51
|
Chen S, Villalta A, Agrawal DK. FOXO1 Mediates Vitamin D Deficiency-Induced Insulin Resistance in Skeletal Muscle. J Bone Miner Res 2016; 31:585-95. [PMID: 26462119 PMCID: PMC4814301 DOI: 10.1002/jbmr.2729] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 09/25/2015] [Accepted: 10/08/2015] [Indexed: 02/06/2023]
Abstract
Prospective epidemiological studies have consistently shown a relationship between vitamin D deficiency, insulin resistance, and type 2 diabetes mellitus (DM2). This is supported by recent trials showing that vitamin D supplementation in prediabetic or insulin-resistant patients with inadequate vitamin D levels improves insulin sensitivity. However, the molecular mechanisms underlying vitamin D deficiency-induced insulin resistance and DM2 remain unknown. Skeletal muscle insulin resistance is a primary defect in the majority of patients with DM2. Although sustained activation of forkhead box O1 (FOXO1) in skeletal muscle causes insulin resistance, a relationship between vitamin D deficiency and FOXO1 activation in muscle is unknown. We generated skeletal muscle-specific vitamin D receptor (VDR)-null mice and discovered that these mice developed insulin resistance and glucose intolerance accompanied by increased expression and activity of FOXO1. We also found sustained FOXO1 activation in the skeletal muscle of global VDR-null mice. Treatment of C2C12 muscle cells with 1,25-dihydroxyvitamin D (VD3) reduced FOXO1 expression, nuclear translocation, and activity. The VD3-dependent suppression of FOXO1 activation disappeared by knockdown of VDR, indicating that it is VDR-dependent. Taken together, these results suggest that FOXO1 is a critical target mediating VDR-null signaling in skeletal muscle. The novel findings provide the conceptual support that persistent FOXO1 activation may be responsible for insulin resistance and impaired glucose metabolism in vitamin D signaling-deficient mice, as well as evidence for the utility of vitamin D supplementation for intervention in DM2.
Collapse
Affiliation(s)
- Songcang Chen
- Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha NE 68178 USA
| | - Armando Villalta
- Diabetes Center, University of California San Francisco, CA 94143 USA
| | - Devendra K. Agrawal
- Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha NE 68178 USA
| |
Collapse
|
52
|
Bi X, Tey SL, Leong C, Quek R, Henry CJ. Prevalence of Vitamin D Deficiency in Singapore: Its Implications to Cardiovascular Risk Factors. PLoS One 2016; 11:e0147616. [PMID: 26799569 PMCID: PMC4723156 DOI: 10.1371/journal.pone.0147616] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023] Open
Abstract
Objective Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors. Design and Methods This was a cross-sectional study. One hundred and fourteen healthy participants (59 males and 55 females) residing in Singapore took part in this study. Plasma 25OH-D3 concentration was measured by using LC-MS/MS. Body fat (%) was measured by using three different techniques including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Basic anthropometric measurements, fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were obtained using standard protocols. Results Approximately 42% of the participants were vitamin D deficient (< 20 ng/mL). Vitamin D status was inversely associated with body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR), and total cholesterol/high density lipoprotein (TC/HDL) ratio, while positively associated with lean body mass (LBM) and hand grip strength (HGS). Conclusions The high prevalence of vitamin D deficiency in a sunny tropical region reinforces the need to recognize that sunlight alone is not the precursor for optimal vitamin D status. This raises the need to investigate public health measures that will encourage exposure to sunlight without overexposure that is harmful to skin. More importantly, vitamin D deficiency is associated with increased cardiovascular risks, i.e. HOMA-IR, TC/HDL, and LDL/HDL. Future studies should attempt to elucidate the potential mechanisms.
Collapse
Affiliation(s)
- Xinyan Bi
- Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07–02, MD 6 Building, Singapore 117599, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore
| | - Siew Ling Tey
- Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07–02, MD 6 Building, Singapore 117599, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore
| | - Claudia Leong
- Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07–02, MD 6 Building, Singapore 117599, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore
| | - Rina Quek
- Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07–02, MD 6 Building, Singapore 117599, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07–02, MD 6 Building, Singapore 117599, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
- * E-mail:
| |
Collapse
|
53
|
Riaz H, Finlayson AE, Bashir S, Hussain S, Mahmood S, Malik F, Godman B. Prevalence of Vitamin D deficiency in Pakistan and implications for the future. Expert Rev Clin Pharmacol 2016; 9:329-38. [PMID: 26582317 DOI: 10.1586/17512433.2016.1122519] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS vitamin D deficiency (25-hydroxyvitamin D) affects over one billion people worldwide. Vitamin D deficiency results in progression of osteoporosis as well as other conditions. Previous studies have shown high rates of vitamin D deficiency in Pakistan despite appreciable levels of sunshine. However, none have assessed vitamin D deficiency across all age groups, genders, incomes, and locations to guide future strategies. METHODS Questionnaire and blood sampling among 4830 randomly selected citizens. RESULTS High levels of deficiency among all age groups, genders, income levels, and locations. Amongst the selected citizens, 53.5% had vitamin D deficiency, 31.2% had insufficient vitamin D, and only 15.3% normal vitamin D. CONCLUSION High rates of vitamin D deficiency in Pakistan despite high levels of sunshine and previous Food Acts asking for food fortification with vitamin D. Public health strategies are needed to address high deficiency rates, including food fortification, i.e. nurture, alongside increasing exposure to sunlight, i.e. nature. This will involve all key stakeholder groups.
Collapse
Affiliation(s)
- H Riaz
- a Faculty of Pharmacy , Sargodha University , Sargodha , Pakistan
| | - A E Finlayson
- b Green Templeton College , Oxford University , Oxford , UK.,c Nuffield Department of Primary Care Health Sciences , University of Oxford , Oxford , UK
| | - S Bashir
- a Faculty of Pharmacy , Sargodha University , Sargodha , Pakistan
| | - S Hussain
- d Drugs Control and Traditional Medicines Division, National Institute of Health , Islamabad , Pakistan
| | - S Mahmood
- e Quaid-i-Azam University , Islamabad , Pakistan
| | - F Malik
- d Drugs Control and Traditional Medicines Division, National Institute of Health , Islamabad , Pakistan
| | - B Godman
- f Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute , Karolinska University Hospital Huddinge , Stockholm , Sweden.,g Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , UK
| |
Collapse
|
54
|
Rosanoff A, Dai Q, Shapses SA. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status? Adv Nutr 2016; 7:25-43. [PMID: 26773013 PMCID: PMC4717874 DOI: 10.3945/an.115.008631] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Although much is known about magnesium, its interactions with calcium and vitamin D are less well studied. Magnesium intake is low in populations who consume modern processed-food diets. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. No simple, reliable biomarker for whole-body magnesium status is currently available, which makes clinical assessment and interpretation of human magnesium research difficult. Between 1977 and 2012, US calcium intakes increased at a rate 2-2.5 times that of magnesium intakes, resulting in a dietary calcium to magnesium intake ratio of >3.0. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ∼2.0. Background calcium to magnesium ratios can affect studies of either mineral alone. For example, US studies (background Ca:Mg >3.0) showed benefits of high dietary or supplemental magnesium for CVD, whereas similar Chinese studies (background Ca:Mg <1.7) showed increased risks of CVD. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases. Research on possible magnesium and vitamin D interactions in these human diseases is currently rare. Increasing calcium to magnesium intake ratios, coupled with calcium and vitamin D supplementation coincident with suboptimal magnesium intakes, may have unknown health implications. Interactions of low magnesium status with calcium and vitamin D, especially during supplementation, require further study.
Collapse
Affiliation(s)
| | - Qi Dai
- Vanderbilt Epidemiology Center, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN; and
| | | |
Collapse
|
55
|
Grant WB, Whiting SJ, Schwalfenberg GK, Genuis SJ, Kimball SM. Estimated economic benefit of increasing 25-hydroxyvitamin D concentrations of Canadians to or above 100 nmol/L. DERMATO-ENDOCRINOLOGY 2016; 8:e1248324. [PMID: 27942348 PMCID: PMC5129897 DOI: 10.1080/19381980.2016.1248324] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/30/2016] [Accepted: 10/11/2016] [Indexed: 12/12/2022]
Abstract
Mounting evidence from observational and clinical trials indicates that optimal vitamin D reduces the risk of many diseases. We used observational studies and recent data on 25-hydroxyvitamin D [25(OH)D] concentrations of Canadians from Cycle 3 of the Canadian Health Measures Survey to estimate the reduction in disease incidence, mortality rates, and the total economic burden (direct plus indirect) of disease if 25(OH)D concentrations of all Canadians were raised to or above 100 nmol/L. Recently, the mean 25(OH)D concentration of Canadians varied depending on age and season (51-69 nmol/L), with an overall mean of 61 nmol/L. The diseases affected by 25(OH)D concentration included cancer, cardiovascular disease, dementia, diabetes mellitus, multiple sclerosis, respiratory infections, and musculoskeletal disorders. We used 25(OH)D concentration-health outcome relations for breast cancer and cardiovascular disease and results of clinical trials with vitamin D for respiratory infections and musculoskeletal disorders to estimate the reductions in disease burden for increased 25(OH)D concentrations. If all Canadians attained 25(OH)D concentrations>100 nmol/L, the calculated reduction in annual economic burden of disease was $12.5 ± 6 billion on the basis of economic burdens for 2016 and a reduction in annual premature deaths by 23,000 (11,000-34,000) on the basis of rates for 2011. However, the effects on disease incidence, economic burden, and mortality rate would be phased in gradually over several years primarily because once a chronic disease is established, vitamin D affects its progression only modestly. Nevertheless, national policy changes are justified to improve vitamin D status of Canadians through promotion of safe sun exposure messages, vitamin D supplement use, and/or facilitation of food fortification.
