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Eleftheriou A, Ong KK, Hughes IA, Petry CJ. Leptin and IGF-1 in Infancy Are Associated With Variants in DHCR7 and CYP2R1 That Relate With Type 1 Diabetes and 25OHD. J Clin Endocrinol Metab 2023; 108:e1394-e1402. [PMID: 37170809 PMCID: PMC10584008 DOI: 10.1210/clinem/dgad263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
CONTEXT Vitamin D has been variably implicated in risk of developing type 1 diabetes based on cohorts of at-risk individuals. Emergent type 1 diabetes in childhood is putatively preceded by altered growth. OBJECTIVE We explored whether polymorphisms in vitamin D metabolism genes modify risk of type 1 diabetes via effects on growth in a prospective, population-based cohort of infants. METHODS The Cambridge Baby Growth Study enrolled newborns from Cambridgeshire, UK, for follow-up in infancy. In 612 infants, we genotyped single nucleotide polymorphisms in vitamin D metabolism genes that relate with type 1 diabetes: rs10741657 and rs12794714 in CYP2R1, rs12785878 in DHCR7, and rs10877012 in CYP27B1. Multivariate linear regression analyses tested associations between genotypes and anthropometric indices (weight, length, and skinfold thickness) or growth-related hormones (C-peptide, IGF-1, and leptin) in infancy. RESULTS Birth weight showed borderline associations with the diabetes risk-increasing alleles in CYP2R1, rs10741657 (β = -.11, P = .02) and rs12794714 (β = -.09, P = .04). The risk-increasing allele rs12794714 was also associated with higher IGF-1 levels at age 24 months (β = .30, P = .01). At age 3 months, the risk-increasing allele rs12785878 in DHCR7, known to negatively associate with 25-hydroxyvitamin D levels, showed a positive association with leptin levels (β = .23, P = .009), which was pronounced in girls (P = .004) vs boys (P = .7). CONCLUSION The vitamin D metabolism genes DHCR7 and CYP2R1 might influence infancy leptin and IGF-1 levels respectively. These findings open the possibility for a developmental role of vitamin D that is mediated by growth-related hormones with implications for the onset of type 1 diabetes autoimmunity.
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Affiliation(s)
| | - Ken K Ong
- Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Ieuan A Hughes
- Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Clive J Petry
- Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, UK
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2
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Jayedi A, Daneshvar M, Jibril AT, Sluyter JD, Waterhouse M, Romero BD, Neale RE, Manson JE, Shab-Bidar S. Serum 25(OH)D Concentration, Vitamin D Supplementation, and Risk of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes or Prediabetes: a Systematic Review and Dose-Response Meta-Analysis. Am J Clin Nutr 2023; 118:697-707. [PMID: 37467897 DOI: 10.1016/j.ajcnut.2023.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Evidence is uncertain about the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and health outcomes in people with type 2 diabetes. OBJECTIVES We aimed to assess the association between vitamin D status and all-cause mortality and cardiovascular disease in people with type 2 diabetes. METHODS We did a systematic search in PubMed, Scopus, CENTRAL, and Web of Science until May 2022. We selected 1) cohort studies investigating the association between serum 25(OH)D concentration and mortality or cardiovascular disease in people with type 2 diabetes or prediabetes and 2) randomized trials of vitamin D supplementation in these patients. We used random-effects pairwise meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CI). RESULTS 21 cohort studies and 6 randomized trials were included. Compared with sufficient vitamin D status (≥50 nmol/L), the RR of all-cause mortality was 1.36 (95% CI: 1.23, 1.49; n = 11 studies, GRADE = moderate) for vitamin D insufficiency (25 to <50 nmol/L), and 1.58 (1.33, 1.83; n = 16, GRADE = moderate) for deficiency (<25 nmol/L). Similar findings were observed for cardiovascular mortality and morbidity but not for cancer mortality. The certainty of evidence ranged from very low to moderate. Dose-response meta-analyses indicated nonlinear associations, with the lowest risk at 25(OH)D ∼60 nmol/L for all-cause and cardiovascular mortality. Supplementation with vitamin D did not reduce the risk of all-cause mortality (RR: 0.96, 95% CI: 0.79, 1.16; risk difference per 1000 patients: 3 fewer, 95% CI: 16 fewer, 12 more; n = 6 trials with 7316 participants; GRADE = low) or the risk of cardiovascular mortality and morbidity (very low- to low-certainty evidence). CONCLUSIONS Vitamin D deficiency and insufficiency are associated with a higher risk of all-cause and cardiovascular mortality in patients with type 2 diabetes or prediabetes. Vitamin D deficiency should be corrected in patients with type 2 diabetes to reach normal serum 25(OH)D concentrations, preferably 60 nmol/L. SYSTEMATIC REVIEW REGISTRATION This systemic review was registered at PROSPERO as CRD42022326429 (=https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=326429).
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - John D Sluyter
- School of Population Health, University of Auckland, New Zealand
| | - Mary Waterhouse
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Briony Duarte Romero
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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A High Dose, Not Low Dose, of Vitamin D Ameliorates Insulin Resistance in Saudi Women. J Clin Med 2022; 11:jcm11216577. [DOI: 10.3390/jcm11216577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Vitamin D has been traditionally seen to be mainly involved in the regulation of bone homeostasis. However, vitamin D has also been clinically linked to various diseases, including metabolic syndrome. The aim of this study was to examine the effect of low and high doses of a vitamin D supplement on the serum levels of 25(OH)D3 and insulin resistance. A total of 120 females were recruited in this study and supplemented weekly with 25,000 IU vitamin D or 50,000 IU vitamin D for three months. Anthropometric measurements were taken at the beginning of the study. Blood samples were collected at the beginning of the study to determine the baseline of the clinical variables and collected again after three months. Insulin resistance was measured using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). After vitamin D supplementation, a non-significant increase was observed in the serum levels of 25(OH)D3 in the group treated with a low dose of vitamin D (LDVD) and a highly significant increase was seen in the group treated with a high dose of vitamin D (HDVD). In the group treated with a higher dose (HDVD), a significant improvement in insulin sensitivity was observed. The high dose of vitamin D (50,000 IU) supplementation was more effective in both correcting the blood levels of vitamin D and improving the sensitivity of insulin.
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Zabeen B, Nahar J, Ahmed B, Tayyeb S, Islam N, Azad K. Vitamin D status in children and adolescents with type 1 diabetes in a specialized diabetes care centre in Bangladesh. Endocrinol Diabetes Metab 2022; 5:e00312. [PMID: 34766458 PMCID: PMC8754235 DOI: 10.1002/edm2.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES High prevalence of vitamin D deficiency (VDD) in children and adolescents with type 1 diabetes (T1D) was found in several epidemiological studies. The current study aimed to assess the Vitamin D status in children and adolescents with T1D and to examine the influence of the disease characteristics on vitamin D status in a specialized care centre in a tertiary hospital in Bangladesh. METHODS Participants were enrolled in the cross-sectional study at the time of a regularly scheduled visit to the CDiC Paediatric Diabetes Center in BIRDEM 2(Bangladesh Institute of Research and Rehabilitation of Diabetes Endocrine and Metabolic Disorders), a tertiary care hospital in Bangladesh. The demographic and clinical data were collected through medical records with a structured questionnaire. RESULTS Among sixty study participants, most had inadequate levels of vitamin D: deficiency 31 (51.7%), insufficiency 14 (23.3%) and sufficiency 15 (25.0%). Participants with vitamin D deficiency (VDD) were significantly older compared to the sufficient and insufficient group (p = .029), and were residing in urban areas (p = .036) and from higher socioeconomic status (p = .014). BMI was significantly higher in VDD compared to the sufficient group (p = .040). Although we observed higher median values of daily insulin requirements and HbA1c values in patients with VDD compared to patients with vitamin D insufficiency or vitamin D sufficiency, these differences did not reach statistical significance. CONCLUSIONS The present study revealed that the prevalence of vitamin D deficiency and insufficiency among T1 diabetes children was very high. Future studies in large sample are required to assess hypovitaminosis D in youth with T1D and also the possible relating factors of vitamin D deficiency.
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Affiliation(s)
- Bedowra Zabeen
- Department of PaediatricsLife for a child (LFAC) & Changing Diabetes in Children (CDiC) ProgrammeBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)Diabetic Association of BangladeshDhakaBangladesh
| | - Jebun Nahar
- Department of PaediatricsBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)DhakaBangladesh
| | - Bulbul Ahmed
- Department of PaediatricsBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)DhakaBangladesh
| | - Samin Tayyeb
- Department of PaediatricsLife for a child (LFAC) & Changing Diabetes in Children (CDiC) ProgrammeBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)Diabetic Association of BangladeshDhakaBangladesh
| | - Nasreen Islam
- Department of PaediatricsBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)DhakaBangladesh
| | - Kishwar Azad
- Department of PaediatricsLife for a child (LFAC) & Changing Diabetes in Children (CDiC) ProgrammeBangladesh Institute of Research & Rehabilitation in DiabetesEndocrine & Metabolic Disorders (BIRDEM)Diabetic Association of BangladeshDhakaBangladesh
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Vitamin D concentration in type 1 diabetic children. Association with glycemic control, lipidic and bone metabolism. NUTR HOSP 2022; 39:997-1003. [DOI: 10.20960/nh.04040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Poopedi MA, Norris SA, Pettifor JM. Is vitamin D status associated with non-communicable disease risk in children? A cohort study. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1976608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Machuene A Poopedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- current address: School of Medicine and Public Health Medicine, Pietersburg Hospital, University of Limpopo, Polokwane, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - John M Pettifor
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
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Manousaki D, Harroud A, Mitchell RE, Ross S, Forgetta V, Timpson NJ, Smith GD, Polychronakos C, Richards JB. Vitamin D levels and risk of type 1 diabetes: A Mendelian randomization study. PLoS Med 2021; 18:e1003536. [PMID: 33630834 PMCID: PMC7906317 DOI: 10.1371/journal.pmed.1003536] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/12/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Vitamin D deficiency has been associated with type 1 diabetes in observational studies, but evidence from randomized controlled trials (RCTs) is lacking. The aim of this study was to test whether genetically decreased vitamin D levels are causally associated with type 1 diabetes using Mendelian randomization (MR). METHODS AND FINDINGS For our two-sample MR study, we selected as instruments single nucleotide polymorphisms (SNPs) that are strongly associated with 25-hydroxyvitamin D (25OHD) levels in a large vitamin D genome-wide association study (GWAS) on 443,734 Europeans and obtained their corresponding effect estimates on type 1 diabetes risk from a large meta-analysis of 12 type 1 diabetes GWAS studies (Ntot = 24,063, 9,358 cases, and 15,705 controls). In addition to the main analysis using inverse variance weighted MR, we applied 3 additional methods to control for pleiotropy (MR-Egger, weighted median, and mode-based estimate) and compared the respective MR estimates. We also undertook sensitivity analyses excluding SNPs with potential pleiotropic effects. We identified 69 lead independent common SNPs to be genome-wide significant for 25OHD, explaining 3.1% of the variance in 25OHD levels. MR analyses suggested that a 1 standard deviation (SD) decrease in standardized natural log-transformed 25OHD (corresponding to a 29-nmol/l change in 25OHD levels in vitamin D-insufficient individuals) was not associated with an increase in type 1 diabetes risk (inverse-variance weighted (IVW) MR odds ratio (OR) = 1.09, 95% CI: 0.86 to 1.40, p = 0.48). We obtained similar results using the 3 pleiotropy robust MR methods and in sensitivity analyses excluding SNPs associated with serum lipid levels, body composition, blood traits, and type 2 diabetes. Our findings indicate that decreased vitamin D levels did not have a substantial impact on risk of type 1 diabetes in the populations studied. Study limitations include an inability to exclude the existence of smaller associations and a lack of evidence from non-European populations. CONCLUSIONS Our findings suggest that 25OHD levels are unlikely to have a large effect on risk of type 1 diabetes, but larger MR studies or RCTs are needed to investigate small effects.
