, vitamin D and probiotic co-supplementation after 12 weeks among diabetic people with CHD had beneficial effects on mental health parameters, serum hs-CRP, plasma NO, TAC, glycemic control and HDL-cholesterol levels. CLINICAL TRIAL REGISTRATION NUMBER http://www.irct.ir: IRCT2017073033941N4.
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Affiliation(s)
- Fariba Raygan
- Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Vahidreza Ostadmohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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Ávila-Rubio V, García-Fontana B, Novo-Rodríguez C, Cantero-Hinojosa J, Reyes-García R, Muñoz-Torres M. Higher Levels of Serum 25-Hydroxyvitamin D Are Related to Improved Glucose Homeostasis in Women with Postmenopausal Osteoporosis. J Womens Health (Larchmt) 2018; 27:1007-1015. [PMID: 29874115 DOI: 10.1089/jwh.2017.6806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Postmenopausal osteoporosis (PMO) is associated with other comorbidities such as impaired glucose homeostasis and cardiovascular disease. Vitamin D insufficiency is highly prevalent and may be a common link between these disorders. However, the relationship between circulating 25-hydroxyvitamin D [25(OH)D] and insulin resistance in women with PMO has not been well evaluated. The aim of this study was to assess the relationship between circulating levels of 25(OH)D and parameters of glucose homeostasis in a cohort of women with PMO to establish a serum concentration threshold of 25(OH)D for improved glycemic parameters. MATERIALS AND METHODS This cross-sectional study included 40 women with PMO. We measured 25(OH)D serum levels and glucose homeostasis parameters (glucose and insulin levels, insulin sensitivity, and β-secretion index HOMA2-%S and HOMA2-%B, respectively). Anthropometric, biochemical, and clinical parameters and bone markers were also evaluated. RESULTS Circulating levels of 25(OH)D were related to glucose parameters (negatively with HOMA2-%B and insulin levels and positively with HOMA2-%S) in women with PMO, resulting in an indicator of insulin sensitivity independent of age, body mass index, percent body fat, and undercarboxylated osteocalcin. Patients with serum 25(OH)D ≥45 ng/mL showed lower HOMA2-%B values and insulinemia and greater HOMA2-%S. CONCLUSIONS Our results support the hypothesis that circulating 25(OH)D levels are related to improved glucose homeostasis in women with PMO. However, this relationship was apparent only in the presence of high circulating levels of 25(OH)D.
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Affiliation(s)
- Verónica Ávila-Rubio
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,2 Department of Medicine, University of Granada , Granada, Spain
| | - Beatriz García-Fontana
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,3 CIBERFES, Instituto de Salud Carlos III , Madrid, Spain
| | - Cristina Novo-Rodríguez
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain
| | - Jesús Cantero-Hinojosa
- 2 Department of Medicine, University of Granada , Granada, Spain .,4 Unit of Internal Medicine, Hospital Universitario San Cecilio , Granada, Spain
| | - Rebeca Reyes-García
- 5 Endocrinology and Nutrition Unit, Complejo Hospitalario Torrecardenas , Almería, Spain
| | - Manuel Muñoz-Torres
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,2 Department of Medicine, University of Granada , Granada, Spain .,3 CIBERFES, Instituto de Salud Carlos III , Madrid, Spain
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Chakhtoura M, Rahme M, Chamoun N, El-Hajj Fuleihan G. Vitamin D in the Middle East and North Africa. Bone Rep 2018; 8:135-146. [PMID: 29955632 PMCID: PMC6020111 DOI: 10.1016/j.bonr.2018.03.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/12/2018] [Accepted: 03/15/2018] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The Middle East and North Africa (MENA) region registers some of the lowest serum 25‑hydroxyvitamin D [25(OH)D] concentrations, worldwide. We describe the prevalence and the risk factors for hypovitaminosis D, completed and ongoing clinical trials, and available guidelines for vitamin D supplementation in this region. METHODS This review is an update of previous reviews published by our group in 2013 for observational studies, and in 2015 for randomized controlled trials (RCTs) from the region. We conducted a comprehensive search in Medline, PubMed, and Embase, and the Cochrane Library, using MeSH terms and keywords relevant to vitamin D, vitamin D deficiency, and the MENA region, for the period 2012-2017 for observational studies, and 