Collapse
Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, CA, USA
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | | | - Stephen J. Genuis
- Faculty of Medicine at the University of Alberta, Edmonton, Alberta, Canada
| | | |
Collapse
|
56
|
Zhang J, Ye J, Guo G, Lan Z, Li X, Pan Z, Rao X, Zheng Z, Luo F, Lin L, Lin Z, Xue Y. Vitamin D Status Is Negatively Correlated with Insulin Resistance in Chinese Type 2 Diabetes. Int J Endocrinol 2016; 2016:1794894. [PMID: 27413370 PMCID: PMC4931076 DOI: 10.1155/2016/1794894] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/13/2016] [Accepted: 05/22/2016] [Indexed: 02/06/2023] Open
Abstract
Objectives. Vitamin D deficiency plays a role in insulin resistance and the pathogenesis of type 2 diabetes mellitus. Little information is available about the association between vitamin D status and insulin resistance in the Chinese population. Currently, vitamin D status is evaluated by the concentrations of serum 25-hydroxyvitamin D [25(OH)D]. This study explores the relationship between insulin resistance and serum 25-hydroxyvitamin D concentrations in Chinese patients with type 2 diabetes mellitus. Subjects and Methods. This study included 117 patients with type 2 diabetes. The following variables were measured: 25-hydroxyvitamin D [25(OH)D], glycosylated hemoglobin A1c (HbA1c), fasting blood glucose (FBS), fasting blood insulin (FINS), fasting blood C-peptide, serum creatinine (SCr), glomerular filtration rate (eGFR), body mass index (BMI), and homeostatic model estimates of insulin resistance (HOMA-IR). Results. The cases were divided into three groups: Group 1 (G1) with 25(OH)D ≤ 20 ng/mL [≤50 nmol/L], Group 2 (G2) with 25(OH)D values from 20 ng/mL [50 nmol/L] to 30 ng/mL [75 nmol/L], and Group 3 (G3) with 25(OH)D ≥ 30 ng/mL [≥75 nmol/L], with 52.6%, 26.3%, and 21.1% of subjects in Groups 1-3, respectively. There was a negative correlation between 25(OH)D and HOMA-IR (β = -0.314, p = 0.001) adjusted by age, BMI, and eGFR. Conclusion. Better vitamin D status may be protective of glucose homeostasis since 25(OH)D was negatively associated with insulin resistance in Chinese patients with type 2 diabetes.
Collapse
Affiliation(s)
- Jie Zhang
- Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Jianhong Ye
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Gang Guo
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Zhenhao Lan
- Sanming City Hospital of Integrated Traditional Chinese and Western Medicine, Sanming 365000, China
| | - Xing Li
- Department of Endocrinology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Zhiming Pan
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Xianming Rao
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Zongji Zheng
- Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Fangtao Luo
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Luping Lin
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Zhihua Lin
- Xiamen Second Hospital affiliated Xiamen Medical College, Xiamen 361021, China
| | - Yaoming Xue
- Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
- *Yaoming Xue:
| |
Collapse
|
57
|
Muscogiuri G, Colao A, Orio F. Comment on Krul-Poel et al. Effect of Vitamin D Supplementation on Glycemic Control in Patients With Type 2 Diabetes (SUNNY Trial): A Randomized Placebo-Controlled Trial. Diabetes Care 2015;38:1420-1426. Diabetes Care 2015; 38:e190. [PMID: 26494814 DOI: 10.2337/dc15-1212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, University of Naples "Parthenope," Naples, Italy Endocrinology and Diabetology, Fertility Techniques Structure, University Hospital San Giovanni di Dio Ruggi d'Aragona, Salerno, Italy
| |
Collapse
|
58
|
Mohamad MI, El-Sherbeny EE, Bekhet MM. The Effect of Vitamin D Supplementation on Glycemic Control and Lipid Profile in Patients with Type 2 Diabetes Mellitus. J Am Coll Nutr 2015; 35:399-404. [PMID: 26391639 DOI: 10.1080/07315724.2015.1026427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM The aim of this study was to evaluate the effect of vitamin D supplementation in patients with type 2 diabetes mellitus (T2DM) with regard to their glycemic control and lipid profile. METHODS One hundred subjects with T2DM were recruited and given 4500 IU/day of vitamin D for 2 months. 25-Hydroxyvitamin D [25(OH)D], fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), and lipid profile were measured pre- and postsupplementation. RESULTS There was a significant increase in the mean value of 25(OH)D level after supplementation (baseline level 16 ± 5.3 ng/ml vs. after supplement level 49.2 ± 17.7 ng/ml, p < 0.05). Both FBG and HbA1c but not lipid profile were significantly decreased after supplementation. However, the univariate general linear model between 25(OH)D percentiles and lipid profile levels showed that diabetic subjects with high 25(OH)D levels (>61 ng/ml) had significantly lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) in comparison to those in the low or middle percentiles. Furthermore, participants in a higher percentile had a significantly higher level of high-density lipoprotein cholesterol (HDL-C) than those in the middle percentile. Lipid profile levels were not affected by the supplement except for triglycerides (TG) levels in females, which were significantly decreased. CONCLUSIONS Vitamin D supplementation may be beneficial to diabetic subjects because it improved glycemic control. Diabetic subjects with high 25(OH)D levels (>61 ng/ml) had better lipid profiles.
Collapse
Affiliation(s)
| | - Enas E El-Sherbeny
- c Faculty of Medicine, Ain Shams University, Cairo, EGYPT; Public Health & Community Medicine Department , Faculty of Medicine, Mansoura University, Mansoura, EGYPT
| | | |
Collapse
|
59
|
Effects of Vitamin D Supplementation on C-peptide and 25-hydroxyvitamin D Concentrations at 3 and 6 Months. Sci Rep 2015; 5:10411. [PMID: 26095242 PMCID: PMC4476090 DOI: 10.1038/srep10411] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/13/2015] [Indexed: 12/11/2022] Open
Abstract
The link between African-Americans' disproportionate rates of diabetes, obesity and vitamin D deficiency may be marked by C-peptide as an indicator of insulin secretion. We hypothesize that vitamin D supplementation will increase C-peptide, a marker of insulin secretion. During 3 winters from 2007-2010, 328 healthy African-Americans (median age, 51 years) living in Boston, MA were randomized into a 4-arm, double-blind trial for 3 months of placebo, 1000, 2000, or 4000 IU of vitamin D3. The differences in non-fasting C-peptide between baseline and 3 months were -0.44 ng/mL for those receiving placebo, -0.10 ng/mL for those receiving 1000 IU/d, 0 ng/mL for those receiving 2000 IU/d, 1.24 ng/mL for those receiving 4000 IU/d (C-peptide increased 0.42 ng/mL for each additional 1000 IU/d of vitamin D3, p < 0.001). Vitamin D supplementation increased C-peptide in overweight African-Americans and may be compatible with other recommendations for diabetes prevention and management including weight loss and increased physical activity.
Collapse
|
60
|
Reis JP, Michos ED, Selvin E, Pankow JS, Lutsey PL. Race, vitamin D-binding protein gene polymorphisms, 25-hydroxyvitamin D, and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 2015; 101:1232-40. [PMID: 25926504 PMCID: PMC4441813 DOI: 10.3945/ajcn.115.107334] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/24/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Low 25-hydroxyvitamin D [25(OH)D] is associated with diabetes, but few studies have examined racially diverse populations while also accounting for key vitamin D-binding protein (DBP) gene polymorphisms. OBJECTIVE We sought to evaluate whether the association between 25(OH)D and incident diabetes varied by race and important DBP single nucleotide polymorphisms (SNPs). DESIGN We studied 10,222 adults (8120 whites, 2102 blacks) aged 46-70 y at baseline (1990-1992) from the ARIC (Atherosclerosis Risk in Communities) Study with follow-up for incident diabetes ascertained during study visits conducted in 1993-1995 and 1996-1998. Adjusted HRs and their 95% CIs for diabetes were estimated according to 25(OH)D status. RESULTS During follow-up there were 750 incident cases of diabetes. The association of 25(OH)D with diabetes varied by race (P-interaction = 0.004). Among whites, the adjusted HR for diabetes corresponding to each additional SD higher 25(OH)D concentration (21.3 nmol/L) was 0.95 (95% CI: 0.91, 0.99). No significant association was observed among blacks (HR: 1.06; 95% CI: 0.99, 1.14). There was evidence that the A allele at rs4588 and the T allele at rs7041, which are reported to be associated with high and low DBP concentrations, respectively, modified the association between 25(OH)D and diabetes among whites (P-interaction < 0.05 for both) but not blacks (P-interaction > 0.50 for both). CONCLUSIONS In this large, community-based study, low 25(OH)D concentrations were associated with diabetes among whites but not blacks. Interactions by key DBP SNPs varied between genotypes associated with either high or low DBP concentrations among whites but not blacks. Nevertheless, the findings from this prospective study suggest that there are important differences in the association of 25(OH)D with incident diabetes between white and black adults.
Collapse
Affiliation(s)
- Jared P Reis
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL).
| | - Erin D Michos
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - Elizabeth Selvin
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - James S Pankow
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - Pamela L Lutsey
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| |
Collapse
|
61
|
Kuchay MS, Laway BA, Bashir MI, Wani AI, Misgar RA, Shah ZA. Effect of Vitamin D supplementation on glycemic parameters and progression of prediabetes to diabetes: A 1-year, open-label randomized study. Indian J Endocrinol Metab 2015; 19:387-392. [PMID: 25932396 PMCID: PMC4366779 DOI: 10.4103/2230-8210.152783] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Whether Vitamin D supplementation in prediabetes subjects prevents the development of diabetes is a matter of debate, and the results are inconsistent. This open-label, randomized study in subjects with prediabetes evaluated the effect of 12 months of Vitamin D supplementation on glycemic parameters and progression of prediabetes to diabetes in an ethnically homogeneous Kashmiri population. MATERIALS AND METHODS A total of 147 subjects were diagnosed as prediabetes out of which 137 subjects were randomized to receive in addition to standard lifestyle measures, either Vitamin D 60,000 IU weekly for 4 weeks and then 60,000 IU monthly (n = 69) or no Vitamin D (n = 68). Fasting plasma glucose (FPG), 2-h plasma glucose and A1C levels were estimated at 0, 6 and 12 months. Changes in FPG, 2-h plasma glucose, A1C level and the proportion of subjects developing diabetes were assessed among 129 subjects. RESULTS At 12 months, A1C levels were significantly lesser (5.7% ± 0.4%) in the Vitamin D supplemented group when compared with non-Vitamin D supplemented (6.0% ± 0.3%). Similarly, FPG (97 ± 7) and 2-h plasma glucose (132 ± 16) were significantly less in Vitamin D supplemented group as compared with non-Vitamin D supplemented group (FPG = 116 ± 6 and 2-h plasma glucose = 157 ± 25) at 12 months. Nine out of 65 in non-Vitamin D supplemented and seven out of 64 in the Vitamin D supplemented group developed diabetes. CONCLUSIONS Vitamin D supplementation in prediabetes subjects significantly lowered FPG, 2-h plasma glucose and A1C levels.