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Affiliation(s)
- Despoina Manousaki
- Department of Pediatrics, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
- * E-mail:
| | - Adil Harroud
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, United States of America
| | - Ruth E. Mitchell
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Stephanie Ross
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Vince Forgetta
- Centre for Clinical Epidemiology, Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Nicholas J. Timpson
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Constantin Polychronakos
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
- Centre of Excellence in Translational Immunology (CETI), Montréal, Quebec, Canada
| | - J Brent Richards
- Centre for Clinical Epidemiology, Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
- Department of Twin Research and Genetic Epidemiology, King’s College London, United Kingdom
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8
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Vitamin D gene polymorphisms and risk of acute cardiovascular events. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Abstract
Abstract
Nutrients are the substances which give nourishment to the body and promote growth. These nutrients are present in varieties of foods in various amounts. Fish is a source of aquatic food which can both be farmed and wild caught. Fish is rich in macronutrients: proteins, lipids and ash and micronutrients: vitamins and minerals. Proteins in the fish have immunoglobins that acts as defense mechanism against viral and bacterial infections and prevent protein calorie malnutrition. Lipids mainly LC n-3 PUFAs like EPA and DHA prevents cardiovascular and coronary heart diseases and maintains blood pressure and neuro-development in child. Selenium is important for the function of thyroid gland. Iron helps in synthesis of hemoglobin and prevents the occurrence of anemia. Calcium and vitamin D naturally present in fish prevents rickets, low bone-mineral density and osteomalacia. Vitamin A in fish helps in normal growth, formation of bones and teeth. Despite these importances’s, fish is still undervalued and less consumed compared to other animal protein sources due to lack of awareness. If the per capita consumption of the fish can be increased, then people can have many health benefits. People should be made known about the health benefits of fish. Many other researches should be conducted to make the nutritional value of fish known to the world.
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Dogan B, Oner C, Feyizoglu G, Yoruk N, Oguz A. Vitamin D status of Turkish type 1 diabetic patients. Diabetes Metab Syndr 2019; 13:2037-2039. [PMID: 31235133 DOI: 10.1016/j.dsx.2019.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/21/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Vitamin D was associated with the pathogenesis, treatment and prognosis of type 1 and type 2 diabetes mellitus. The aim of this study is to assess vitamin D status of Turkish adult type 1 DM patients and compare them with health controls and also to assess the relationship of vitamin D and glycemic control. METHOD Study was designed as cross-sectional and conducted in a tertiary Hospital diabetes unit. 296 type diabetic patients and 151 healthy controls was included to the study. Venous samples were collected into plain tubes after overnight fasting. Serum 25-hydroxyvitamin D level was measured by radioimmunoassay technique. Statistical analysis was performed with SPSS 15.0. RESULTS 25-Hydroxyvitamin D levels were similar between patients with type 1 diabetes (22, 9 ± 17, 4 ng/ml) and controls (24, 5 ± 19, 3 ng/ml) (p = 0,382). Most of the participants have 25-Hydroxyvitamin D deficiency. As shown in Table 2 serum 25-Hydroxyvitamin D level was not associated with most of the biochemical or anthropometric parameters. CONCLUSION As a result there were no difference between type 1 diabetics and healthy controls according to their vitamin D levels. Further studies with a larger sample of patients will improve our understanding of the relation of vitamin D and diabetes.
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Affiliation(s)
- Burcu Dogan
- Department of Family Medicine, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Can Oner
- Department of Family Medicine, Kartal Dr Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
| | - Gunes Feyizoglu
- Diabetes Nursing Department of Internal Medicine, Istanbul Medeniyet University Göztepe Training and Research Hospital, ıstanbul, Turkey
| | - Nurdan Yoruk
- Diabetes Nursing Department of Internal Medicine, Istanbul Medeniyet University Göztepe Training and Research Hospital, ıstanbul, Turkey
| | - Aytekin Oguz
- Department of Internal Medicine, Istanbul Medeniyet University Goztepe Training and Research Hospital, ıstanbul, Turkey
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Lin YC, Lee HH, Tseng SC, Lin KD, Tseng LP, Lee JF, Lee YH, Chen BH. Quantitation of serum 25(OH)D2 and 25(OH)D3 concentrations by liquid chromatography tandem mass spectrometry in patients with diabetes mellitus. J Food Drug Anal 2019; 27:510-517. [PMID: 30987722 PMCID: PMC9296195 DOI: 10.1016/j.jfda.2018.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 11/22/2022] Open
Abstract
Vitamin D has been considered to regulate calcium and phosphorus homeostasis and to preserve skeletal integrity. Serum 25-hydroxyvitamin D (25(OH)D) is the best indicator of vitamin D levels. The association of serum 25(OH)D deficiency with increased risk of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) is controversial. We investigated serum 25(OH) D2 and 25(OH)D3 levels in diabetes patients by using liquid chromatography tandem mass spectrometry (LC-MS/MS). Serum 25(OH)D2 and 25(OH)D3 levels were measured with liquid chromatography tandem mass spectrometry in electrospray ionization positive mode. Chromatograms were separated using an ACE5 C18 column on a gradient of methanol. The total 25(OH)D levels were calculated as the sum of 25(OH)D3 and 25(OH)D2 levels. A total of 56 patients with T1DM and 41 patients with T2DM were enrolled in this study. There were 42 and 28 non-diabetic, age-matched volunteers who participated as the T1DM controls and the T2DM controls, respectively. The total 25(OH)D levels were lowest in the 21–40 age group. The levels of both 25(OH)D3 and the total 25(OH)D were significantly higher in the T1DM and T2DM groups than in the controls (p < 0.01 in T1DM and p < 0.05 in T2DM group, respectively). The 25(OH)D2 levels were only significantly higher in T1DM patients than in the controls. The percentages of vitamin D deficiency (total 25(OH)D less than 20 ng/mL) in the T1DM, T2DM, the T1DM controls and the T2DM controls were 7.1%, 0%, 14.3% and 3.6%, respectively. The percentages of vitamin D insufficiency (total 25(OH)D less than 30 ng/mL) in the T1DM, T2DM, the T1DM controls and the T2DM controls were 26.8%, 7.3%, 54.8% and 17.9%, respectively. The percentages of vitamin D deficiency and insufficiency were significantly lower in the T1DM patients than in the T1DM controls (p < 0.01). In the present study, both type 1 and type 2 diabetes patients had higher serum 25(OH)D levels and lower percentages of vitamin D deficiency/insufficiency.
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Affiliation(s)
- Yi-Ching Lin
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hei-Hwa Lee
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shing-Cheng Tseng
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Der Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Ping Tseng
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jong-Feng Lee
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Hung Lee
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bai-Hsiun Chen
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Saif-Elnasr M, Ibrahim IM, Alkady MM. Role of Vitamin D on glycemic control and oxidative stress in type 2 diabetes mellitus. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:22. [PMID: 28413419 PMCID: PMC5377965 DOI: 10.4103/1735-1995.200278] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/15/2016] [Accepted: 11/30/2016] [Indexed: 12/12/2022]
Abstract
Background: Vitamin D deficiency may play a key role in the development of impaired glucose tolerance, type 2 diabetes mellitus (T2DM), and metabolic syndrome. Several studies have shown that Vitamin D has an antioxidant property. We aimed to investigate 25-hydroxy Vitamin D (25[OH]D) levels in patients with T2DM and in nondiabetic healthy controls and to ascertain the impact of 25(OH)D levels on glycemic control and oxidative stress in T2DM patients. Materials and Methods: Thirty male patients with T2DM and twenty age- and socioeconomic status-matched male healthy controls were included in the study. Fasting and postprandial blood sugar and glycated hemoglobin (HbA1c) were measured. Enzyme activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) was determined by spectrophotometric assay, and serum levels of 25(OH)D were measured using radioimmunoassay. Results: Serum Vitamin D levels were significantly lower in patients with T2DM than healthy controls (P = 0.015). There was a significantly lower GPx activity in patients with T2DM than controls (P = 0.048), but the difference in SOD activity did not reach statistical significance. There was a significant negative correlation between serum Vitamin D levels and HbA1c (P = 0.016), but no statistical correlation was shown between serum Vitamin D levels and GPx and SOD. Conclusion: We conclude that low level of Vitamin D might play a significant role in T2DM pathogenesis. Hence, Vitamin D supplementation may improve glycemic control and oxidative stress in T2DM.