2015-2017 for RCTs. We included large cross-sectional studies with at least 100 subjects/study, and RCTs with at least 50 participants per arm. RESULTS We identified 41 observational studies. The prevalence of hypovitaminosis D, defined as a 25‑hydroxyvitamin D [25(OH)D] level below the desirable level of 20 ng/ml, ranged between 12-96% in children and adolescents, and 54-90% in pregnant women. In adults, it ranged between 44 and 96%, and the mean 25(OH)D varied between 11 and 20 ng/ml. In general, significant predictors of low 25(OH)D levels were female gender, increasing age and body mass index, veiling, winter season, use of sun screens, lower socioeconomic status, and higher latitude.We retrieved 14 RCTs comparing supplementation to control or placebo, published during the period 2015-2017: 2 in children, 8 in adults, and 4 in pregnant women. In children and adolescents, a vitamin D dose of 1000-2000 IU/d was needed to maintain serum 25(OH)D level at target. In adults and pregnant women, the increment in 25(OH)D level was inversely proportional to the dose, ranging between 0.9 and 3 ng/ml per 100 IU/d for doses ≤2000 IU/d, and between 0.1 and 0.6 ng/ml per 100 IU/d for doses ≥3000 IU/d. While the effect of vitamin D supplementation on glycemic indices is still controversial in adults, vitamin D supplementation may be protective against gestational diabetes mellitus in pregnant women. In the only identified study in the elderly, there was no significant difference between 600 IU/day and 3750 IU/day doses on bone mineral density. We did not identify any fracture studies.The available vitamin D guidelines in the region are based on expert opinion, with recommended doses between 400 and 2000 IU/d, depending on the age category, and country. CONCLUSION Hypovitaminosis D is prevalent in the MENA region, and doses of 1000-2000 IU/d may be necessary to reach a desirable 25(OH)D level of 20 ng/ml. Studies assessing the effect of such doses of vitamin D on major outcomes, and confirming their long term safety, are needed.
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Key Words
- 25(OH)D, 25‑hydroxyvitamin D
- ALKP, alkaline phosphatase
- BMC, bone mineral content
- BMD, bone mineral density
- BMI, body mass index
- CARS, Childhood Autism Rating Scale
- CDC, Centers for Disease Control
- Ca, Calcium
- DEQAS, Vitamin D External Quality Assessment Scheme
- DXA, dual-energy X-ray absorptiometry
- ESCEO, European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis
- GDM, Gestational Diabetes Mellitus
- HOMA-IR, homeostatic model assessment of insulin resistance
- HbA1c, glycated hemoglobin
- Hypovitaminosis D
- ID LC-MS/MS, isotope dilution liquid chromatography - tandem mass spectrometry
- IOM, Institute of Medicine
- KSA, Kingdom of Saudi Arabia
- LCMS/MS, liquid chromatography-tandem mass spectrometry
- MENA, Middle East North Africa
- Middle East and North Africa
- OSTEOS, Lebanese Society for Osteoporosis and Metabolic Bone Disorders
- PO4, phosphorus
- PTH, parathyroid hormone
- Predictors
- RCT, randomized controlled trials
- ROB, risk of bias
- RR, relative risk
- SDp, pooled standard deviation
- T2D, type 2 diabetes
- UAE, United Arab Emirates
- UVB, ultraviolet B
- VDDR2, vitamin d dependent rickets type 2
- VDR, vitamin d receptor
- VDSP, Vitamin D Standardization Program
- Vitamin D assays
- Vitamin D guidelines
- WM, weighted mean
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Affiliation(s)
- Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, P.O. Box: 113-6044/C8, Lebanon
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Role of Vitamin D Beyond the Skeletal Function: A Review of the Molecular and Clinical Studies. Int J Mol Sci 2018; 19:ijms19061618. [PMID: 29849001 PMCID: PMC6032242 DOI: 10.3390/ijms19061618] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
The classical function of Vitamin D, which involves mineral balance and skeletal maintenance, has been known for many years. With the discovery of vitamin D receptors in various tissues, several other biological functions of vitamin D are increasingly recognized and its role in many human diseases like cancer, diabetes, hypertension, cardiovascular, and autoimmune and dermatological diseases is being extensively explored. The non-classical function of vitamin D involves regulation of cellular proliferation, differentiation, apoptosis, and innate and adaptive immunity. In this review, we discuss and summarize the latest findings on the non-classical functions of vitamin D at the cellular/molecular level and its role in complex human diseases.