Collapse
Affiliation(s)
- Mohammad Shafi Kuchay
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Bashir Ahmad Laway
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Mir Iftikhar Bashir
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Arshad Iqbal Wani
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Raiz Ahmad Misgar
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Zaffar Amin Shah
- Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
62
|
Abbasi F, Blasey C, Feldman D, Caulfield MP, Hantash FM, Reaven GM. Low circulating 25-hydroxyvitamin D concentrations are associated with defects in insulin action and insulin secretion in persons with prediabetes. J Nutr 2015; 145:714-9. [PMID: 25740907 PMCID: PMC4381771 DOI: 10.3945/jn.114.209171] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 02/06/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Individuals with prediabetes mellitus (PreDM) and low circulating 25-hydroxyvitamin D [25(OH)D] are at increased risk of type 2 diabetes mellitus (T2DM). OBJECTIVE We aimed to determine whether low 25(OH)D concentrations are associated with defects in insulin action and insulin secretion in persons with PreDM. METHODS In this cross-sectional study, we stratified 488 nondiabetic subjects as having PreDM or normal fasting glucose (NFG) and a 25(OH)D concentration ≤20 ng/mL (deficient) or >20 ng/mL (sufficient). We determined insulin resistance by steady state plasma glucose (SSPG) concentration and homeostasis model assessment of insulin resistance (HOMA-IR) and insulin secretion by homeostasis model assessment of β-cell function (HOMA-β). We compared insulin resistance and secretion measures in PreDM and NFG groups; 25(OH)D-deficient and 25(OH)D-sufficient groups; and PreDM-deficient, PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups, adjusting for age, sex, race, body mass index, multivitamin use, and season. RESULTS In the PreDM group, mean SSPG concentration and HOMA-IR were higher and mean HOMA-β was lower than in the NFG group (P < 0.001 for all comparisons). In the 25(OH)D-deficient group, mean SSPG concentration was higher (P < 0.001), but neither mean HOMA-IR nor HOMA-β was significantly different from that in the 25(OH)D-sufficient group. In the PreDM-deficient subgroup, mean (95% CI) SSPG concentration was higher (P < 0.01) than in the PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups [192 (177-207) mg/dL vs. 166 (155-177) mg/dL, 148 (138-159) mg/dL, and 136 (127-144) mg/dL, respectively]. Despite greater insulin resistance, mean HOMA-β was not significantly higher in the PreDM-deficient subgroup than in the PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups [98 (85-112) vs. 91 (82-101), 123 (112-136), and 115 (106-124), respectively]. CONCLUSION Subjects with PreDM and low circulating 25(OH)D concentrations are the subgroup of nondiabetic individuals who are the most insulin resistant and have impaired β-cell function, attributes that put them at enhanced risk of T2DM.
Collapse
Affiliation(s)
| | - Christine Blasey
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA; and
| | - David Feldman
- Endocrinology, Gerontology, and Metabolism, Department of Medicine, and
| | | | - Feras M Hantash
- Quest Diagnostics Nichols Institute, San Juan Capistrano, CA
| | | |
Collapse
|
63
|
Heer M, Egert S. Nutrients other than carbohydrates: their effects on glucose homeostasis in humans. Diabetes Metab Res Rev 2015; 31:14-35. [PMID: 24510463 DOI: 10.1002/dmrr.2533] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 01/30/2014] [Accepted: 02/02/2014] [Indexed: 02/06/2023]
Abstract
Besides carbohydrates, other nutrients, such as dietary protein and amino acids; the supply of fat, vitamin D, and vitamin K; and sodium intake seem to affect glucose homeostasis. Although their effect is less pronounced than that of the amount and composition of carbohydrates, it seems reasonable to consider how nutrient intake habits may be modified to support an improved glucose homeostasis. For instance, taking into account the effect of some nutrients to lower blood glucose concentration on a day-by-day basis might support improvement of glucose homeostasis in the long run. On the other hand, lowering sodium intake too much, as recommended to avoid the development of hypertension, particularly in sodium-sensitive people, might lead to insulin resistance and thereby might risk increasing fasting as well as postprandial blood glucose concentrations. This review summarizes the state of our knowledge of how several nutrients other than carbohydrates, such as protein, fatty acids, vitamin D, vitamin K, magnesium, zinc, chromium, and sodium, affect blood glucose concentrations. Sufficient evidence exists to show that, in prospective studies based on randomized controlled trials, these selected nutrients affect blood glucose regulation. The review describes potential mechanisms leading to the observed effect. As much as is possible from the available data, the extent of the effect, is considered.
Collapse
|
64
|
Guan C, Zhen D, Tang X, Yang X, Zhu T, Fu S, Tian Y. The status of 25-hydroxyvitamin D across the spectrum of glucose tolerance among middle-aged and elderly Chinese individuals. Clin Endocrinol (Oxf) 2014; 81:834-40. [PMID: 25132402 DOI: 10.1111/cen.12574] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/21/2014] [Accepted: 07/26/2014] [Indexed: 01/19/2023]
Abstract
CONTEXT Although vitamin D status and its inverse association with diabetes among White people have been recognized, little research on vitamin D status has been well conducted in Chinese individuals based on glucose tolerance. OBJECTIVE To compare the vitamin D status of Chinese individuals aged 40-75 years based on the glucose tolerance status. DESIGN AND METHODS Serum 25OHD was measured in a cross-sectional sample of 10 038 individuals aged 40-75 years from Lanzhou city, which is located in western China. RESULTS People with normal glucose tolerance (NGT, n = 4744), prediabetes (n = 2808) or diabetes (n = 2486) aged 40-75 years were included in the study. The difference in 25OHD concentration between people with NGT and prediabetes was not significant (16·5 vs 16·0 ng/ml, P = 0·773), but the 25OHD concentration of diabetes was higher than that of subjects with NGT (16·5 vs 16·5 ng/ml, P = 0·025) and prediabetes (16·5 vs 16·0 ng/ml, P = 0·032) after adjusting confounders. There was no difference in the prevalence of vitamin D deficiency between people with NGT and diabetes (74·7% vs 74·0%, P = 0·535), but the prevalence of vitamin D deficiency of prediabetes was higher than that of people with NGT (77·0% vs 74·7%, P = 0·024) and diabetes (77·0% vs 74·0%, P = 0·012). CONCLUSIONS Although vitamin D status was significantly different across the spectrum of glucose tolerance in middle-aged and elderly Chinese individuals, the difference was not clinically significant. The results, however, highlight the very high prevalence of vitamin D deficiency in this population and should raise the awareness of this important public health issue among health-care providers.
Collapse
Affiliation(s)
- Conghui Guan
- Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | | | | | | | | | | | | |
Collapse
|
65
|
Markers of subclinical atherosclerosis in premenopausal women with vitamin D deficiency and effect of vitamin D replacement. Atherosclerosis 2014; 237:784-9. [PMID: 25463121 DOI: 10.1016/j.atherosclerosis.2014.10.096] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 10/05/2014] [Accepted: 10/17/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent studies have revealed a relationship between vitamin D deficiency and atherosclerosis. This study aims to investigate the impact of vitamin D deficiency and replacement on markers of subclinical atherosclerosis in young premenopausal women in whom vitamin D deficiency is prevalent. METHODS Thirty-one premenopausal vitamin D deficient women and 27 age and gender-matched control subjects were enrolled in this study. Markers of subclinical atherosclerosis including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD), endothelial progenitor cell (EPC) count and cytokine levels were determined at baseline. All measurements were repeated at 6-month follow-up in vitamin D-deficient subjects after vitamin D replacement. RESULTS Vitamin D deficient premenopausal women had lower FMD (9.9 ± 1.3 vs. 13.8 ± 1.7%, p < 0.001) and EPC counts at baseline. This population also had lower IL-10 and higher IL-17 levels. A 6-month vitamin D replacement therapy resulted in a significant increase in FMD (9.9 ± 1.3 vs. 11.4 ± 1.4%, p < 0.001) and EPC counts. Furthermore, cytokine profile shifted toward a more anti-inflammatory phenotype including elevated IL-10 and decreased IL-17 levels. cIMT was not different between patient and control groups and did not change following vitamin D replacement. Change in 25(OH)D and IL-17 levels were independent predictors of the change in FMD measurements following vitamin D replacement. CONCLUSION This study demonstrates that endothelial function is impaired in otherwise healthy vitamin D deficient young premenopausal women and improves with 6-month replacement therapy. Immune-modulatory effects of vitamin D may, at least partly, be responsible for its beneficial effects on vascular health.