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Affiliation(s)
- Mostafa Saif-Elnasr
- Department of Radiation Health Research, National Center for Radiation Research and Technology, Atomic Energy Authority, Nasr City, Cairo, Egypt
| | - Iman M Ibrahim
- Department of Radiation Health Research, National Center for Radiation Research and Technology, Atomic Energy Authority, Nasr City, Cairo, Egypt
| | - Manal M Alkady
- Department of Radiation Health Research, National Center for Radiation Research and Technology, Atomic Energy Authority, Nasr City, Cairo, Egypt
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Al-Agha AE, Alafif MM, Abd-Elhameed IA. Glycemic control, complications, and associated autoimmune diseases in children and adolescents with type 1 diabetes in Jeddah, Saudi Arabia. Saudi Med J 2016; 36:26-31. [PMID: 25630001 PMCID: PMC4362194 DOI: 10.15537/smj.2015.1.9829] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To investigate the relationship between metabolic control, acute and long-term complications, the coexistence of autoimmune diseases, and to assess the different factors that can affect the glycemic control level among children with type 1 diabetes mellitus (T1DM). Methods: This is a cross-sectional study that included 228 T1DM children and adolescents visiting the pediatric diabetes clinic at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2013 to January 2014. The clinical and laboratory characteristics of the patients were recorded. Metabolic control, complications, and associated autoimmune diseases were evaluated. Results: The mean age of patients was 10.99 years, and the glycated hemoglobin (HbA1c) level was 8.8%. Acute complications included ketoacidosis in 65.4% of patients, and hypoglycemic attacks in 68.9%. Long-term complications were detected in patients including retinopathy (4.4%), microalbuminuria (16.2%), and dyslipidemia (8.3%). Autoimmune thyroiditis was noted in 14%, and celiac disease was found in 19.7% of patients. A significant difference was found in pubertal and pre-pubertal age groups in terms of glycemic control (p=0.01). Conclusion: The level of HbA1c was found to be higher among the pubertal age group. A relationship between autoimmune diseases and gender was determined.
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Affiliation(s)
- Abdulmoein E Al-Agha
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. Fax. +966 (12) 6403841. E-mail.
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Savastio S, Cadario F, Genoni G, Bellomo G, Bagnati M, Secco G, Picchi R, Giglione E, Bona G. Vitamin D Deficiency and Glycemic Status in Children and Adolescents with Type 1 Diabetes Mellitus. PLoS One 2016; 11:e0162554. [PMID: 27607348 PMCID: PMC5015862 DOI: 10.1371/journal.pone.0162554] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 08/24/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D (25OHD) effects on glycemic control are unclear in children and adolescents with type 1 diabetes. Aims of this study were to investigate 25OHD status among children with T1DM and its relationship with insulin sensitivity and glycemic status. SUBJECTS AND METHODS A cross sectional study was carried out between 2008-2014. A total of 141 patients had a T1DM >12 months diagnosis and were enrolled in the present study. Of these 35 (24.8%) were migrants and 106 (75.2%) Italians (T2). We retrospectively analyzed data at the onset of the disease (T0)(64 subjects) and 12-24 months before the last visit (T1,124 subjects). Fasting glucose, glycated hemoglobin (HbA1c), 25OHD levels and daily insulin requirement were evaluated and Cholecalciferol 1000 IU/day supplementation for the management of vitamin D insufficiency (<75 nmol/L) was systematically added. RESULTS A generalized 25OHD insufficiency was found at each study time, particularly in migrants. At T0, the 25OHD levels were inversely related to diabetic keto-acidosis (DKA) severity (p<0.05). At T1 and T2, subjects with 25OHD ≤25nmol/L (10 ng/mL) showed higher daily insulin requirement (p<0.05) and HbA1c values (p<0.01) than others vitamin D status. The 25OHD levels were negatively related with HbA1c (p<0.001) and daily insulin dose (p<0.05) during follow up. There was a significant difference in 25OHD (p<0.01) between subjects with different metabolic control (HbA1c <7.5%,7.5-8%,>8%), both at T1 and T2. In supplemented subjects, we found a significant increase in 25OHD levels (p<0.0001) and decrease of HbA1c (p<0.001) between T1 and T2, but this was not significant in the migrants subgroup. Multivariate regression analysis showed a link between HbA1c and 25OHD levels (p<0.001). CONCLUSIONS Children with T1DM show a generalized 25OHD deficiency that impact on metabolic status and glycemic homeostasis. Vitamin D supplementation improves glycemic control and should be considered as an additional therapy.
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Affiliation(s)
- Silvia Savastio
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- * E-mail:
| | - Francesco Cadario
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Novara, Italy
| | - Giulia Genoni
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Giorgio Bellomo
- Central Laboratory of Maggiore della Carità Hospital, University of Piemonte Orientale, Novara, Italy
| | - Marco Bagnati
- Central Laboratory of Maggiore della Carità Hospital, University of Piemonte Orientale, Novara, Italy
| | - Gioel Secco
- Division of Cardiology, Ospedale Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Raffaella Picchi
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Enza Giglione
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Gianni Bona
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
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Rasoul MA, Al-Mahdi M, Al-Kandari H, Dhaunsi GS, Haider MZ. Low serum vitamin-D status is associated with high prevalence and early onset of type-1 diabetes mellitus in Kuwaiti children. BMC Pediatr 2016; 16:95. [PMID: 27422640 PMCID: PMC4947357 DOI: 10.1186/s12887-016-0629-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/17/2016] [Indexed: 11/16/2022] Open
Abstract
Background Type 1 diabetes mellitus (T1DM) is highly prevalent in Kuwait with incidence of around 40.1/100,000 individuals. Evidence indicate that vitamin D plays an important role in modulating the immune system and could thus impact the onset and high prevalence of T1DM. We report serum vitamin D levels in Kuwaiti children with T1DM and non-diabetic controls to explore its relationship with prevalence and onset of the disease. Methods This study included 216 Kuwaiti Arab children with T1DM. The diagnosis of T1DM was based on the ISPAD criteria. The control subjects (204 Kuwaitis) were age and gender matched, healthy, non-diabetic, and had no close relative with T1DM. Vitamin D levels were determined in serum using an enzyme immunoassay (EIA) method. Results The age of onset of T1DM was <4y in 20 % of the T1DM cases, between 4 and 6y in 28 % cases and >6y in 52 % patients. In T1DM patient group, 84 % subjects were found to be deficient in serum vitamin D level compared to 77 % of the controls (p = 0.046). Collectively, the deficient and insufficient vitamin D status was detected in 99 % of the T1DM patients compared to 92 % of the controls (p = 0.027). The mean serum vitamin D levels were found to be significantly different in early onset cases (age <4y) compared to the late onset sub-group (p = 0.001). A significant correlation was found between some elements of socioeconomic status, SES (i.e. parent’s profession and family’s income) and lower vitamin D levels in Kuwaiti T1DM children. There was no significant difference between mean serum vitamin D levels during winter and summer months in the T1DM patients. Conclusions The proportion of cases with a deficient vitamin D status was significantly high in Kuwaiti T1DM children compared to the controls. The serum vitamin D levels were found to be significantly different in early onset and late onset T1DM patients. Therefore, serum vitamin D status can be considered an important contributor in high prevalence of T1DM in Kuwaiti children.
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Affiliation(s)
- Majedah A Rasoul
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait.,Department of Pediatrics, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Maria Al-Mahdi
- Department of Pediatrics, Adan Hospital, Al-Adan, Kuwait
| | | | - Gursev S Dhaunsi
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait.,Department of Pediatrics, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Mohammad Z Haider
- Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait.
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Kawahara T, Suzuki G, Inazu T, Mizuno S, Kasagi F, Okada Y, Tanaka Y. Rationale and design of Diabetes Prevention with active Vitamin D (DPVD): a randomised, double-blind, placebo-controlled study. BMJ Open 2016; 6:e011183. [PMID: 27388357 PMCID: PMC4947789 DOI: 10.1136/bmjopen-2016-011183] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Recent research suggests that vitamin D deficiency may cause both bone diseases and a range of non-skeletal diseases. However, most of these data come from observational studies, and clinical trial data on the effects of vitamin D supplementation on individuals with pre-diabetes are scarce and inconsistent. The aim of the Diabetes Prevention with active Vitamin D (DPVD) study is to assess the effect of eldecalcitol, active vitamin D analogue, on the incidence of type 2 diabetes among individuals with pre-diabetes. METHODS AND ANALYSIS DPVD is an ongoing, prospective, multicentre, randomised, double-blind and placebo-controlled outcome study in individuals with impaired glucose tolerance. Participants, men and women aged ≥30 years, will be randomised to receive eldecalcitol or placebo. They will also be given a brief (5-10 min long) talk about appropriate calorie intake from diet and exercise at each 12-week visit. The primary end point is the cumulative incidence of type 2 diabetes. Secondary endpoint is the number of participants who achieve normoglycaemia at 48, 96 and 144 weeks. Follow-up is estimated to span 144 weeks. ETHICS AND DISSEMINATION All protocols and an informed consent form comply with the Ethics Guideline for Clinical Research (Japan Ministry of Health, Labour and Welfare). The study protocol has been approved by the Institutional Review Board at Kokura Medical Association and University of Occupational and Environmental Health. The study will be implemented in line with the CONSORT statement. TRIAL REGISTRATION NUMBER UMIN000010758; Pre-results.
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Affiliation(s)
- Tetsuya Kawahara
- Department of Internal Medicine, Kokura Medical Association Health Testing Center, Kitakyushu, Japan
| | - Gen Suzuki
- Department of Internal Medicine, International University of Health and Welfare Clinic, Ohtawara, Japan
| | - Tetsuya Inazu
- Department of Pharmacy, College of Pharmaceutical Sciences, Ritsumeikan University, Kusatsu, Japan
| | - Shoichi Mizuno
- Department of Epidemiology, Radiation Effects Association, Tokyo, Japan
| | - Fumiyoshi Kasagi
- Department of Epidemiology, Radiation Effects Association, Tokyo, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Vitamin D deficiency and the associated factors in children with type 1 diabetes mellitus in southern Iran. Int J Diabetes Dev Ctries 2016. [DOI: 10.1007/s13410-016-0499-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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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.
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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
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Esteghamati A, Fotouhi A, Faghihi-Kashani S, Hafezi-Nejad N, Heidari B, Sheikhbahaei S, Zandieh A, Nakhjavani M. Non-linear contribution of serum vitamin D to symptomatic diabetic neuropathy: A case-control study. Diabetes Res Clin Pract 2016; 111:44-50. [PMID: 26548603 DOI: 10.1016/j.diabres.2015.10.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/23/2015] [Accepted: 10/12/2015] [Indexed: 12/12/2022]
Abstract
AIMS Vitamin D deficiency has recently been speculated to be associated with increased risk of diabetes neuropathy (DN). The aim of this study was to evaluate the odds of symptomatic DN across serum vitamin D levels. METHODS All patients with DM were assessed using diabetic neuropathy symptoms and diabetic neuropathy examination score. Overall, 150 cases with DN and 600 controls were included. Serum 25-hydroxyvitamin D (25-OH-D) was measured to determine vitamin D status. RESULTS A non-linear association between 25-OH-D and suffering from symptomatic DN was observed which was extracted after stratifying the ORs across different serum 25-OH-D levels. When compared to individuals with 25-OH-D of 30-40 ng/mL, patients with deficient (<20 ng/mL) vitamin D levels had higher odds of having symptomatic DN (OR: 2.04, 95%CI: 0.99-4.02, P=0.054). Participants with vitamin D values of greater than 40 ng/mL were also more likely to exhibit symptomatic DN (fully adjusted OR: 4.29, 95%CI: 1.59-11.55). CONCLUSIONS We hypothesize a non-linear contribution of serum vitamin D to symptomatic DN occurrence, which emphasizes that administration of vitamin D should be monitored and evaluated more carefully, especially in patients with diabetes.