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84
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Skurk T. [Not Available]. MMW Fortschr Med 2018; 160:39. [PMID: 29619697 DOI: 10.1007/s15006-018-0378-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Li X, Liu Y, Zheng Y, Wang P, Zhang Y. The Effect of Vitamin D Supplementation on Glycemic Control in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10030375. [PMID: 29562681 PMCID: PMC5872793 DOI: 10.3390/nu10030375] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 01/13/2023] Open
Abstract
Observational studies have indicated an inverse association between vitamin D levels and the risk of diabetes, yet evidence from population interventions remains inconsistent. PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched up to September 2017. Data from studies regarding serum 25(OH)D, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were pooled. Twenty studies (n = 2703) were included in the meta-analysis. Vitamin D supplementation resulted in a significant improvement in serum 25(OH)D levels (weighted mean difference (WMD) = 33.98; 95%CI: 24.60-43.37) and HOMA-IR (standardized mean difference (SMD) = -0.57; 95%CI: -1.09~-0.04), but not in other outcomes. However, preferred changes were observed in subgroups as follows: short-term (WMDFBG = -8.44; 95%CI: -12.72~-4.15), high dose (WMDFBG = -8.70; 95%CI: -12.96~-4.44), non-obese (SMDFasting insulin = -1.80; 95%CI: -2.66~-0.95), Middle Easterners (WMDFBG = -10.43; 95%CI: -14.80~-6.06), baseline vitamin D deficient individuals (WMDFBG = -5.77; 95%CI: -10.48~-1.05) and well-controlled HbA1c individuals (WMDFBG = -4.09; 95%CI: -15.44~7.27). Vitamin D supplementation was shown to increase serum 25(OH)D and reduce insulin resistance effectively. This effect was especially prominent when vitamin D was given in large doses and for a short period of time, and to patients who were non-obese, Middle Eastern, vitamin D deficient, or with optimal glycemic control at baseline.
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Affiliation(s)
- Xinyi Li
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yan Liu
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yingdong Zheng
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Peiyu Wang
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yumei Zhang
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
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86
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Al-Khalidi B, Kimball SM, Kuk JL, Ardern CI. Metabolically healthy obesity, vitamin D, and all-cause and cardiometabolic mortality risk in NHANES III. Clin Nutr 2018. [PMID: 29525513 DOI: 10.1016/j.clnu.2018.02.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Previous studies assessing the prognosis of metabolically healthy obesity (MHO) have been limited by a lack of a harmonized definition of MHO phenotype. Furthermore, obesity is a risk factor for vitamin D deficiency and low vitamin D status has been associated with a higher risk of mortality; however, few studies have evaluated the joint association between vitamin D, metabolic health phenotype, and mortality risk. Using a harmonized definition, we investigated whether MHO is associated with subsequent all-cause and cardiometabolic mortality, and whether serum 25-hydroxyvitamin D [25(OH)D] modifies these associations. METHODS This study included participants aged ≥20 years from the Third National Health and Nutrition Examination Survey (NHANES III). MHO phenotype was defined as a combination of obesity (≥30 kg/m2) and zero component of metabolic syndrome. Multivariable Cox regression was used to assess the risk of mortality across metabolic phenotypes, and the joint association between metabolic phenotype and 25(OH)D. Fine and Gray regression was performed to account for competing risk events. RESULTS Among 11,333 participants, a total of 2980 deaths (937 cardiometabolic death outcomes) occurred during a median follow-up of 19.1 years. In the absence of any metabolic abnormality, obesity (MHO) was not associated with a higher risk of all-cause (hazard ratio [HR], 0.89 [95% CI, 0.52-1.51]) or cardiometabolic mortality (cause-specific HR, 1.21 [95% CI 0.33-4.46]). Similar results were obtained from competing risk analysis. No significant differences in average 25(OH)D levels were observed between MHO and non-MHO participants; however, there was a significant interaction between metabolic health phenotype and serum 25(OH)D in relation to cardiometabolic mortality such that levels of serum 25(OH)D < 50 nmol/L were associated with increased risk of cardiometabolic mortality, particularly in participants within the normal-weight and obese BMI ranges. CONCLUSIONS Our results support the hypothesis that MHO phenotype is a benign health condition. Vitamin D deficiency may exacerbate the risk of cardiometabolic death outcomes associated with metabolic dysfunction in normal weight and obese individuals. Further research is warranted to validate our findings.