Collapse
|
66
|
Kositsawat J, Kuchel GA, Tooze JA, Houston DK, Cauley JA, Kritchevsky SB, Strotmeyer ES, Kanaya AM, Harris TB, Johnson KC, Barry LC. Vitamin D insufficiency and abnormal hemoglobin a1c in black and white older persons. J Gerontol A Biol Sci Med Sci 2014; 70:525-31. [PMID: 25112493 DOI: 10.1093/gerona/glu122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Although vitamin D has been mechanistically linked to insulin secretion and sensitivity, it remains unclear whether low 25-hydroxyvitamin D levels confer an increased risk of impaired glucose metabolism. We evaluated the relationship between vitamin D insufficiency (25-hydroxyvitamin D < 20ng/mL) and abnormal hemoglobin A1c (A1c) (≥6.5%) in community-dwelling older persons and examined whether this relationship differed according to race. METHODS Participants were 2,193 persons of age 70-79 years at Year 1 (52% women; 37% black) in the Health, Aging, and Body Composition study who had clinic visits at Years 2 and 4. Logistic regression analyses, adjusted for potential confounders, were used to evaluate the association between vitamin D insufficiency and abnormal A1c 2 years later. Interaction of race and vitamin D insufficiency was tested. RESULTS A total of 665 (30%) and 301 (14%) of the participants had vitamin D insufficiency at Year 2 and abnormal A1c at Year 4, respectively. After controlling for demographics, other potential confounders, and diabetes status at Year 4 (n = 477 diabetics), we found that vitamin D insufficiency was associated with an increased likelihood of having abnormal A1c (odds ratio = 1.56; 95% CI: 1.03-2.37). We also found that this relationship persisted among the 1,765 participants without diabetes in Year 2 (odds ratio = 2.33; 95% CI: 1.00-5.40). Findings did not differ by race. CONCLUSIONS Vitamin D insufficiency was associated with abnormal A1c levels among black and white older persons independent of diabetes status. Future studies are needed to establish the temporal relationship between vitamin D and A1c in diverse samples of older persons.
Collapse
Affiliation(s)
- Jatupol Kositsawat
- UCONN Center on Aging, Department of Medicine, University of Connecticut Health Center, Farmington.
| | - George A Kuchel
- UCONN Center on Aging, Department of Medicine, University of Connecticut Health Center, Farmington
| | - Janet A Tooze
- Department of Biostatistical Sciences, Division of Public Health Sciences and
| | - Denise K Houston
- Section on Gerontology & Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jane A Cauley
- Department of Epidemiology, Center for Aging and Population Health, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Stephen B Kritchevsky
- Section on Gerontology & Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Elsa S Strotmeyer
- Department of Epidemiology, Center for Aging and Population Health, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Alka M Kanaya
- Division of General Internal Medicine, University of California, San Francisco
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Lisa C Barry
- UCONN Center on Aging, Department of Psychiatry, University of Connecticut Health Center, Farmington
| | | |
Collapse
|
67
|
Oosterwerff MM, Eekhoff EM, Van Schoor NM, Boeke AJP, Nanayakkara P, Meijnen R, Knol DL, Kramer MH, Lips P. Effect of moderate-dose vitamin D supplementation on insulin sensitivity in vitamin D-deficient non-Western immigrants in the Netherlands: a randomized placebo-controlled trial. Am J Clin Nutr 2014; 100:152-60. [PMID: 24898240 DOI: 10.3945/ajcn.113.069260] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Low serum 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with insulin resistance, the metabolic syndrome, and type 2 diabetes. Because many non-Western immigrants in the Netherlands are vitamin D deficient, obese, and at high risk of diabetes, vitamin D supplementation may contribute to prevent diabetes and insulin resistance. OBJECTIVE We examined the effect of vitamin D supplementation on insulin sensitivity and β cell function in overweight, vitamin D-deficient, non-Western immigrants at high risk of diabetes. DESIGN The study was a 16-wk, randomized, placebo-controlled trial. A total of 130 non-Western immigrants with prediabetes (fasting glucose concentration >5.5 mmol/L or random glucose concentration from 7.8 to 11.1 mmol/L) and vitamin D deficiency (serum 25[OH]D concentration <50 nmol/L) were randomly assigned after stratification by sex to receive either cholecalciferol (1200 IU/d) or a placebo for 16 wk. All participants received 500 mg Ca/d as calcium carbonate. The primary outcome was the difference in the area under the curve of insulin and glucose after a 75-g oral-glucose-tolerance test after 4 mo of treatment. Secondary outcomes were insulin-sensitivity variables, β cell-function variables, and metabolic syndrome. RESULTS Mean serum 25(OH)D concentrations increased significantly in the vitamin D compared with placebo groups. After 4 mo of therapy, the mean between-group difference was 38 nmol/L (95% CI: 32.1, 43.9 nmol/L; P < 0.001). There was no significant effect on insulin sensitivity and β cell function. In a post hoc analysis, when patients with diabetes at baseline were excluded, a significant increase in the insulinogenic index was observed in participants who obtained a 25(OH)D concentration ≥60 nmol/L (P = 0.040). CONCLUSIONS Vitamin D supplementation in non-Western vitamin D-deficient immigrants with prediabetes did not improve insulin sensitivity or β cell function or change the incidence of metabolic syndrome. However, after the exclusion of diabetic subjects, an improvement in the insulinogenic index was observed in participants who obtained a 25(OH)D concentration ≥60 nmol/L. This trial was registered at trialregister.nl as NTR1827.
Collapse
Affiliation(s)
- Mirjam M Oosterwerff
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Elisabeth Mw Eekhoff
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Natasja M Van Schoor
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - A Joan P Boeke
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Prabath Nanayakkara
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Rosa Meijnen
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Dirk L Knol
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Mark Hh Kramer
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| | - Paul Lips
- From the Department of Internal Medicine, Section of Endocrinology ZH4A65 (MMO, EMWE, PN, RM, MHHK, and PL), the EMGO Institute for Health and Care Research (NMVS), and the Department of Epidemiology and Biostatistics (DLK), VU University Medical Center, Amsterdam, Netherlands, and General Practice, Postjesweg, Amsterdam (AJPB)
| |
Collapse
|
68
|
Abstract
There has been increasing evidence that vitamin D may have a role in modifying risk of diabetes. Vitamin D has both direct and indirect effects on various mechanisms related to the pathophysiology of type 2 diabetes, including pancreatic beta cell dysfunction, impaired insulin action and systemic inflammation. This article describes the biologic plausibility behind the potential association between vitamin D and type 2 diabetes and summarizes the current evidence from human studies that suggests but does not prove a relation between vitamin D and type 2 diabetes, and briefly reports on the potential association between vitamin D and type 1 diabetes.
Collapse
Affiliation(s)
- Joanna Mitri
- Division of Endocrinology, Diabetes and Metabolism, Prima CARE Medical Center, 277 Pleasant Street, Fall River, MA 02721, USA.
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA
| |
Collapse
|
69
|
Mitri J, Nelson J, Ruthazer R, Garganta C, Nathan DM, Hu FB, Dawson-Hughes B, Pittas AG. Plasma 25-hydroxyvitamin D and risk of metabolic syndrome: an ancillary analysis in the Diabetes Prevention Program. Eur J Clin Nutr 2014; 68:376-83. [PMID: 24448494 PMCID: PMC4091839 DOI: 10.1038/ejcn.2013.293] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/12/2013] [Accepted: 08/23/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES Low blood levels of 25-hydroxyvitamin D (25OHD) have been associated with cardiometabolic disease but results are inconsistent. The objective of the study was to investigate the association of 25OHD with metabolic syndrome in a population at increased risk for diabetes. SUBJECTS/METHODS Using baseline data from the placebo and lifestyle intervention arms of the Diabetes Prevention Program (N=2000), multivariable logistic regression models were used to estimate the odds of prevalent metabolic syndrome and each of its individual components across 25OHD tertiles. Multivariable linear regression was used to estimate the adjusted mean difference of insulin secretion and sensitivity across the same 25OHD tertiles. In participants free of metabolic syndrome at baseline (N=546), incident metabolic syndrome in the first 2 years of follow-up was assessed using discrete-time proportional hazards regression to test its association with 25OHD concentration. RESULTS After multivariate adjustment, participants in the highest tertile of 25OHD had lower odds of prevalent metabolic syndrome (odds ratio=0.62; 95% confidence interval (CI)=0.45-0.84), smaller waist circumference, higher high-density lipoprotein and lower fasting plasma glucose compared with participants in the lowest tertile of 25OHD. Higher plasma 25OHD concentration was associated with greater insulin sensitivity and lower insulin secretion. After multivariate adjustment, there was a nonsignificant lower risk of metabolic syndrome in the highest tertile of 25OHD (hazard ratio=0.79; 95% CI=0.48-1.32) compared with the lowest tertile. CONCLUSIONS In a population at increased risk for diabetes, higher plasma 25OHD concentration was inversely associated with prevalent metabolic syndrome and nonsignificantly with incident metabolic syndrome.
Collapse
Affiliation(s)
- J Mitri
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - J Nelson
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - R Ruthazer
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - C Garganta
- Department of Clinical Genetics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
| | - D M Nathan
- Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - F B Hu
- 1] Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA [2] Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - B Dawson-Hughes
- 1] Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA [2] Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - A G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
70
|
Grant WB, Cannell JJ. Autism prevalence in the United States with respect to solar UV-B doses: An ecological study. DERMATO-ENDOCRINOLOGY 2014; 5:159-64. [PMID: 24494049 PMCID: PMC3897584 DOI: 10.4161/derm.22942] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 11/05/2012] [Accepted: 11/17/2012] [Indexed: 01/08/2023]
Abstract
Evidence is mounting that vitamin D deficiency is intimately involved in autism. We report on autism prevalence by US state for those aged 6–17 y in 2010 with respect to indices of solar UV-B (UVB) doses. We calculated autism prevalence rates for white, black and Asian Americans by using total prevalence and relative populations of minors for each ethnic group by state. Analyses omit AK and HI (considered extreme cases), WY (no data), along with AZ and ND for black Americans (low numbers) and DC, ME, MT, ND and SD for Asian Americans (low numbers). For white Americans, the regression coefficient for solar UVB doses and autism prevalence ranged from -0.52 in January to -0.57 in October. For black Americans, the regression coefficient for latitude was 0.61, whereas those for solar UVB ranged from -0.55 to -0.61. For Asian Americans, the values for solar UVB ranged from -0.28 to -0.38. The inverse correlation between solar UVB and autism prevalence is similar to that for many types of cancer in the US. The journal literature indicates that adverse effects on fetal brain development during pregnancy due to vitamin D deficiency can explain these findings. However, we cannot rule out a role of vitamin D deficiency in early life. These results add to the evidence that vitamin D deficiency may be an important risk factor for autism and suggest that pregnant women and autistic individuals raise their serum 25-hydroxyvitamin D concentrations above 30 ng/ml.