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Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Sara Faghihi-Kashani
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Behnam Heidari
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Sara Sheikhbahaei
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Ali Zandieh
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Perez-Diaz I, Sebastian-Barajas G, Hernandez-Flores ZG, Rivera-Moscoso R, Osorio-Landa HK, Flores-Rebollar A. The impact of vitamin D levels on glycemic control and bone mineral density in postmenopausal women with type 2 diabetes. J Endocrinol Invest 2015; 38:1365-72. [PMID: 26476727 DOI: 10.1007/s40618-015-0394-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 09/21/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Whether glycemic control contributes to a decreased number of fractures or favorably impacts bone density in patients with type 2 diabetes mellitus (T2DM)has not been well established. Vitamin D (25 (OH) D3) deficiency appears to be related to glycemic control in patients with T2DM. The aim of this study was to determine the relationship between 25 (OH) D3 levels, glycemic control, bone mineral density (BMD), and the development of osteoporotic fractures (OPF) in postmenopausal women with T2DM. METHODS We reviewed the charts of 110 postmenopausal women diagnosed with T2DM. Glycosylated hemoglobin A1c (HbA1c) values over the previous 5 years were recorded and an average was obtained. Based on these values,the patients were divided into three groups: optimal,suboptimal, and poor control. Bone mineral density and 25(OH) D3 levels were also recorded. RESULTS In the group of patients with poorly controlled T2DM, 25 (OH) D3 levels were not significantly lower in comparison with the optimal control group 19.29 ± 7.70 vs 17.26 ± 6.93 (p = 0.53). No statistically significant linear relationship between HbA1c and 25 (OH) D3 levels( r(s) = −0.17, p = 0.06) was established. The frequency of osteoporosis and osteopenia was not significantly different between groups. The group with optimal glycemic control had an increased number of OPF events (p = 0.04). CONCLUSIONS We do not appreciate a significant relationship between 25 (OH) D3 levels and glucose control or OPF. Therefore, more studies are needed to identify the specific effect of 25 (OH) D3 in T2DM physiopathology.
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An inverse association between serum vitamin D levels with the presence and severity of impaired nerve conduction velocity and large fiber peripheral neuropathy in diabetic subjects. Neurol Sci 2015; 36:1121-6. [DOI: 10.1007/s10072-015-2207-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
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Kampmann U, Mosekilde L, Juhl C, Moller N, Christensen B, Rejnmark L, Wamberg L, Orskov L. Effects of 12 weeks high dose vitamin D3 treatment on insulin sensitivity, beta cell function, and metabolic markers in patients with type 2 diabetes and vitamin D insufficiency - a double-blind, randomized, placebo-controlled trial. Metabolism 2014; 63:1115-24. [PMID: 25044176 DOI: 10.1016/j.metabol.2014.06.008] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Vitamin D insufficiency is common in subjects with type 2 diabetes. Observational studies suggest that vitamin D plays a role in the pathogenesis of type 2 diabetes. However, results of intervention studies have been inconsistent. We investigated the effects of improving vitamin D status on insulin sensitivity, insulin secretion, and inflammatory markers in patients with type 2 diabetes. MATERIALS/METHODS A double blind, randomized, placebo controlled trial was conducted. Sixteen patients with type 2 diabetes and hypovitaminosis D were recruited. Eight patients received colecalciferol and (280 μg daily for 2 weeks, 140 μg daily for 10 weeks) and 8 patients received identical placebo tablets for 12 weeks. Before and after intervention, patients underwent IVGTT, hyperinsulinemic euglycemic clamp, assessment of baseline high-frequency insulin pulsatility, glucose-entrained insulin pulsatility, DXA scans, 24-hour-ambulatory blood pressure monitorings, and fasting blood samples. RESULTS Serum-25(OH) vitamin D and serum-1,25(OH)₂ vitamin D increased significantly after 12 weeks in the intervention group (p=0.01, p=0.004). Serum-25(OH) vitamin D was also significantly higher in the vitamin D group compared to the placebo group (p=0.02) after intervention. Although no significant changes in insulin sensitivity, inflammation, blood pressure, lipid profile, or HbA1c were found, we observed borderline (p between 0.05 and 0.10) improvements of insulin secretion, in terms of c-peptide levels, first phase incremental AUC insulin and insulin secretory burst mass. CONCLUSIONS Improvement in vitamin D status does not improve insulin resistance, blood pressure, inflammation or HbA1c, but might increase insulin secretion in patients with established type 2 diabetes.
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Affiliation(s)
- Ulla Kampmann
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Leif Mosekilde
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Claus Juhl
- Department of Endocrinology, Sydvestjysk Hospital, Esbjerg, Denmark
| | - Niels Moller
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Britt Christensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; Section of Sports Science, Institute of Public Health, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Louise Wamberg
- Department of Endocrinology, Sydvestjysk Hospital, Esbjerg, Denmark
| | - Lotte Orskov
- Department of Internal Medicine, Silkeborg Regional Hospital, Silkeborg, Denmark
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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.
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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
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Justice JN, Pierpoint LA, Mani D, Schwartz RS, Enoka RM. Motor function is associated with 1,25(OH)(2)D and indices of insulin-glucose dynamics in non-diabetic older adults. Aging Clin Exp Res 2014; 26:249-54. [PMID: 24155214 DOI: 10.1007/s40520-013-0166-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/09/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Advancing age is accompanied by changes in metabolic characteristics, such as reduced insulin sensitivity and low levels of vitamin D, which may exacerbate age-related declines in physical function. AIMS The aim of the present study was to determine the associations between insulin-glucose dynamics, vitamin D metabolites, and performance on a battery of motor tasks in healthy, non-diabetic older adults. METHODS Sixty-nine community-dwelling men and women (65-90 years) were recruited. Insulin-glucose dynamics were determined by an intravenous glucose tolerance test, and vitamin D metabolites were measured. Motor function was characterized by the time to walk 500 m, chair-rise time, lower body strength, dorsiflexor steadiness and endurance time, and muscle coactivation. RESULTS Significant unadjusted correlations were found between insulin-glucose dynamics and 1,25-dihydroxyvitamin D [1,25(OH)2D] with walk time, strength, steadiness, endurance time, and muscle activation (p < 0.05). A significant amount of the variance in walking endurance was explained by the sex of the individual, 1,25(OH)2D, and fasting blood insulin (R (2) = 0.36, p < 0.001). Strength could be partially explained by age, body fatness, and fasting glucose (R (2) = 0.55, p < 0.001). DISCUSSION Poor motor function in non-diabetic older men and women was associated with indices of insulin-glucose dynamics and the bio-active vitamin D metabolite 1,25(OH)2D. Walking endurance and strength were explained by 1,25(OH)2D and fasting blood glucose and insulin, even after adjusting for age, sex, and body fat. CONCLUSION Motor function in a relatively small sample of non-diabetic older men and women was associated with metabolic factors that increase in prevalence with aging.
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Abd-Allah SH, Pasha HF, Hagrass HA, Alghobashy AA. Vitamin D status and vitamin D receptor gene polymorphisms and susceptibility to type 1 diabetes in Egyptian children. Gene 2013; 536:430-4. [PMID: 24370753 DOI: 10.1016/j.gene.2013.12.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 11/20/2013] [Accepted: 12/13/2013] [Indexed: 01/02/2023]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is recognized as a T-cell-mediated autoimmune disease. Vitamin D compounds are known to suppress T-cell activation by binding to vitamin D receptor (VDR); and thus, VDR gene polymorphisms may be related to T-cell-mediated autoimmune diseases. The aim of this study was to investigate the association between vitamin D status and VDR gene polymorphisms and T1DM. MATERIALS AND METHODS One hundred and twenty patients with T1DM and one hundred and twenty controls were enrolled in the study. VDR gene BsmI, FokI, ApaI and TaqI polymorphisms were determined using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Serum 25-hydroxyvitamin D (25(OH)D) was determined using ELISA. RESULT Serum 25(OH)D levels revealed a vitamin D deficiency or insufficiency in 75% of the patients. The mean levels of vitamin D were significantly lower in patients as compared to their controls (P=<0.001). VDR BsmI Bb and bb genotypes and VDR FokI Ff and ff genotypes were associated with increased risk of T1DM (OR=2.3, 95% CI=1.3-4.2, P=0.005; OR=2.2, 95% CI=1.1-4.7, P=0.04; OR=1.8, 95% CI=1.03-3.04, P=0.04; OR=4.03, 95% CI=1.2-13.1, P=0.01 respectively), while the VDR ApaI and TaqI polymorphisms were not. CONCLUSION Our study indicated that vitamin D deficiency and VDR BsmI and FokI polymorphisms were associated with T1DM in Egyptian children.
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Affiliation(s)
- Somia H Abd-Allah
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Heba F Pasha
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Hoda A Hagrass
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ashgan A Alghobashy
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Parildar H, Dogruk Unal A, Aksan Desteli G, Cigerli O, Guvener Demirag N. Frequency of Vitamin D deficiency in pregnant diabetics at Baskent University Hospital, Istanbul. Pak J Med Sci 2013; 29:15-20. [PMID: 24353500 PMCID: PMC3809191 DOI: 10.12669/pjms.291.2896] [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] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 09/04/2012] [Accepted: 10/29/2012] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To find out the frequency of vitamin D deficiency and its relation with glucose parameters and the incidence of gestational diabetes (GDM). METHODOLOGY Gestational diabetes was diagnosed with 75 gram oral glucose tolerance test. Forty-four pregnant women diagnosed with GDM and 78 non-GDM pregnant women were enrolled as case and control group, respectively in this descriptive study. Vitamin D status was classified as deficiency at ≤20 ng/ml for serum 25(OH)D concentrations. RESULTS The mean ages were 33.4±5.2 (18-44) years and 29.7±4.1 (21-39) years, mean BMI was 30.6±5.9 kg/m² (19.5-46.1) and 25.9±4.4 kg/m2 (16.5-38) in case and control groups, respectively. The frequency of GDM was found 9.38%. The mean serum vitamin D levels in GDM group were significantly lower than in non-GDM subjects (p=0.07). A total of 56.8% of GDM patients were compared with 35.8% of control group which had Vitamin D deficiency and the difference was significant (p= 0.02). There was no significant association between vitamin D levels and fasting glucose, insulin and HbA1c. Vitamin D levels were inversely correlated with clothing style, parathyroid hormone levels, dental problems and muscle cramps. CONCLUSIONS The association of maternal Vitamin D status with the markers of glucose metabolism in pregnancy needs prospective studies.