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Affiliation(s)
- Banaz Al-Khalidi
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
| | | | - Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Chris I Ardern
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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87
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Angellotti E, D'Alessio D, Dawson-Hughes B, Nelson J, Cohen RM, Gastaldelli A, Pittas AG. Vitamin D Supplementation in Patients With Type 2 Diabetes: The Vitamin D for Established Type 2 Diabetes (DDM2) Study. J Endocr Soc 2018; 2:310-321. [PMID: 29577107 PMCID: PMC5848819 DOI: 10.1210/js.2018-00015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/21/2018] [Indexed: 01/10/2023] Open
Abstract
Context Observational data support a role for vitamin D in type 2 diabetes, but evidence from trials is inconclusive. Objective To evaluate the effect of vitamin D supplementation on β-cell function and hemoglobin A1c (HbA1c) in patients with well-controlled type 2 diabetes. Design Double-blind, randomized, placebo-controlled clinical trial. Setting Tufts Medical Center, Boston, MA; VA Medical Center, Cincinnati, OH. Participants A total of 127 patients (mean age, 60 years) with stable (HbA1c ≤7.5%) diabetes managed with lifestyle only or lifestyle plus metformin. Intervention Subjects were given 4000 units of vitamin D3 (cholecalciferol) daily or placebo for 48 weeks. Main Outcome Measure Insulin secretion rate (ISR) was estimated from peripheral plasma C-peptide levels after a 3-hour 75-g oral glucose tolerance test done at baseline and week 24. Changes in HbA1c were assessed at 16, 24, 36, and 48 weeks. Results Baseline mean plasma 25-hydroxyvitamin D [25(OH)D] concentration was 26.6 ng/mL, mean HbA1c was 6.6%, and 78% of patients were on metformin. At week 24, mean 25(OH)D changed by 20.5 and −1.6 ng/mL in the vitamin D and placebo groups, respectively (P < 0.001). The vitamin D and placebo groups did not differ in change in ISR or HbA1c. Among patients treated with lifestyle only (n = 28), vitamin D supplementation reduced HbA1c compared with placebo (−0.1% vs 0.3%, respectively; P = 0.034) at week 24. This result was not observed at the other time points and could be due to chance. Conclusion Vitamin D3 at 4000 IU/d did not change ISR or HbA1c in patients with well-controlled type 2 diabetes on metformin not selected for vitamin D deficiency.
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Affiliation(s)
- Edith Angellotti
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts
| | - David D'Alessio
- Division of Endocrinology, Diabetes and Metabolism, Duke University, Durham, North Carolina
| | - Bess Dawson-Hughes
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts.,Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jason Nelson
- Predictive Analytics and Comparative Effectiveness (PACE) Center, Tufts Medical Center, Boston, Massachusetts
| | - Robert M Cohen
- Division of Endocrinology, Diabetes & Metabolism University of Cincinnati College of Medicine and Cincinnati VA Medical Center, Cincinnati, Ohio
| | - Amalia Gastaldelli
- Cardiometabolic Risk Laboratory, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts
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88
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Rusińska A, Płudowski P, Walczak M, Borszewska-Kornacka MK, Bossowski A, Chlebna-Sokół D, Czech-Kowalska J, Dobrzańska A, Franek E, Helwich E, Jackowska T, Kalina MA, Konstantynowicz J, Książyk J, Lewiński A, Łukaszkiewicz J, Marcinowska-Suchowierska E, Mazur A, Michałus I, Peregud-Pogorzelski J, Romanowska H, Ruchała M, Socha P, Szalecki M, Wielgoś M, Zwolińska D, Zygmunt A. Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland-Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies-2018 Update. Front Endocrinol (Lausanne) 2018; 9:246. [PMID: 29904370 PMCID: PMC5990871 DOI: 10.3389/fendo.2018.00246] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/02/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Vitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency. METHODS A systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted. Updated recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation system describing the strength of the recommendation and the quality of supporting evidence. Twenty-seven contributors representing different areas of expertise and medical specialties, including pediatricians, geriatricians, endocrinologists, epidemiologists, nephrologists, gynecologists and obstetricians evaluated the available published evidence related to vitamin D, formulated the goals of this document and developed a common consolidated position. The consensus group, representing six national specialist consultants and eight Polish and international scientific organizations/societies, participated in the process of grading evidence and drawing up the general and specific recommendations. RESULTS The updated recommendations define the diagnostic criteria for the evaluation of vitamin D status and describe the prevention and treatment strategies of vitamin D deficiency in the general population and in groups at increased risk of the deficiency. Age- and weight-specific recommendations for prevention, supplementation and treatment of vitamin D deficiency are presented, and detailed practice guidance is discussed regarding the management in primary and specialized health care. CONCLUSION Vitamin D deficiency remains still highly prevalent in Poland, in all age groups. Currently, there is a great necessity to implement a regular supplementation with recommended doses and to develop an effective strategy to alleviate vitamin D deficiency in the population. These updated recommendations are addressed to health professionals and the authorities pursuing comprehensive health policies and should also be included in public health programs aimed at preventing a broad spectrum of chronic diseases.