Collapse
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center; San Francisco, CA USA
| | | |
Collapse
|
71
|
Affiliation(s)
- Eva Kassi
- Department of Biological Chemistry, University of Athens Medical School, Athens, Greece
| | | | | | | |
Collapse
|
72
|
Kajbaf F, Mentaverri R, Diouf M, Fournier A, Kamel S, Lalau JD. The Association between 25-Hydroxyvitamin D and Hemoglobin A1c Levels in Patients with Type 2 Diabetes and Stage 1-5 Chronic Kidney Disease. Int J Endocrinol 2014; 2014:142468. [PMID: 25250050 PMCID: PMC4163314 DOI: 10.1155/2014/142468] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/18/2014] [Accepted: 08/14/2014] [Indexed: 12/03/2022] Open
Abstract
Aim. To examine the relationship between plasma 25-hydroxyvitamin D (25(OH)D) levels and blood hemoglobin A1c (HbA1c) levels in diabetic patients at various stages of chronic kidney disease (CKD). Methods. We screened for data collected between 2003 and 2012. The correlation between 25(OH)D and HbA1c levels was studied in patients categorized according to the severity of CKD and their vitamin D status. A multivariate linear regression model was used to determine whether 25(OH)D and HbA1c levels were independently associated after adjustment for a number of covariates (including erythrocyte metformin levels). Results. We identified 542 reports from 245 patients. The mean HbA1c value was 6.7 ± 1.0% in vitamin D sufficiency, 7.3 ± 1.5% in insufficiency, and 8.4 ± 2.0% in deficiency (P < 0.0001). There was a negative correlation between 25(OH)D and HbA1c levels for the population as a whole (r = -0.387, P < 0.0001) and in the CKD severity subgroups (r = -0.384, P < 0.0001 and r = -0.333, P < 0.0001 for CKD stages 1-3 and 4-5, resp.). In the multivariate analysis, the 25(OH)D level was the only factor associated with HbA1c (P < 0.0001). Conclusion. 25(OH)D levels were negatively correlated with HbA1c levels independently of study covariates.
Collapse
Affiliation(s)
- Farshad Kajbaf
- Department of Endocrinology and Nutrition, University Hospital of Amiens, 80054 Amiens, France
- INSERM Unit 1088, Jules Verne University of Picardie, 80037 Amiens, France
| | - Romuald Mentaverri
- INSERM Unit 1088, Jules Verne University of Picardie, 80037 Amiens, France
- Bone Biology and Endocrine Division, University Hospital of Amiens, 80054 Amiens, France
| | - Momar Diouf
- Clinical Research Center, University Hospital of Amiens, 80054 Amiens, France
| | - Albert Fournier
- Department of Clinical Nephrology, University Hospital of Amiens, 80054 Amiens, France
| | - Said Kamel
- Bone Biology and Endocrine Division, University Hospital of Amiens, 80054 Amiens, France
| | - Jean-Daniel Lalau
- Department of Endocrinology and Nutrition, University Hospital of Amiens, 80054 Amiens, France
- INSERM Unit 1088, Jules Verne University of Picardie, 80037 Amiens, France
- *Jean-Daniel Lalau:
| |
Collapse
|
73
|
Madar AA, Knutsen KV, Stene LC, Brekke M, Meyer HE, Lagerløv P. Effect of vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, serum lipids, and body mass index: a randomized, double-blinded, placebo-controlled trial among healthy immigrants living in Norway. BMJ Open Diabetes Res Care 2014; 2:e000026. [PMID: 25452867 PMCID: PMC4212570 DOI: 10.1136/bmjdrc-2014-000026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/26/2014] [Accepted: 08/04/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Despite the suggested role of vitamin D in the prevention of diabetes and cardiovascular disease or its risk factors, the evidence is not consistent and there is a paucity of randomized controlled trials in this field. We aimed to investigate the effect of 16-week daily vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, body mass index (BMI), and serum lipids. DESIGN Double-blind, randomized, placebo-controlled trial. SETTING Immigrant community centers in Oslo, Norway. PARTICIPANTS 251 healthy adults aged 18-50 years with a non-Western immigrant background. All participants performed the baseline test and 215 (86%) returned to the follow-up test. INTERVENTION 16 weeks of daily oral supplementation with either 10 μg vitamin D3, 25 μg vitamin D3, or placebo. MAIN OUTCOME MEASURES Difference in absolute change during the 16-week intervention between the intervention groups combined (10 or 25 μg of vitamin D3/day) and placebo, in HbA1c, fructosamine, serum lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), and BMI. RESULTS A total of 215 (86%) participants completed the study. Serum 25-hydroxyvitamin D increased from 29 nmol/L at baseline to 49 nmol/L after intervention, with little change in the placebo group. However, there was no difference in change of HbA1c between those receiving vitamin D3 compared with placebo (mean difference: 0.01% (95% CI -0.04 to 0.06, p=0.7)). Neither did the vitamin D3 supplementation have any effect on the other end points: fructosamine, serum lipids, and BMI. CONCLUSIONS 16-week vitamin D3 supplementation to healthy immigrants from South Asia, the Middle East, or Africa and now living in Norway with low vitamin D status did not improve HbA1c, fructosamine, lipid profiles, or BMI. An updated meta-analysis of similar published trials showed that our results were generally consistent with those of other studies. TRIAL REGISTRATION NUMBER NCT01263288.
Collapse
Affiliation(s)
- Ahmed A Madar
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kirsten V Knutsen
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lars C Stene
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Haakon E Meyer
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Lagerløv
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
74
|
Wium C, Gulseth HL, Eriksen EF, Birkeland KI. Characteristics of glucose metabolism in Nordic and South Asian subjects with type 2 diabetes. PLoS One 2013; 8:e83983. [PMID: 24391858 PMCID: PMC3877129 DOI: 10.1371/journal.pone.0083983] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/11/2013] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Insulin resistance and type 2 diabetes are more prevalent in people of South Asian ethnicity than in people of Western European origin. To investigate the source of these differences, we compared insulin sensitivity, insulin secretion, glucose and lipid metabolism in South Asian and Nordic subjects with type 2 diabetes. METHODS Forty-three Nordic and 19 South Asian subjects with type 2 diabetes were examined with intra-venous glucose tolerance test, euglycemic clamp including measurement of endogenous glucose production, indirect calorimetry measuring glucose and lipid oxidation, and dual x-ray absorptiometry measuring body composition. RESULTS Despite younger mean ± SD age (49.7 ± 9.4 vs 58.3 ± 8.3 years, p = 0.001), subjects of South Asian ethnicity had the same diabetes duration (9.3 ± 5.5 vs 9.6 ± 7.0 years, p = 0.86), significantly higher median [inter-quartile range] HbA1c (8.5 [1.6] vs 7.3 [1.6] %, p = 0.024) and lower BMI (28.7 ± 4.0 vs 33.2 ± 4.7 kg/m(2), p<0.001). The South Asian group exhibited significantly higher basal endogenous glucose production (19.1 [9.1] vs 14.4 [6.8] µmol/kgFFM · min, p = 0.003). There were no significant differences between the groups in total glucose disposal (39.1 ± 20.4 vs 39.2 ± 17.6 µmol/kgFFM · min, p = 0.99) or first phase insulin secretion (AUC0-8 min: 220 [302] vs 124 [275] pM, p = 0.35). In South Asian subjects there was a tendency towards positive correlations between endogenous glucose production and resting and clamp energy expenditure. CONCLUSIONS Subjects of South Asian ethnicity with type 2 diabetes, despite being younger and leaner, had higher basal endogenous glucose production, indicating higher hepatic insulin resistance, and a trend towards higher use of carbohydrates as fasting energy substrate compared to Nordic subjects. These findings may contribute to the understanding of the observed differences in prevalence of type 2 diabetes between the ethnic groups.
Collapse
Affiliation(s)
- Cecilie Wium
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Hormone Laboratory, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Hanne Løvdal Gulseth
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Hormone Laboratory, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Fink Eriksen
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kåre Inge Birkeland
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
75
|
Nimitphong H, Chailurkit LO, Chanprasertyothin S, Sritara P, Ongphiphadhanakul B. The Association of vitamin D status and fasting glucose according to body fat mass in young healthy Thais. BMC Endocr Disord 2013; 13:60. [PMID: 24369921 PMCID: PMC3996198 DOI: 10.1186/1472-6823-13-60] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 12/20/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Existing inconclusive data on the relationship between vitamin D status and human glucose homeostasis suggests that other factors, such as adiposity, might influence this relationship. The present study aimed to investigate the association between 25-hydroxyvitamin D [25(OH)D] and fasting plasma glucose (FPG) in the context of different amounts of total body fat in a healthy community-based population in Bangkok, Thailand. METHODS This cross-sectional study was a part of health survey of employees of the Electricity Generating Authority of Thailand. There were 1,990 healthy subjects (72.8% male) in this study. Total body fat was measured by bioelectrical impedance analysis. Total serum 25(OH)D, 25(OH)D3 and 25(OH)D2 were measured by LC-MS/MS. RESULTS Age (r = 0.134, p < 0.001) and FPG (r = 0.089, p < 0.001) were positively correlated with 25(OH)D levels, while total body fat mass (r = -0.049, p = 0.03) were negatively correlated with 25(OH)D levels. 25(OH)D levels were higher in males than in females (65.0 ± 0.5 vs. 53.5 ± 0.5 nmol/L, p < 0.001). After controlling for age, gender and total fat mass, FPG was no longer correlated with 25(OH)D. However, when subjects were stratified according to fat-free mass tertiles and controlled for age and gender, there was a positive, although weak association between 25(OH)D levels and FPG (p = 0.01) in the lowest tertile. CONCLUSIONS We therefore speculate that adiposity might influence the relationship of vitamin D status and FPG.