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Affiliation(s)
- Hulya Parildar
- Hulya Parildar, MD, Department of Family Medicine, Baskent University, Istanbul Hospital, Mahir Iz caddesi No: 53 Altunizade/Uskudar,Istanbul, Turkey
| | - Asli Dogruk Unal
- Asli Dogruk Unal, MD, Department of Endocrinology and Metabolism, Baskent University, Istanbul Hospital, Oymaci Sokak No: 7 Altunizade/Uskudar, Istanbul, Turkey
| | - Guldeniz Aksan Desteli
- Guldeniz Aksan Desteli, MD, Department of Gynecology and Obstetrics, Baskent University, Istanbul Hospital, Oymaci Sokak No:7 Altunizade/Uskudar Istanbul, Turkey
| | - Ozlem Cigerli
- Ozlem Cigerli, MD, Department of Family Medicine, Baskent University, Istanbul Hospital, Mahir Iz caddesi No: 53 Altunizade/Uskudar,Istanbul, Turkey
| | - Nilgun Guvener Demirag
- Nilgun Guvener Demirag, MD, Department of Endocrinology and Metabolism, Baskent University, Istanbul Hospital, Oymaci Sokak No: 7 Altunizade/Uskudar, Istanbul, Turkey
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Azab SFA, Saleh SH, Elsaeed WF, Abdelsalam SM, Ali AA, Esh AMH. Vitamin D status in diabetic Egyptian children and adolescents: a case-control study. Ital J Pediatr 2013; 39:73. [PMID: 24228797 PMCID: PMC3834534 DOI: 10.1186/1824-7288-39-73] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 11/13/2013] [Indexed: 12/02/2022] Open
Abstract
Background Recently, studies suggesting that vitamin D deficiency correlates with the severity and frequency of Type 1 (insulin-dependent) diabetes mellitus (T1DM) and that vitamin D supplementation reduces the risk of developing T1DM have been reported. Objective In this study, we aimed to assess vitamin D status in Egyptian children and adolescents with T1DM. Methods This was a case–control study including 80 T1DM diagnosed cases aged 6 to 16 years and 40 healthy children with comparable age and gender as the control group. For all subjects, serum 25 (OH) D levels were measured by ELISA, Serum parathyroid hormone (PTH) and serum insulin were measured by an electrochemiluminesce immunoassay. Serum glucose, Glycosylated hemoglobin (HbA1c) levels and homeostasis model assessment of insulin resistance (HOMA-IR) were also assessed. Results Compared to the control group, serum vitamin D levels were not significantly lower in diabetic subjects (24.7 ± 5.6 vs 26.5 ± 4.8 ng/ml; P > 0.05). Among diabetic cases 44(55%) were vitamin D deficient; meanwhile 36(45%) cases had normal vitamin D level (P < 0.01). In addition, 26(32.5%) diabetic cases had 2ry hyperparathyroidism and 54(67.5%) cases had normal parathyroid hormone level; meanwhile, none of the control group had 2ry hyperparathyroidism (P < 0.01). Furthermore, we found a significant difference between vitamin D deficient diabetic cases and those with normal vitamin D level as regards HOMA-IR and diabetes duration (P < 0.01). Conclusion Public health message on the importance of vitamin D status; especially in diabetic children and adolescents, should be disseminated to the public.
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Affiliation(s)
- Seham F A Azab
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 18 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, Sharkia Governorate, Egypt.
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Crews M, Lally J, Gardner-Sood P, Howes O, Bonaccorso S, Smith S, Murray RM, Di Forti M, Gaughran F. Vitamin D deficiency in first episode psychosis: a case-control study. Schizophr Res 2013; 150:533-7. [PMID: 24060571 DOI: 10.1016/j.schres.2013.08.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/24/2013] [Accepted: 08/25/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Vitamin D deficiency is seen in a high proportion of people with established psychotic disorders, but it is not known if this is present at onset of the illness. We set out to examine vitamin D levels in people with their first episode of psychosis (FEP). METHOD We conducted a matched case-control study to examine vitamin D levels and rates of vitamin D deficiency in sixty nine patients presenting with their FEP and sixty nine controls matched for age, sex and ethnicity. Differences between groups were tested using student's-t tests, paired t-tests and odds ratios for further analysis. RESULTS Vitamin D levels were significantly lower in cases than in controls (p<0.001). The odds ratio of being vitamin D deficient was 2.99 in the FEP group relative to the control group. There was no correlation between vitamin D levels and length of hospitalisation in the patient group (r=-0.027, p=0.827). CONCLUSIONS We found higher rates of vitamin D deficiency in people with FEP compared to matched controls. Given that vitamin D is neuroprotective; that developmental vitamin D deficiency may be a risk factor for psychosis, and that incipient psychosis may affect lifestyle factors and diet, future studies are required to examine this association further. In the meantime, there is a need for more widespread testing of vitamin D levels in FEP and for the development of appropriate management strategies.
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Affiliation(s)
- Matthieu Crews
- Bromley Assertive Outreach and Rehabilitation Team, Oxleas NHS Foundation Trust, London, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom
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Kojima G, Tamai A, Masaki K, Gatchell G, Epure J, China C, Ross GW, Petrovitch H, Tanabe M. Prevalence of vitamin D deficiency and association with functional status in newly admitted male veteran nursing home residents. J Am Geriatr Soc 2013; 61:1953-7. [PMID: 24117324 DOI: 10.1111/jgs.12495] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To provide the first report on prevalence of vitamin D deficiency in newly admitted nursing home (NH) residents and associations with functional disabilities and chronic diseases. DESIGN Retrospective chart review. SETTING Nursing home (NH). PARTICIPANTS Male veterans newly admitted to a NH for rehabilitation, skilled-nursing care, intermediate care, or respite care between January 2011 and June 2012. MEASUREMENTS Total serum 25-hydroxyvitamin D (25(OH)D) levels were measured on admission. Vitamin D supplement users and those without 25(OH)D measurement within 7 days of admission were excluded, leaving an analytical sample of 104 residents. Vitamin D deficiency was defined as 25(OH)D less than 20 ng/mL. Data were collected on age, ethnicity, season, body mass index (BMI), functional disability in activities of daily living (ADLs) (mobility, bathing, dressing, toileting, continence, and feeding), and prevalent chronic diseases. RESULTS Prevalence of vitamin D deficiency was 49.0%. In multivariate logistic regression models adjusted for age, ethnicity, and BMI, vitamin D deficiency was significantly associated with number of ADL disabilities (odds ratio (OR) = 1.4 for each 1-point increase in ADL disability score, P = .03) and prevalent diabetes mellitus (OR = 3.0, P = .03). In regression models using each ADL disability as a separate variable, only disability in feeding (OR = 4.7, P = .05) and diabetes mellitus (OR = 2.9, P = .04) remained significant. CONCLUSION Almost half the individuals entering the NH and not taking vitamin D supplements had vitamin D deficiency. Greater number of ADL disabilities, disability in feeding, and prevalent diabetes mellitus were independently associated with vitamin D deficiency.
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Affiliation(s)
- Gotaro Kojima
- Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii; Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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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.
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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.
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Laczmanski L, Milewicz A, Lwow F, Puzianowska-Kuznicka M, Pawlak M, Kolackov K, Jedrzejuk D, Krzyzanowska-Swiniarska B, Bar-Andziak E, Chudek J, Mossakowska M. Vitamin D receptor gene polymorphism and cardiovascular risk variables in elderly Polish subjects. Gynecol Endocrinol 2013; 29:268-72. [PMID: 23173643 DOI: 10.3109/09513590.2012.736562] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The aim of this work was to evaluate whether the FokI and BsmI polymorphisms of the VDR gene are associated with anthropometric and biochemical features of cardiovascular disease (CVD) in a Caucasian population aged over 65, participants of the Polish PolSenior study. We performed the study on randomly selected subjects: 427 women and 454 men aged over 65. Measurements of anthropometric parameters were carried out and biochemical parameters were estimated using commercial kits. VDR polymorphisms (rs10735810, rs1544410) were genotyped by PCR and FRLP. The prevalence of BsmI genotypes was 50% Bb, 23% bb, 27% BB in women and 48% Bb, 20% bb, 32% BB in men. The prevalence of FokI was 48% Ff, 22% ff, 30% FF in women and 50% Ff, 18% ff, 32% FF in men. The women bearing the rare allele b differ in homeostatic model assessment (HOMA) (p < 0.049) from women bearing common allele B, and the men differ in insulin level (p < 0.047) and HOMA (p < 0.017). There were no significant differences in anthropometric or biochemical parameters between genotypes in FokI in female and male groups. The common allele B is connected with biochemical risk factors of CVD in older Caucasian men and women.
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Affiliation(s)
- Lukasz Laczmanski
- Department of Endocrinology and Diabetology, Wroclaw Medical University, Wroclaw, Poland.
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Usher-Smith JA, Thompson M, Ercole A, Walter FM. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia 2012; 55:2878-94. [PMID: 22933123 PMCID: PMC3464389 DOI: 10.1007/s00125-012-2690-2] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 07/12/2012] [Indexed: 01/02/2023]
Abstract
AIMS/HYPOTHESIS Type 1 diabetes is the most frequent endocrine disease in children, with 65,000 children diagnosed worldwide every year. Up to 80% of these children present with diabetic ketoacidosis (DKA), which is associated with both short-term risks and long-term consequences. This study aimed to characterise the worldwide variation in presentation of type 1 diabetes to inform future interventions to reduce this excess morbidity and mortality. METHODS This was a systematic review of studies indexed on PubMed, EMBASE, Web of Science, Scopus or CINAHL before March 2011 that included unselected groups of children presenting with new-onset type 1 diabetes, reported the proportion presenting with DKA and used a definition of DKA based on measurement of pH or bicarbonate. RESULTS Sixty-five studies of cohorts comprising over 29,000 children in 31 countries were included. The frequency of DKA at diagnosis ranged from 12.8% to 80%, with highest frequencies in the United Arab Emirates, Saudi Arabia and Romania, and the lowest in Sweden, the Slovak Republic and Canada. Multivariable modelling showed the frequency of DKA was inversely associated with gross domestic product, latitude and background incidence of type 1 diabetes. CONCLUSIONS/INTERPRETATION This is the first description of the variation in frequency of DKA at presentation of type 1 diabetes in children across countries. It demonstrates large variations that may, at least in part, be explained by different levels of disease awareness and healthcare provision and suggests ways to decrease the excess morbidity and mortality associated with DKA at diagnosis.