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Affiliation(s)
- Agnieszka Rusińska
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| | - Paweł Płudowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
- *Correspondence: Paweł Płudowski, ,
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | | | - Artur Bossowski
- Department of Pediatrics, Endocrinology and Diabetology with Cardiology Divisions, Medical University of Bialystok, Bialystok, Poland
| | - Danuta Chlebna-Sokół
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| | - Justyna Czech-Kowalska
- Department of Neonatology and Neonatal Intensive Care Unit, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Anna Dobrzańska
- Department of Neonatology and Neonatal Intensive Care Unit, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Edward Franek
- Mossakowski Medical Research Center, Polish Academy of Sciences, Department of Internal Diseases, Endocrinology and Diabetology, Central Hospital MSWiA, Warsaw, Poland
| | - Ewa Helwich
- Department of Neonatology, Institute of Mother and Child, Warsaw, Poland
| | - Teresa Jackowska
- Department of Pediatrics, The Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Maria A. Kalina
- Division of Clinical Genetics, Department of Molecular Biology and Genetics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Janusz Książyk
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
| | - Jacek Łukaszkiewicz
- Faculty of Pharmacy with Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Artur Mazur
- 2nd Department of Pediatrics, Endocrinology, Diabetology, University of Rzeszow, Rzeszow, Poland
| | - Izabela Michałus
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| | | | - Hanna Romanowska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Mieczysław Szalecki
- Clinic of Endocrinology and Diabetology, The Children’s Memorial Health Institute, Warsaw, Poland
- Faculty of Medicine and Health Sciences, Jan Kochanowski Univeristy, Kielce, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Danuta Zwolińska
- Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland
| | - Arkadiusz Zygmunt
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
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Buhary BM, Almohareb O, Aljohani N, Alrajhi S, Elkaissi S, Sherbeeni S, Almaghamsi A, Khan SA, Almalki MH. Association of Glycosylated Hemoglobin Levels With Vitamin D Status. J Clin Med Res 2017; 9:1013-1018. [PMID: 29163736 PMCID: PMC5687907 DOI: 10.14740/jocmr3227w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/23/2017] [Indexed: 02/04/2023] Open
Abstract
Background The discovery of vitamin D is one of medicine’s great achievements. Despite all the positive evidence emerging about the beneficial effect of vitamin D, we still find many are vitamin D deficient. The purposes of this study were to examine the association between serum 25-hydroxyvitamin D (25(OH)D) and glycosylated hemoglobin (HbA1c) levels, to test the hypothesis that lower 25(OH)D levels are associated with poorer glucose control in diabetes mellitus (DM) patients and to investigate the effect of vitamin D supplementation on HbA1c levels. Methods This was a prospective observational cohort study of all patients with type 1 and type 2 diabetes (above 12 years) who attended the outpatient clinics of a tertiary center in Riyadh. HbA1c and vitamin D levels were recorded prior to supplementation and after 9 months of supplementation with vitamin D. All patients were divided into four groups according to their vitamin D level and an association between 25(OH)D and HbA1c was tested. Results Results showed that 73.1% of the patients had 25(OH)D levels < 50 nmol/L. We observed lowering of HbA1c after vitamin D supplementation (from mean HbA1c of 10.55 to 7.70). We found HbA1c to be inversely related to serum vitamin D levels (r = -0.14 (P < 0.0000002) before supplementation and -0.16 (P < 0.000001) after supplementation with vitamin D). Conclusions Advising patients with higher HbA1c to test their vitamin D level and correct any deficiency will result in better blood glucose control and benefit the patient’s overall health.
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Affiliation(s)
| | - Ohoud Almohareb
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Naji Aljohani
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia.,King Fahad Medical City, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Saleh Alrajhi
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Samer Elkaissi
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Suphia Sherbeeni
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Abdulrahman Almaghamsi
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Shawana Abdulhamid Khan
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Mussa H Almalki
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia.,King Fahad Medical City, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
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