Collapse
Affiliation(s)
- Hataikarn Nimitphong
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
| | - La-or Chailurkit
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
| | - Suwannee Chanprasertyothin
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
| | - Piyamitr Sritara
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
| | - Boonsong Ongphiphadhanakul
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
| |
Collapse
|
76
|
Abstract
Approximately 347 million persons were estimated to have diabetes worldwide in 2008, an increase of 194 million cases from 1980. Diabetes now affects both high- and low-income countries, with low-income countries bearing the majority of the burden. The epidemiologic transition from traditional health risks, such as poor hygiene, to modern health risks, such as sedentary lifestyle, has facilitated the increase in incidence in diabetes, especially in developing countries. The effect of these risk factors may be especially pronounced in some racial and ethnic populations. Increased surveillance for diabetes has contributed to increased diabetes prevalence in higher-income countries. Survival with and some risk factors for diabetes have improved in developed countries, but global diabetes mortality has increased by 20 % since 1990. Population growth and aging will only increase the burden of diabetes, and public health interventions are needed to address diabetes risk factors to stem the tide of this epidemic.
Collapse
Affiliation(s)
- Nisa M Maruthur
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Rm 2-601, Baltimore, MD, 21287, USA,
| |
Collapse
|
77
|
O'Connor MY, Thoreson CK, Ramsey NLM, Ricks M, Sumner AE. The uncertain significance of low vitamin D levels in African descent populations: a review of the bone and cardiometabolic literature. Prog Cardiovasc Dis 2013; 56:261-9. [PMID: 24267433 PMCID: PMC3894250 DOI: 10.1016/j.pcad.2013.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Vitamin D levels in people of African descent are often described as inadequate or deficient. Whether low vitamin D levels in people of African descent lead to compromised bone or cardiometabolic health is unknown. Clarity on this issue is essential because if clinically significant vitamin D deficiency is present, vitamin D supplementation is necessary. However, if vitamin D is metabolically sufficient, vitamin D supplementation could be wasteful of scarce resources and even harmful. In this review vitamin D physiology is described with a focus on issues specific to populations of African descent such as the influence of melanin on endogenous vitamin D production and lactose intolerance on the willingness of people to ingest vitamin D fortified foods. Then data on the relationship of vitamin D to bone and cardiometabolic health in people of African descent are evaluated.
Collapse
Affiliation(s)
- Michelle Y O'Connor
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | | | | | | | | |
Collapse
|
78
|
Deng X, Song Y, Manson JE, Signorello LB, Zhang SM, Shrubsole MJ, Ness RM, Seidner DL, Dai Q. Magnesium, vitamin D status and mortality: results from US National Health and Nutrition Examination Survey (NHANES) 2001 to 2006 and NHANES III. BMC Med 2013; 11:187. [PMID: 23981518 PMCID: PMC3765911 DOI: 10.1186/1741-7015-11-187] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 07/24/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Magnesium plays an essential role in the synthesis and metabolism of vitamin D and magnesium supplementation substantially reversed the resistance to vitamin D treatment in patients with magnesium-dependent vitamin-D-resistant rickets. We hypothesized that dietary magnesium alone, particularly its interaction with vitamin D intake, contributes to serum 25-hydroxyvitamin D (25(OH)D) levels, and the associations between serum 25(OH)D and risk of mortality may be modified by magnesium intake level. METHODS We tested these novel hypotheses utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2001 to 2006, a population-based cross-sectional study, and the NHANES III cohort, a population-based cohort study. Serum 25(OH)D was used to define vitamin D status. Mortality outcomes in the NHANES III cohort were determined by using probabilistic linkage with the National Death Index (NDI). RESULTS High intake of total, dietary or supplemental magnesium was independently associated with significantly reduced risks of vitamin D deficiency and insufficiency respectively. Intake of magnesium significantly interacted with intake of vitamin D in relation to risk of both vitamin D deficiency and insufficiency. Additionally, the inverse association between total magnesium intake and vitamin D insufficiency primarily appeared among populations at high risk of vitamin D insufficiency. Furthermore, the associations of serum 25(OH)D with mortality, particularly due to cardiovascular disease (CVD) and colorectal cancer, were modified by magnesium intake, and the inverse associations were primarily present among those with magnesium intake above the median. CONCLUSIONS Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status. The associations between serum 25(OH)D and risk of mortality may be modified by the intake level of magnesium. Future studies, including cohort studies and clinical trials, are necessary to confirm the findings.
Collapse
Affiliation(s)
- Xinqing Deng
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37203, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
79
|
Tohidi M, Bozorgmanesh M, Mohebi R, Khalili D, Saadat N, Khorrami N, Azizi F, Hadaegh F. Non-linear association between 25-hydroxyvitamin D and the incidence of type 2 diabetes: a community-based nested case-control study. Diabet Med 2013; 30:934-8. [PMID: 23560705 DOI: 10.1111/dme.12180] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2013] [Indexed: 02/06/2023]
Abstract
AIMS To examine the nature of the association between 25-hydroxyvitamin D [25(OH)D] and newly diagnosed type 2 diabetes. METHODS Serum 25(OH)D concentrations were measured for 761 participants (aged 20-83 years) in the Tehran Lipid and Glucose Study, selected for a 1-to-3 nested case-control study. Cases were 191 cases of Type 2 diabetes diagnosed during a median follow-up of 3.6 years. A total of 570 participants were matched with these cases with regard to age, sex, BMI, and month of entering the study. Diabetes was defined according to the American Diabetes Association criteria, 2003. Serum 25(OH)D was measured using the enzyme immunoassay method. Odds ratios for Type 2 diabetes were obtained from conditional logistic regression models for tertiles of serum 25(OH)D concentrations [tertile-1: 2.82-11.02 (reference), tertile-2: 11.03-21.80, and tertile-3: ≥ 21.82 ng/ml]. The multivariate model was adjusted for age, sex, family history of diabetes, systolic blood pressure, triglyceride-to- HDL cholesterol ratio, waist-to-height ratio, lifestyle modification intervention, leisure time physical activity, and fasting plasma glucose at baseline. Non-linearity in the associations between baseline 25(OH)D and Type 2 diabetes, was examined by using restricted cubic splines. RESULTS Unadjusted odds ratios (95% confidence intervals) of diabetes were 0.73 (0.74-1.13), 0.54 (0.34-0.85) for the second and third tertiles, respectively. Multivariate adjusted odds ratios were 0.47 (0.25-0.90) and 0.43 (0.23-0.82), respectively. Below the cutoff of ~ 10 ng/ml the risk of newly diagnosed Type 2 diabetes increased dramatically. DISCUSSION It was found that 25(OH)D concentrations contributed to the Type 2 diabetes incidence rate in a non-linear fashion, with the risk beginning to increase sharply for values < 10 ng/ml.
Collapse
Affiliation(s)
- M Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
80
|
Beveridge LA, Witham MD. Vitamin D and the cardiovascular system. Osteoporos Int 2013; 24:2167-80. [PMID: 23468072 DOI: 10.1007/s00198-013-2281-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/21/2013] [Indexed: 12/31/2022]
Abstract
Vitamin D, a secosteroid hormone, affects multiple biological pathways via both genomic and nongenomic signalling. Several pathways have potential benefit to cardiovascular health, including effects on parathyroid hormone, the renin-angiotensin-aldosterone system, vascular endothelial growth factor and cytokine production, as well as direct effects on endothelial cell function and myocyte calcium influx. Observational data supports a link between low vitamin D metabolite levels and cardiovascular health. Cross-sectional data shows associations between low 25-hydroxyvitamin D levels and stroke, myocardial infarction, diabetes mellitus, hypertension, and heart failure. Longitudinal data also suggests a relationship with incident hypertension and new cardiovascular events. However, these associations are potentially confounded by reverse causality and by the effects that other cardiovascular risk factors have on vitamin D metabolite levels. Intervention studies to date suggest a modest antihypertensive effect of vitamin D, no effect on serum lipids, a small positive effect on insulin resistance and fasting glucose, and equivocal actions on arterial stiffness and endothelial function. Analysis of cardiovascular event data collected from osteoporosis trials does not currently show a clear signal for reduced cardiovascular events with vitamin D supplementation, but results may be confounded by the coadministration of calcium, and by the secondary nature of the analyses. Despite mechanistic and observational data that suggest a protective role for vitamin D in cardiovascular disease, intervention studies to date are less promising. Large trials using cardiovascular events as a primary outcome are needed before vitamin D can be recommended as a therapy for cardiovascular disease.
Collapse
Affiliation(s)
- L A Beveridge
- Ageing and Health, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, DD1 9SY, UK
| | | |
Collapse
|
81
|
Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Ther Adv Endocrinol Metab 2013; 4:122-8. [PMID: 23997931 PMCID: PMC3755528 DOI: 10.1177/2042018813501189] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The extraskeletal effects of vitamin D have attracted considerable interest. Vitamin D deficiency appears to be related to the development of diabetes mellitus type 2 and the metabolic syndrome. Vitamin D may affect glucose homeostasis, vitamin D levels having been found to be inversely related to glycosylated hemoglobin levels in gestational diabetes mellitus. In addition, vitamin D appears to protect from the development of gestational diabetes mellitus. The aim was to study levels of 25-hydroxy vitamin D3 [25(OH)D3] and the relationship between 25(OH)D3 levels and glycemic control in patients with diabetes mellitus type 2. METHODS Glycosylated hemoglobin (HbA1c) and 25(OH)D3 levels were measured in a group of 120 diabetes mellitus type 2 patients. The same measurements were performed in a group of 120 control subjects of the same age and sex. 25(OH)D3 was measured by radioimmunoassay and glycosylated hemoglobin (HbA1c) was measured by high-performance liquid chromatography. RESULTS 25(OH)D3 levels were lower in the diabetes mellitus type 2 patients than in the control group, being 19.26 ± 0.95 ng/ml and 25.49 ± 1.02 ng/ml, in the patient and control groups, respectively (p < 0.001, Student's t-test). 25(OH)D3 levels were found to be inversely associated with HbA1c levels in the diabetic patients (p = 0.008, r (2) = 0.058, linear regression). 25(OH)D3 levels were found to be inversely associated with HbA1c when the patient and control groups were analysed together (p < 0.001, r (2) = 0.086). CONCLUSIONS Vitamin D levels appeared to be lower in diabetes mellitus type 2 patients than in the control group, vitamin D levels being related to glycemic control in diabetes mellitus type 2. These findings may have therapeutic implications as cautious vitamin D supplementation may improve glycemic control in diabetes mellitus type 2.