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Affiliation(s)
- J A Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge CB1 8RN, UK.
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Kositsawat J, Freeman VL. Vitamin C and A1c relationship in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. J Am Coll Nutr 2012; 30:477-83. [PMID: 22331682 DOI: 10.1080/07315724.2011.10719993] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The scope of the diabetes epidemic stresses the critical need for primary prevention. The consumption of foods high in vitamin C has been associated with lower risk of diabetes. The aim of this study was to analyze the relation between vitamin C concentration and glycemic control index in a large sample of U.S. adults without a history of diabetes. METHODS We analyzed data collected from 7697 adult participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006 who did not report a history of diabetes. Multivariate linear regression analyzed the association of vitamin C and hemoglobin A1c (A1c) levels after accounting for potential confounders. We also conducted stratified analyses based on race/ethnicity, gender, age group, body mass index, and vitamin D status. RESULTS Vitamin C concentrations were inversely associated with A1c (p = 0.0202). Stronger inverse associations were observed in subjects 18-44 years of age (p = 0.0017), as well as in female (p = 0.0035) and Mexican American (p = 0.0149) subgroups. Evidence of a significant interaction between vitamin C and vitamin D was noted in subjects aged 18-44 years and in females (p = 0.0073 and 0.0095 respectively), with the inverse association tending to be evident at lower levels of vitamin D. CONCLUSIONS Vitamin C status may influence glycemic control. Investigators should be cognizant of the interaction of vitamins C and D and should take this into consideration in planning future studies.
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Affiliation(s)
- Jatupol Kositsawat
- University of Connecticut, Center on Aging, Farmington, Connecticut 06030-6232, USA.
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Deleskog A, Hilding A, Brismar K, Hamsten A, Efendic S, Östenson CG. Low serum 25-hydroxyvitamin D level predicts progression to type 2 diabetes in individuals with prediabetes but not with normal glucose tolerance. Diabetologia 2012; 55:1668-78. [PMID: 22426800 DOI: 10.1007/s00125-012-2529-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 02/23/2012] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS Vitamin D deficiency may increase the risk of type 2 diabetes. We therefore investigated whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] would predict the development of prediabetes (impaired fasting glucose, impaired glucose tolerance or the two combined) and type 2 diabetes, either on their own or when combined with serum concentrations of IGF-1 or IGF-binding protein-1 (IGFBP-1), which may interact with 25(OH)D. METHODS At baseline, participants aged 35-56 years without known type 2 diabetes were examined using OGTTs, 25(OH)D and IGF peptide measurements, and anthropometric and lifestyle data. Participants who had prediabetes or type 2 diabetes at follow-up 8-10 years later were selected as cases; these were then age- and sex-matched to controls with normal glucose tolerance (NGT) at both baseline and follow-up, giving a total of 980 women and 1,398 men. RESULTS Men but not women in the highest quartile of 25(OH)D level had a decreased OR for developing type 2 diabetes after adjustment for confounders (OR 0.52, 95% CI 0.30, 0.90), an effect accounted for by individuals with prediabetes, but not with NGT, at baseline. In both sexes, progression from prediabetes to type 2 diabetes was reduced by about 25% per 10 nmol/l increase in 25(OH)D. A high IGFBP-1 value was a better predictor of a reduced risk of type 2 diabetes than high 25(OH)D for both sexes, whereas high IGF-1 concentrations predicted a decreased risk only in men. CONCLUSIONS/INTERPRETATION High serum 25(OH)D concentrations predict a reduced risk of type 2 diabetes in individuals with prediabetes, but not NGT. There were no significant interactions between 25(OH)D and IGFBP-1 or IGF-1 in terms of risk of diabetes. Our data suggest that vitamin D supplementation should be evaluated for the prevention of type 2 diabetes in prediabetic individuals.
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Affiliation(s)
- A Deleskog
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, M1:03, SE-17176 Stockholm, Sweden.
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Jablonski NG, Chaplin G. Human skin pigmentation, migration and disease susceptibility. Philos Trans R Soc Lond B Biol Sci 2012; 367:785-92. [PMID: 22312045 DOI: 10.1098/rstb.2011.0308] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Human skin pigmentation evolved as a compromise between the conflicting physiological demands of protection against the deleterious effects of ultraviolet radiation (UVR) and photosynthesis of UVB-dependent vitamin D(3). Living under high UVR near the equator, ancestral Homo sapiens had skin rich in protective eumelanin. Dispersals outside of the tropics were associated with positive selection for depigmentation to maximize cutaneous biosynthesis of pre-vitamin D(3) under low and highly seasonal UVB conditions. In recent centuries, migrations and high-speed transportation have brought many people into UVR regimes different from those experienced by their ancestors and, accordingly, exposed them to new disease risks. These have been increased by urbanization and changes in diet and lifestyle. Three examples-nutritional rickets, multiple sclerosis (MS) and cutaneous malignant melanoma (CMM)-are chosen to illustrate the serious health effects of mismatches between skin pigmentation and UVR. The aetiology of MS in particular provides insight into complex and contingent interactions of genetic and environmental factors necessary to trigger lethal disease states. Low UVB levels and vitamin D deficiencies produced by changes in location and lifestyle pose some of the most serious disease risks of the twenty-first century.
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Affiliation(s)
- Nina G Jablonski
- Department of Anthropology, The Pennsylvania State University, University Park, PA 16802, USA.
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Birgisdottir BE, Brantsaeter AL, Kvalem HE, Knutsen HK, Haugen M, Alexander J, Hetland RB, Aksnes L, Meltzer HM. Fish liver and seagull eggs, vitamin D-rich foods with a shadow: results from the Norwegian Fish and Game Study. Mol Nutr Food Res 2012; 56:388-98. [PMID: 22319024 DOI: 10.1002/mnfr.201100395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 10/19/2011] [Accepted: 10/21/2011] [Indexed: 11/10/2022]
Abstract
SCOPE Fish liver, fish liver oil, oily fish and seagull eggs have been major sources of vitamin D for the coastal population of Norway. They also provide dioxin and polychlorinated dioxin-like compounds (dl-compounds), which may interfere with vitamin D homeostasis. We investigated whether serum 25-hydroxyvitamin D (25(OH)D) might be compromised by concomitant intake of dl-compounds. METHODS AND RESULTS We studied 182 adults participating in the Norwegian Fish and Game Study. Participants who consumed fish liver and/or seagull eggs had higher dl-compound intake and blood concentrations than non-consumers (p < 0.001). Vitamin D intake was higher (p < 0.001), whereas serum 25(OH)D was lower (p = 0.029) in consumers than in non-consumers. Among non-consumers, vitamin D intake was associated with serum 25(OH)D (β=1.06; 95% CI: 0.48, 1.63). This association was weaker among consumers (β = 0.52; 95% CI: -0.05, 1.08), but strengthened when adjusted for retinol intake (β = 0.66; 95% CI: 0.12, 1.21). The association between vitamin D intake and serum 25(OH)D did not seem to be compromised by intake of dl-compounds. CONCLUSION To secure adequate vitamin D status while keeping the intake of dioxins and dl-polychlorinated biphenyls low, a healthy diet should include both supplemental vitamin D and oily fish. Despite high nutrient content, dietary fish liver and seagull eggs should be restricted, due to dl-compounds and possible vitamin A-D antagonism.
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Ardawi MSM, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA. High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int 2012; 23:675-86. [PMID: 21625888 DOI: 10.1007/s00198-011-1606-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 03/01/2011] [Indexed: 12/25/2022]
Abstract
SUMMARY In this cross-sectional study, the prevalence of vitamin D deficiency [serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L] was 87.8% among Saudi Arabian men. There was a linear inverse relationship between serum 25(OH)D and intact parathyroid hormone (PTH) levels, but without a threshold of 25(OH)D at which intact PTH values plateaued. INTRODUCTION Vitamin D insufficiency and/or deficiency has now reached epidemic proportions and has been linked to low bone mineral density (BMD), some lifestyle factors, and obesity in adults. This relationship is not well documented in Saudi Arabian men. This study examines the relationship between vitamin D status, intact parathyroid hormone (intact PTH), and lifestyle factors among Saudi Arabian men. METHODS This cross-sectional study involved 834 men aged 20-74 years living in Jeddah area who were randomly selected and medically examined. Men had their BMD (lumbar spine (L1-L4) and neck femur), 25(OH)D, intact PTH, and other parameters measured according to detailed inclusion criteria. RESULTS Deficiency (25(OH)D<50 nmol/L) and insufficiency (≥50-75 nmol/L) were present in 87.8% and 9.7%, respectively. Deficiency was common among older and obese men with no education and sedentary lifestyle sampled during summer and spring. Serum 25(OH)D showed an inverse linear relationship with intact PTH, but there was no threshold of serum 25(OH)D at which PTH levels plateaued. There was a positive correlation between BMD values at both lumbar spine (L1-L4) (P < 0.023) and neck femur (P < 0.036) and serum 25(OH)D levels, respectively. CONCLUSIONS Functionally significant vitamin D deficiency affects BMD and bone turnover markers among Saudi Arabian men and is largely attributed to older age, obesity, sedentary lifestyle, no education, poor exposure to sunlight, smoking, and poor dietary vitamin D supplementation. The data suggest that an increase in PTH cannot be used as a marker for vitamin D deficiency.
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Affiliation(s)
- M-S M Ardawi
- Center of Excellence for Osteoporosis Research, King Abdulaziz University, P.O. Box 20724, Jeddah 21465, Saudi Arabia.