Collapse
|
82
|
Abstract
Diabetes mellitus (particularly type 2) and osteoporosis are two very common disorders, and both are increasing in prevalence. Adolescents with type 1 diabetes mellitus may not reach potential peak bone mass, putting them at greater fracture risk. In adults with type 2 diabetes, fracture risk is increased and is not explained by the bone mineral density measured by dual-energy X-ray absorptiometry, still considered the gold standard predictor of fracture. In this review, we explore potential mechanisms behind the increased fracture risk that occurs in patients with diabetes, even those with increased bone mineral density. One potential link between diabetes and bone is the osteoblast-produced factor, osteocalcin. It remains to be established whether osteocalcin reflects or affects the connection between bone and glucose metabolism. Several other potential mediators of the effects of diabetes on bone are discussed.
Collapse
Affiliation(s)
- Robert Sealand
- Endocrinology (111P), McGuire Veterans Affairs Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
| | | | | |
Collapse
|
83
|
Moreno-Pérez O, Portilla J, Escoín C, Alfayate R, Reus S, Merino E, Boix V, Bernabeu A, Giner L, Mauri M, Sánchez-Paya J, Picó A. Impact of vitamin D insufficiency on insulin homeostasis and beta cell function in nondiabetic male HIV-infected patients. HIV Med 2013; 14:540-8. [DOI: 10.1111/hiv.12042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 12/14/2022]
Affiliation(s)
- O Moreno-Pérez
- Endocrinology and Nutrition Department; Alicante University General Hospital; Alicante Spain
| | - J Portilla
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - C Escoín
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - R Alfayate
- Hormone Laboratory; Alicante University General Hospital; Alicante Spain
| | - S Reus
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - E Merino
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - V Boix
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - A Bernabeu
- Magnetic Resonance Unit - Inscanner S.L.; Alicante University General Hospital; Alicante Spain
| | - L Giner
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - M Mauri
- Hormone Laboratory; Alicante University General Hospital; Alicante Spain
| | - J Sánchez-Paya
- Preventive Medicine Department; Alicante University General Hospital; Alicante Spain
| | - A Picó
- Endocrinology and Nutrition Department; Alicante University General Hospital; Alicante Spain
| |
Collapse
|
84
|
Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, Hu FB. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care 2013; 36:1422-8. [PMID: 23613602 PMCID: PMC3631862 DOI: 10.2337/dc12-0962] [Citation(s) in RCA: 342] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To quantitatively assess the strength and shape of the association between blood 25-hydroxy vitamin D [25(OH)D] levels and incident risk of type 2 diabetes. RESEARCH DESIGN AND METHODS A systematic search of the MEDLINE and Embase databases and a hand search of references from original reports were conducted up to 31 October 2012. Prospective observational studies that assessed the association between blood levels of 25(OH)D and risk of incident type 2 diabetes were included for meta-analysis. DerSimonian and Laird's random-effects model was used. A quadratic spline regression analysis was used to examine the shape of the association with a generalized least-squares trend test performed for the dose-response relation. RESULTS A total of 21 prospective studies involving 76,220 participants and 4,996 incident type 2 diabetes cases were included for meta-analysis. Comparing the highest to the lowest category of 25(OH)D levels, the summary relative risk for type 2 diabetes was 0.62 (95% CI 0.54-0.70). A spline regression model showed that higher 25(OH)D levels were monotonically associated with a lower diabetes risk. This inverse association did not differ by sex, duration of follow-up, study sample size, diabetes diagnostic criteria, or 25(OH)D assay method. A linear trend analysis showed that each 10 nmol/L increment in 25(OH)D levels was associated with a 4% lower risk of type 2 diabetes (95% CI 3-6; P for linear trend < 0.0001). CONCLUSIONS Our meta-analysis showed an inverse and significant association between circulating 25(OH)D levels and risk of type 2 diabetes across a broad range of blood 25(OH)D levels in diverse populations.
Collapse
Affiliation(s)
- Yiqing Song
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | | | | |
Collapse
|
85
|
Pilz S, Rutters F, Dekker JM. Comment on: Davidson et al. High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes Care 2013;36:260-266. Diabetes Care 2013; 36:e71. [PMID: 23613611 PMCID: PMC3631860 DOI: 10.2337/dc12-2089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Stefan Pilz
- From the Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre Amsterdam, the Netherlands; and the
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Austria
| | - Femke Rutters
- From the Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre Amsterdam, the Netherlands; and the
| | - Jacqueline M. Dekker
- From the Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre Amsterdam, the Netherlands; and the
| |
Collapse
|
86
|
Tsur A, Feldman BS, Feldhammer I, Hoshen MB, Leibowitz G, Balicer RD. Decreased serum concentrations of 25-hydroxycholecalciferol are associated with increased risk of progression to impaired fasting glucose and diabetes. Diabetes Care 2013; 36:1361-7. [PMID: 23393216 PMCID: PMC3631845 DOI: 10.2337/dc12-1050] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To study the association between vitamin D status and the risk of incident impaired fasting glucose (IFG) and diabetes in a population-based cohort of diabetes-free subjects. RESEARCH DESIGN AND METHODS In a historical prospective cohort study of subjects from the Clalit Health Services database, which includes information on nearly 4 million people, diabetes-free subjects aged 40-70 years with serum 25-hydroxycholecalciferol (25-OHD) measurements available were followed for 2 years to assess the development of IFG and diabetes in five 25-OHD subgroups: ≥25, 25.1-37.5, 37.6-50, 50.1-75, and >75 nmol/L. RESULTS The baseline cohort included 117,960 adults: 83,526 normoglycemic subjects and 34,434 subjects with IFG. During follow-up, 8,629 subjects (10.3% of the normoglycemic group) developed IFG, and 2,162 subjects (1.8% of the total cohort) progressed to diabetes. A multivariable model adjusted for age, sex, population group, immigrant status, BMI, season of vitamin D measurement, LDL and HDL cholesterol, triglycerides, estimated glomerular filtration rate, history of hypertension or cardiovascular disease, Charlson comorbidity index, smoking, and socioeconomic status revealed an inverse association between 25-OHD and the risk of progression to IFG and diabetes. The odds of transitioning from normoglycemia to IFG, from normoglycemia to diabetes, and from IFG to diabetes in subjects with a 25-OHD level ≤25 nmol/L were greater than those of subjects with a 25-OHD level >75 nmol/L [odds ratio 1.13 (95% CI 1.03-1.24), 1.77 (1.11-2.83), and 1.43 (1.16-1.76), respectively]. CONCLUSIONS Vitamin D deficiency appears to be an independent risk factor for the development of IFG and diabetes.
Collapse
Affiliation(s)
- Anat Tsur
- Clalit Health Services, Jerusalem, Israel.
| | | | | | | | | | | |
Collapse
|
87
|
Pilz S, Kienreich K, Rutters F, de Jongh R, van Ballegooijen AJ, Grübler M, Tomaschitz A, Dekker JM. Role of vitamin D in the development of insulin resistance and type 2 diabetes. Curr Diab Rep 2013; 13:261-70. [PMID: 23264189 DOI: 10.1007/s11892-012-0358-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency is mainly a consequence of insufficient sunlight induced vitamin D production in the skin and has been associated with various chronic diseases including type 2 diabetes. Experimental data have shown that vitamin D is important for glucose induced insulin secretion, improves insulin resistance, and exerts anti-inflammatory actions. Epidemiological studies have largely documented that a poor vitamin D status is associated with higher risk of insulin resistance and type 2 diabetes. The majority of randomized controlled trials (RCTs) in healthy or prediabetic individuals have, however, failed to demonstrate relevant vitamin D effects on insulin resistance or diabetes incidence. In patients with type 2 diabetes, a few RCTs reported some moderate effects of vitamin D on glycemic control and insulin resistance. While these findings warrant further in-depth studies, the current evidence is insufficient to recommend vitamin D supplementation for the prevention or treatment of type 2 diabetes.
Collapse
Affiliation(s)
- Stefan Pilz
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
88
|
Fradkin JE, Wallace JA, Rodgers GP. Biomedical research: paving a pathway to diabetes prevention. Am J Prev Med 2013; 44:S317-23. [PMID: 23498293 DOI: 10.1016/j.amepre.2012.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 10/12/2012] [Accepted: 12/11/2012] [Indexed: 01/15/2023]
Affiliation(s)
- Judith E Fradkin
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland, USA.
| | | | | |
Collapse
|
89
|
Ahmad S, Chowdhury TA, Boucher BJ. Diabetes and cancer: Could vitamin D provide the link? J Diabetes Complications 2013; 27:184-90. [PMID: 23164631 DOI: 10.1016/j.jdiacomp.2012.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/05/2012] [Accepted: 10/08/2012] [Indexed: 02/06/2023]
Abstract
Diabetes and cancer are common diseases that may co-exist in the same individual. There is significant evidence that patients with diabetes have increased risk of developing certain cancers, especially colorectal, pancreatic and primary hepatic cancer. There is also good evidence that low levels of vitamin D are associated with increased risk of diabetes and increased risk of colorectal, and possibly other, cancers. In this article we propose that low levels of vitamin D may increase the risk of cancer in people with diabetes and describe potential molecular pathways. We suggest that large scale randomised trials of vitamin D supplementation in patients at risk of diabetes, and in patients with established diabetes to examine the effect on cancer risk, are required.
Collapse
Affiliation(s)
- Shahzaib Ahmad
- Centre for Diabetes and Metabolism, Bart's and the London School of Medicine and Dentistry, London, UK
| | | | | |
Collapse
|
90
|
Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, Billings LK, Meigs JB. Association of vitamin D deficiency with incidence of type 2 diabetes in high-risk Asian subjects. Am J Clin Nutr 2013; 97:524-30. [PMID: 23364011 PMCID: PMC3578401 DOI: 10.3945/ajcn.112.048496] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recent studies suggest an association between 25-hydroxyvitamin D [25(OH)D] and type 2 diabetes (T2D) risk. However, prospective studies investigating the relation between vitamin D inadequacy and incidence of T2D incorporating obesity and dynamic measures of insulin resistance (IR) and pancreatic β cell function are limited. OBJECTIVE We tested the hypothesis that baseline 25(OH)D is associated with the incidence of T2D in high-risk subjects for up to 5 y of follow-up, independently of obesity, baseline IR, and β cell function. DESIGN We recruited 1080 nondiabetic Korean subjects [mean ± SD age: 49.5 ± 11.4 y] based on the presence of one or more risk factors for T2D, including obesity, hypertension, dyslipidemia, and/or family history of T2D. We measured anthropometric and biochemical indicators, HOMA2-IR, and the insulinogenic index (IGI; calculated as change in insulin at 30 min/change in glucose at 30 min) from a 75-g oral-glucose-tolerance test. RESULTS Of the participants, 10.5% had a serum 25(OH)D deficiency (<10 ng/mL), 51.6% had an insufficiency (10.0-19.9 ng/mL), and 38.0% had a sufficiency (≥20 ng/mL), and the incidence of T2D at 32.3 ± 15.6 mo (±SD) declined accordingly: 15.9%, 10.2%, and 5.4%, respectively (P < 0.001). After adjustment for age, sex, blood pressure, lifestyles, family history, season, parathyroid hormone, and high-sensitivity C-reactive protein, the participants with 25(OH)D deficiency had an increased risk of T2D independently of BMI, HOMA2-IR, and IGI; the HRs were 2.06 (95% CI: 1.22, 3.49) for 25(OH)D 10-19.9 ng/mL compared with ≥20 ng/mL and 3.23 (95% CI: 1.66, 6.30) for 25(OH)D <10 ng/mL compared with ≥20 ng/mL. CONCLUSION The current prospective study suggests that vitamin D metabolism may play a role in T2D pathogenesis independently of known risk factors. This trial was registered at clinicaltrials.gov as NCT01508481.
Collapse
Affiliation(s)
- Soo Lim
- Seoul National University College of Medicine, Seongnam, Korea
| | | | | | | | | | | | | | | |
Collapse
|
91
|
Davidson MB, Duran P, Lee ML, Friedman TC. High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes Care 2013; 36:260-6. [PMID: 23033239 PMCID: PMC3554269 DOI: 10.2337/dc12-1204] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Low vitamin D levels predict the development of diabetes. This double-blind, randomized, control study in subjects with prediabetes and hypovitaminosis D evaluated whether high doses of vitamin D for 1 year affected insulin secretion, insulin sensitivity, and the development of diabetes. RESEARCH DESIGN AND METHODS A total of 1,551 subjects ≥40 years of age not known to have diabetes were screened with A1C levels. Subjects with A1C levels of 5.8-6.9% underwent an oral glucose tolerance test (OGTT). Subjects with prediabetes and 25-OH vitamin D (25-OHD) levels <30 ng/mL were randomized to receive weekly placebo (n = 53) or vitamin D (n = 56) with doses based on body weight and baseline 25-OHD levels. OGTTs were performed 3, 6, 9, and 12 months later. Insulin secretion and sensitivity were measured, and the proportion of subjects developing diabetes was assessed. RESULTS 25-OHD levels rapidly rose from 22 to nearly 70 ng/mL after vitamin D supplementation with a mean weekly dose of 88,865 IU. There were no differences between the placebo and vitamin D groups regarding fasting plasma glucose, 2-h glucose, or insulin secretion and sensitivity or in the percent developing diabetes or returning to normal glucose tolerance. No subjects experienced increased serum or urinary calcium levels. At 12 months, A1C levels were significantly slightly less (0.2%) in the vitamin D group. CONCLUSIONS In individuals with prediabetes and hypovitaminosis D, doses of vitamin D supplementation designed to raise serum 25-OHD levels into the upper-normal range for 1 year had no effect on insulin secretion, insulin sensitivity, or the development of diabetes compared with placebo administration.
Collapse
Affiliation(s)
- Mayer B Davidson
- Department of Internal Medicine, Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University, Los Angeles, CA, USA.
| | | | | | | |
Collapse
|
92
|
Girgis CM, Clifton-Bligh RJ, Hamrick MW, Holick MF, Gunton JE. The roles of vitamin D in skeletal muscle: form, function, and metabolism. Endocr Rev 2013; 34:33-83. [PMID: 23169676 DOI: 10.1210/er.2012-1012] [Citation(s) in RCA: 342] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Beyond its established role in bone and mineral homeostasis, there is emerging evidence that vitamin D exerts a range of effects in skeletal muscle. Reports of profound muscle weakness and changes in the muscle morphology of adults with vitamin D deficiency have long been described. These reports have been supplemented by numerous trials assessing the impact of vitamin D on muscle strength and mass and falls in predominantly elderly and deficient populations. At a basic level, animal models have confirmed that vitamin D deficiency and congenital aberrations in the vitamin D endocrine system may result in muscle weakness. To explain these effects, some molecular mechanisms by which vitamin D impacts on muscle cell differentiation, intracellular calcium handling, and genomic activity have been elucidated. There are also suggestions that vitamin D alters muscle metabolism, specifically its sensitivity to insulin, which is a pertinent feature in the pathophysiology of insulin resistance and type 2 diabetes. We will review the range of human clinical, animal, and cell studies that address the impact of vitamin D in skeletal muscle, and discuss the controversial issues. This is a vibrant field of research and one that continues to extend the frontiers of knowledge of vitamin D's broad functional repertoire.
Collapse
Affiliation(s)
- Christian M Girgis
- Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, New South Wales, Australia.
| | | | | | | | | |
Collapse
|
93
|
Serum 25-hydroxyvitamin D levels and incident diabetes mellitus type 2: a competing risk analysis in a large population-based cohort of older adults. Eur J Epidemiol 2013; 28:267-75. [DOI: 10.1007/s10654-013-9769-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
|
94
|
Cangoz S, Chang YY, Chempakaseril SJ, Guduru RC, Huynh LM, John JS, John ST, Joseph ME, Judge R, Kimmey R, Kudratov K, Lee PJ, Madhani IC, Shim PJ, Singh S, Singh S, Ruchalski C, Raffa RB. Vitamin D and type 2 diabetes mellitus. J Clin Pharm Ther 2012; 38:81-4. [PMID: 23216626 DOI: 10.1111/jcpt.12026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 10/25/2012] [Indexed: 01/20/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE The deleterious effect of vitamin D deficiency on bone health has long been known. More recent studies suggest a deleterious effect of low vitamin D (hypovitaminosis D) on general health. And specific studies propose an association between hypovitaminosis D and the aetiology and progression of type 2 diabetes (T2DM). Given a commonly assumed lack of toxicity of vitamin D, routine measurement of plasma vitamin D and supplementation is rapidly becoming accepted general practice. COMMENT Authoritative practice guidelines have raised the level of vitamin D that is to be considered minimal for optimum health. This recommendation was based on a wealth of information and definitive evidence for skeletal benefits of vitamin D, but there was a lack of compelling evidence that hypovitaminosis D is causally related to extra-skeletal health outcomes such as diabetes. Hence, vitamin D supplementation for the purpose of achieving a level consistent with good health is evidence based, but measurement and supplementation for the purpose of preventing or treating T2DM is not. WHAT IS NEW AND CONCLUSION Although the maintenance of adequate vitamin D levels is desirable for all patients, we conclude that routine measurement of vitamin D level in every patient or initiating high-dose supplementation for the purpose of preventing or treating T2DM is not evidence based.
Collapse
Affiliation(s)
- S Cangoz
- School of Pharmacy, Temple University, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
95
|
Brandenburg VM, Vervloet MG, Marx N. The role of vitamin D in cardiovascular disease: From present evidence to future perspectives. Atherosclerosis 2012; 225:253-63. [DOI: 10.1016/j.atherosclerosis.2012.08.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 08/02/2012] [Accepted: 08/08/2012] [Indexed: 12/17/2022]
|
96
|
Husemoen LLN, Skaaby T, Thuesen BH, Jørgensen T, Fenger RV, Linneberg A. Serum 25(OH)D and incident type 2 diabetes: a cohort study. Eur J Clin Nutr 2012; 66:1309-14. [PMID: 23031851 DOI: 10.1038/ejcn.2012.134] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes. SUBJECTS/METHODS The MONICA10 cohort consists of 2656 participants (men and women aged 41-71 years) who participated in a 10-year follow-up examination during 1993-1994 as part of the MONICA 1 population survey. A total of 2571 participants free of diabetes at baseline and with successful measurement of serum 25(OH)D were included in the current study. The Danish National Diabetes register enabled identification of 288 cases of incident diabetes during follow-up (median: 16.4 years). Data were analysed by Cox proportional hazard models and associations were expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS Serum 25(OH)D was inversely associated with incident diabetes adjusted for potential confounders (HR per 25 nmol/l=0.83; 95% CI: 0.72-0.95; P=0.009). A statistically significant interaction was observed between 25(OH)D and waist circumference (WC) (P(interaction)=0.042) suggesting an association in persons with a high WC (HR (95%CI) per 25 nmol/l=0.74 (0.63-0.88), 218 incident cases) and not in persons with a normal WC (HR (95%CI) per 25 nmol/l=0.98 (0.78-1.24), 70 incident cases). CONCLUSIONS Low serum 25(OH)D was associated independently with incident diabetes. The inverse association was only found in overweight-obese and not in normal weight individuals, suggesting that obesity may modify the effect of vitamin D status on the risk of diabetes.
Collapse
Affiliation(s)
- L L N Husemoen
- Research Centre for Prevention and Health, Glostrup Hospital, Nordre Ringvej 57, Glostrup, Denmark.
| | | | | | | | | | | |
Collapse
|