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Erdönmez D, Hatun Ş, Çizmecioğlu FM, Keser A. No relationship between vitamin D status and insulin resistance in a group of high school students. J Clin Res Pediatr Endocrinol 2011; 3:198-201. [PMID: 22155462 PMCID: PMC3245493 DOI: 10.4274/jcrpe.507] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the effects of vitamin D deficiency on both insulin resistance and risk of metabolic syndrome in children. METHODS The study group consisted of 301 children and adolescents with a mean age of 14.2 ± 1.8 years. Serum 25-hydroxyvitamin D [25(OH)D] levels and insulin resistance indices were evaluated. According to serum 25(OH)D levels, the subjects were classified in 3 groups. Those with levels ≤ 10 ng/mL were labeled as the vitamin D deficient group (group A), those with levels of 10-20 ng/mL as the vitamin D insufficient group (group B) and those with ≥ 20 ng/mL as having normal vitamin D levels (group C). Metabolic syndrome was defined according to the International Diabetes Federation consensus. The participants with and without metabolic syndrome were compared in terms of 25(OH)D levels. RESULTS Mean 25(OH)D level of the total group was 18.2 ± 9.3 (2.8-72.0) ng/mL. Distribution of individuals according to their vitamin D levels showed that 11.6% were in group A, 53.5% in group B, and 34.9% in group C. The proportions of boys and girls in these categories were 22.9% and 77.1% in group A, 36.6% and 63.4% in group B, 54.3% and 45.7% in group C, respectively. There were no significant differences in 25(OH)D levels in the individuals with and without impaired fasting glucose or impaired glucose tolerance. No relationship was observed between insulin resistance/sensitivity indices and vitamin D status (p > 0.05). Metabolic syndrome was diagnosed in 12.3% (n = 37) of the children. There was also no difference in mean 25(OH)D levels between individuals who had and those who did not have the metabolic syndrome. CONCLUSION In our study, no correlations were found between insulin measurements during oral glucose tolerance test and vitamin D deficiency. Nonetheless, more extended studies including vitamin D supplementation and evaluating insulin sensitivity via clamp technique are needed to further elucidate this relationship.
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Affiliation(s)
- Dilek Erdönmez
- Kocaeli University of Medical School, Pediatric Endocrinology and Diabetes Unit, Kocaeli, Turkey
| | - Şükrü Hatun
- Kocaeli University of Medical School, Pediatric Endocrinology and Diabetes Unit, Kocaeli, Turkey
| | - Filiz Mine Çizmecioğlu
- Kocaeli University of Medical School, Pediatric Endocrinology and Diabetes Unit, Kocaeli, Turkey
| | - Alev Keser
- Kocaeli University of Medical School, Pediatric Endocrinology and Diabetes Unit, Kocaeli, Turkey
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Bischoff-Ferrari HA. Vitamin D: role in pregnancy and early childhood. ANNALS OF NUTRITION AND METABOLISM 2011; 59:17-21. [PMID: 22123632 DOI: 10.1159/000332069] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several studies in pregnant women and early childhood suggest that vitamin D deficiency (serum 25-hydroxyvitamin D levels <50 nmol/l) is common in both population groups. Recent recommendations have therefore reviewed the literature regarding the role of vitamin D in pregnant women and in early childhood. The Institute of Medicine, in their most recent assessment in 2010, recommended 600 IU per day in pregnant and lactating women. In 2011, the US Endocrine Task Force on Vitamin D commented that 600 IU per day may not be sufficient to correct vitamin D deficiency in pregnant and lactating women. Their recommendation was 1,500-2,000 IU vitamin D per day in pregnant and lactating women with vitamin D deficiency. For infants, the recommendation from both societies is consistently 400 IU vitamin D per day, and also in children both societies recommend 600 IU vitamin D per day. This review will summarize the scientific basis that led to the most recent recommendations.
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Affiliation(s)
- Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University of Zurich and City Hospital Waid, University Hospital, Switzerland.
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Subramanian A, Nigam P, Misra A, Pandey RM, Mathur M, Gupta R, Madhusudan S. Severe vitamin D deficiency in patients with Type 2 diabetes in north India. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/dmt.11.38] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Potential explanatory factors for higher incident hip fracture risk in older diabetic adults. Curr Gerontol Geriatr Res 2011; 2011:979270. [PMID: 21837239 PMCID: PMC3152969 DOI: 10.1155/2011/979270] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 03/22/2011] [Accepted: 05/24/2011] [Indexed: 01/08/2023] Open
Abstract
Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N = 5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG) ≥126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI ≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI ≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78). PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.
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Zhang Y, Papasian CJ, Deng HW. Alteration of vitamin D metabolic enzyme expression and calcium transporter abundance in kidney involved in type 1 diabetes-induced bone loss. Osteoporos Int 2011; 22:1781-8. [PMID: 20878391 PMCID: PMC4537183 DOI: 10.1007/s00198-010-1404-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 08/17/2010] [Indexed: 12/24/2022]
Abstract
UNLABELLED This study aimed to delineate the mechanism involved in type 1 diabetes-induced bone loss. The results revealed the alteration of vitamin D metabolic enzyme expression and the downregulation of renal calcium transporter abundance in type 1 diabetic mice. INTRODUCTION The purpose of this study was to investigate the changes of the expression of vitamin D metabolic enzymes and transcellular calcium-transporting proteins in kidneys from mice with experimentally induced diabetes. METHODS Male DBA/2J mice were injected with either vehicle (control) or streptozotocin (STZ) daily for five consecutive days. Bone mineral density was measured by peripheral quantitative computerized tomography, and bone histomorphology was analyzed by Safranin O staining. Real-time PCR and Western blotting were applied to determine the expression of target genes and proteins. RESULTS Type 1 diabetes produced high urinary calcium excretion and loss of trabecular bone measured at the proximal metaphysis of the tibia and the distal femur. Bone loss was associated with deterioration of trabecular bone microstructure. Quantified PCR results showed that mRNA expression level in the kidney of diabetic mice for 25-hydroxyvitamin D-24-hydroxylase was downregulated at week 10, while those for 25-hydroxyvitamin D-1α-hydroxylase were upregulated at week 20. In addition, mRNA expression levels for renal transient receptor potential V6, plasma membrane Ca-ATPase (PMCA)1b, and vitamin D receptor (VDR) genes were decreased in STZ-treated mice. Western blot analysis showed that protein expression of PMCA1b and VDR was significantly decreased in kidneys from STZ-treated mice compared to that of controls. CONCLUSIONS The limitation in this study is the lack of vitamin D, parathyroid hormone, and phosphorus levels in serum. However, the present study supports the conclusion that the underlying mechanism contributing to type 1 diabetes-associated bone loss may be alterations of vitamin D metabolic enzyme expression and associated decreases in expression of renal calcium transporters.
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Affiliation(s)
- Y Zhang
- Center of System Biomedical Sciences, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China.
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Cooper JD, Smyth DJ, Walker NM, Stevens H, Burren OS, Wallace C, Greissl C, Ramos-Lopez E, Hyppönen E, Dunger DB, Spector TD, Ouwehand WH, Wang TJ, Badenhoop K, Todd JA. Inherited variation in vitamin D genes is associated with predisposition to autoimmune disease type 1 diabetes. Diabetes 2011; 60:1624-31. [PMID: 21441443 PMCID: PMC3292339 DOI: 10.2337/db10-1656] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 02/27/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) is commonly reported in both children and adults worldwide, and growing evidence indicates that vitamin D deficiency is associated with many extraskeletal chronic disorders, including the autoimmune diseases type 1 diabetes and multiple sclerosis. RESEARCH DESIGN AND METHODS We measured 25(OH)D concentrations in 720 case and 2,610 control plasma samples and genotyped single nucleotide polymorphisms from seven vitamin D metabolism genes in 8,517 case, 10,438 control, and 1,933 family samples. We tested genetic variants influencing 25(OH)D metabolism for an association with both circulating 25(OH)D concentrations and disease status. RESULTS Type 1 diabetic patients have lower circulating levels of 25(OH)D than similarly aged subjects from the British population. Only 4.3 and 18.6% of type 1 diabetic patients reached optimal levels (≥75 nmol/L) of 25(OH)D for bone health in the winter and summer, respectively. We replicated the associations of four vitamin D metabolism genes (GC, DHCR7, CYP2R1, and CYP24A1) with 25(OH)D in control subjects. In addition to the previously reported association between type 1 diabetes and CYP27B1 (P = 1.4 × 10(-4)), we obtained consistent evidence of type 1 diabetes being associated with DHCR7 (P = 1.2 × 10(-3)) and CYP2R1 (P = 3.0 × 10(-3)). CONCLUSIONS Circulating levels of 25(OH)D in children and adolescents with type 1 diabetes vary seasonally and are under the same genetic control as in the general population but are much lower. Three key 25(OH)D metabolism genes show consistent evidence of association with type 1 diabetes risk, indicating a genetic etiological role for vitamin D deficiency in type 1 diabetes.
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Affiliation(s)
- Jason D. Cooper
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Deborah J. Smyth
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Neil M. Walker
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Helen Stevens
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Oliver S. Burren
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Chris Wallace
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Christopher Greissl
- Department of Internal Medicine I, Division of Endocrinology, Diabetes, and Metabolism, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Elizabeth Ramos-Lopez
- Department of Internal Medicine I, Division of Endocrinology, Diabetes, and Metabolism, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Elina Hyppönen
- University College London Institute of Child Health, Medical Research Council Centre of Epidemiology for Child Health and Centre for Paediatric Epidemiology and Biostatistics, London, U.K
| | - David B. Dunger
- Department of Paediatrics, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, U.K
| | - Willem H. Ouwehand
- Department of Haematology, University of Cambridge and National Health Service Blood and Transplant, Cambridge, U.K
- Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, U.K
| | - Thomas J. Wang
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Framingham Heart Study, Framingham, Massachusetts
| | - Klaus Badenhoop
- Department of Internal Medicine I, Division of Endocrinology, Diabetes, and Metabolism, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - John A. Todd
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K
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Lagunova Z, Porojnicu AC, Lindberg FA, Aksnes L, Moan J. Vitamin D status in Norwegian children and adolescents with excess body weight. Pediatr Diabetes 2011; 12:120-6. [PMID: 21352427 DOI: 10.1111/j.1399-5448.2010.00672.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The prevalence of childhood and adolescent obesity has increased during the past decades. A high body mass index (BMI) is associated with a low vitamin D status. The purpose of this study was to determine the prevalence of vitamin D deficiency and insufficiency in Norwegian children and adolescents with excess body weight. METHODS Vitamin D status and seasonal variations of 25(OH)D and 1,25(OH)(2)D were analyzed in 102 children and adolescents (70 girls and 32 boys), 8-19 yr of age, with overweight and obesity. RESULTS Overall, 50% of the children and adolescents included in the study had a low vitamin D status (25(OH)D <75 nmol/L) and 19% had vitamin D deficiency (25(OH)D <50 nmol/L). This was most prevalent in adolescents. Only 42% of teenagers had 25(OH)D levels ≥75 nmol/L vs. 72% of preteens. Both 25(OH)D and 1,25(OH)(2)D showed seasonal variations. A peak in serum 25(OH)D concentrations was observed during the summer while the lowest values were seen during the spring. In contrast, serum 1,25(OH)(2)D had a peak during the spring and the lowest concentrations during the winter. CONCLUSIONS The prevalence of vitamin D deficiency and insufficiency is higher in obese and overweight adolescents than in overweight children. This might be related to low outdoor activities and low vitamin D intake in teenagers. Seasonal variations of both the vitamin D metabolites were observed.
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Affiliation(s)
- Zoya Lagunova
- Department of Radiation Biology, Oslo University Hospital, The Norwegian Radium Hospital, 0310 Oslo, Norway.
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Garcia-Bailo B, El-Sohemy A, Haddad PS, Arora P, Benzaied F, Karmali M, Badawi A. Vitamins D, C, and E in the prevention of type 2 diabetes mellitus: modulation of inflammation and oxidative stress. Biologics 2011; 5:7-19. [PMID: 21383912 PMCID: PMC3044790 DOI: 10.2147/btt.s14417] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Indexed: 12/15/2022]
Abstract
The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and certain population subgroups are especially vulnerable to the disease. To reduce T2DM risk and progression at the population level, preventative strategies are needed that can be implemented on a population-wide scale with minimal cost and effort. Chronic low-grade inflammation resulting from oxidative stress and imbalances in the innate immune system has been associated with obesity, metabolic syndrome, and insulin resistance – critical stages in the development and progression of T2DM. Therefore, inflammation may play a causal role in the pathogenesis of T2DM, and reducing it via modulation of oxidative stress and the innate immune response could lead to a status of improved insulin sensitivity and delayed disease onset. Dietary supplementation with anti-inflammatory and antioxidant nutritional factors, such as micronutrients, might present a novel strategy toward the prevention and control of T2DM at the population level. This review examines current knowledge linking oxidation, inflammatory signaling pathways, and vitamin supplementation or intake to the risk of T2DM. The concept that micronutrients, via attenuation of inflammation, could be employed as a novel preventive measure for T2DM is evaluated in the context of its relevance to public health.
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Affiliation(s)
- Bibiana Garcia-Bailo
- Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
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Ho-Pham LT, Nguyen ND, Lai TQ, Eisman JA, Nguyen TV. Vitamin D status and parathyroid hormone in a urban population in Vietnam. Osteoporos Int 2011; 22:241-8. [PMID: 20414642 DOI: 10.1007/s00198-010-1207-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 02/03/2010] [Indexed: 12/31/2022]
Abstract
UNLABELLED In this cross-sectional study in Vietnam, the prevalence of vitamin D insufficiency was 46% in adult women and 20% in adult men. There was a linear inverse relationship between serum 25(OH)D and PTH concentrations, but there was no threshold of 25(OH)D at which PTH levels plateaued. INTRODUCTION Vitamin D insufficiency is adversely associated with health outcomes. Vitamin D status in Asian populations is not well documented. This study sought to assess vitamin D status and its relationship to parathyroid hormone in a Vietnamese population. METHODS This cross-sectional study involved 205 men and 432 women aged 18-87 years, who were randomly sampled from various districts in Ho Chi Minh City (Vietnam) according to a proportional sampling scheme. Serum concentration of 25(OH)D and PTH were measured by the Electrochemiluminescence immunoassay on the Roche Elecsys 10100/201 system (Roche Diagnosis Elecsys). Vitamin D insufficiency was quantified as serum 25(OH)D levels below 30 ng/ml (75 nmol/L). RESULTS The average age for men and women was 43.8 ± 18.4 years (mean ± SD) and 47.7 ± 17.1 years, respectively. The mean 25(OH)D concentration in men (36.8 ± 10.2 ng/mL) was significantly higher than in women (30.1 ± 5.9; P < 0.0001). The prevalence of vitamin D insufficiency in men was 20% (41/205) which was significantly lower than in women (46%, 199/432). Age, height and weight were independent predictors of 25(OH)D concentrations, and the three factors explained 15% and 5% of variance in 25(OH)D in men and women, respectively. There was a linear inverse relationship between serum 25(OH)D and PTH concentrations, but there was no threshold of 25(OH)D at which PTH levels plateaued. CONCLUSIONS These data show that vitamin D insufficiency is common even in tropical region, and that women had a greater risk of vitamin D insufficiency than men. These data suggest that an elevation in PTH cannot be used as a marker for vitamin D deficiency.
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Affiliation(s)
- L T Ho-Pham
- Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Thanh Thai Street, District 10, Ho Chi Minh City, Vietnam.
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Wei MY, Giovannucci EL. Vitamin D and multiple health outcomes in the Harvard cohorts. Mol Nutr Food Res 2010; 54:1114-26. [PMID: 20486209 DOI: 10.1002/mnfr.200900574] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The hypothesis that vitamin D is inversely associated with multiple health outcomes has been studied in the Harvard cohorts, including the Nurses' Health Study I (n=121,700 female nurses aged 37-64 at baseline in 1984), Nurses' Health Study II (n=116,671 female nurses aged 27-44 years at baseline in 1991), Health Professionals Follow-up Study (n=51,529 male health professionals aged 40-75 years at baseline in 1986), and Physicians' Health Study (n=22 071 male physicians aged 40-84 years at baseline in 1982). These studies assessed vitamin D through circulating 25-hydroxyvitamin D, dietary and supplemental intake, predicted 25-hydroxyvitamin D, and vitamin D receptor polymorphisms. This review summarizes studies of vitamin D and various endpoints considered in these cohorts, including risk of cardiovascular disease, hypertension, elevated plasma C-peptide, various cancers, bone fractures, and multiple sclerosis. Based on the multiple observed benefits of vitamin D, this article postulates recommendations for vitamin D intake in the US population for reduced incidence of multiple health outcomes.
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Affiliation(s)
- Melissa Y Wei
- Department of Public Health and Preventive Medicine, Oregon Health and Science University School of Medicine, Portland, OR, USA
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Borkar VV, Devidayal, Verma S, Bhalla AK. Low levels of vitamin D in North Indian children with newly diagnosed type 1 diabetes. Pediatr Diabetes 2010; 11:345-50. [PMID: 19906128 DOI: 10.1111/j.1399-5448.2009.00589.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To find out whether vitamin D levels are lower in children with newly diagnosed type 1 diabetes (T1D) as compared to non-diabetic subjects. METHODS Plasma levels of vitamin D (25-OHD) were measured by high performance liquid chromatography (HPLC) in 50 children aged between 6 and 12 yr within a week of diagnosis of T1D, and in 50 healthy children. RESULTS The mean levels of vitamin D were significantly lower in patients as compared to their controls [20.02 +/- 10.63 ng/mL (50.05 +/- 26.57 mmol/L) vs. 26.16 +/- 12.28 ng/mL (65.4 +/- 30.7 mmol/L), p-value 0.009]. Twenty-nine (58%) children in the study group were vitamin D deficient (25-OHD level < 20 ng/mL or < 50 mmol/L) as compared to only 16 (32%) in the control group. Overall, 43 (86%) diabetic and 38 (76%) healthy children were either vitamin D deficient or insufficient. CONCLUSION These results suggest that vitamin D levels are low at the onset of T1D, and they strongly support the need for further clinical studies to prospectively evaluate the effect of vitamin D supplementation on T1D rates in this patient population.
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Affiliation(s)
- Vibhor V Borkar
- Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kositsawat J, Freeman VL, Gerber BS, Geraci S. Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey. Diabetes Care 2010; 33:1236-8. [PMID: 20215453 PMCID: PMC2875430 DOI: 10.2337/dc09-2150] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Data relating vitamin D status with indices of glucose homeostasis as manifested by A1C in the U.S. adult population are few. RESEARCH DESIGN AND METHODS We examined the association between serum 25 hydroxyvitamin D [25(OH)D] and A1C levels in 9,773 adults (age >or=18 years old) participating in the 2003-2006 National Health and Nutrition Examination Survey. Multivariate linear regression analyzed the association after accounting for potential confounders. RESULTS Serum 25(OH)D levels were inversely associated with A1C levels in subjects age 35-74 years (P = 0.0045) and those who did not report a history of diabetes (P = 0.0282). CONCLUSIONS These findings support a mechanistic link between serum vitamin D concentrations, glucose homeostasis, and the evolution of diabetes in a large segment of the U.S. adult population. Screening people with elevated A1C levels for vitamin D insufficiency should be considered.
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Affiliation(s)
- Jatupol Kositsawat
- 1Medical Service, GV Sonny Montgomery VA Medical Center, Jackson, Mississippi, USA.
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50
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Badawi A, Klip A, Haddad P, Cole DEC, Bailo BG, El-Sohemy A, Karmali M. Type 2 diabetes mellitus and inflammation: Prospects for biomarkers of risk and nutritional intervention. Diabetes Metab Syndr Obes 2010; 3:173-86. [PMID: 21437087 PMCID: PMC3047967 DOI: 10.2147/dmsott.s9089] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Obesity is a major risk factor for type 2 diabetes mellitus (T2DM), which is a significant health problem worldwide. Active disease is associated with low-grade chronic inflammation resulting in part from the activation of the innate immune system. In obesity, this activation leads to the release of pro-inflammatory cytokines such as tumor necrosis factor-α, interleukin-1β and interleukin-6 that block major anabolic cascades downstream of insulin signaling and thus disrupt insulin homeostasis and action. Cytokines also trigger the production of acute-phase reactants such as C-reactive protein, plasminogen activator inhibitor-1, serum amyloid-A, and haptoglobin. The elevated synthesis of pro-inflammatory cytokines and acute-phase proteins (inflammatory network) characterizes the early (or pre-clinical) stages of T2DM and exhibits a graded increase with the disease progression. Current evidence suggests that understanding inflammatory networks can point to new biomarkers that may permit capturing the interaction between genetic and environmental risk factors in the pathogenesis of T2DM. Such biomarkers have a significant public health potential in the prediction of disease occurrence beyond risk factors presently monitored, such as family history, lifestyle assessment and standard clinical chemistry profiles. Furthermore, inflammatory markers may assist in the evaluation of novel strategies for prevention, particularly in relation to micronutrients. This review discusses the current knowledge linking T2DM risk to inflammatory signaling pathways interacting with the innate immunity system and the prospect of inflammatory markers serving as molecular targets for prevention and/or biomarkers for early risk prediction of T2DM. The potential of micronutrients replenishment to improve insulin action by attenuating inflammation is also evaluated in the context of the public health relevance of this approach.
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Affiliation(s)
- Alaa Badawi
- Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
- Correspondence: Alaa Badawi, Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, 180 Queen Street West, 11th Floor, Toronto, ON M5V 3L7, Canada, Email
| | - Amira Klip
- Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Pierre Haddad
- Natural Health Products and Metabolic Diseases Laboratory, Department of Pharmacology and Montreal Diabetes Research Centre, Montreal, QC, Canada
| | - David EC Cole
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Bibiana Garcia Bailo
- Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Mohamed Karmali
- Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
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