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Li S, Song Z, Fan C, Zhang W, Ma T, Li X, Zhang Q, Zhao M, Yu T, Li S. Potential of FGF21 in type 2 diabetes mellitus treatment based on untargeted metabolomics. Biochem Pharmacol 2024; 225:116306. [PMID: 38782076 DOI: 10.1016/j.bcp.2024.116306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
Fibroblast growth factor 21 (FGF21) has promise for treating diabetes and its associated comorbidities. It has been found to reduce blood glucose in mice and humans; however, its underlying mechanism is not known. Here, the metabolic function of FGF21 in diabetes was investigated. Diabetic db/db mice received intraperitoneal injections of FGF21 for 28 days, the serum of each mouse was collected, and their metabolites were analyzed by untargeted metabolomics using UHPLC-MS/MS. It was found that FGF21 reduced blood glucose and oral glucose tolerance without causing hypoglycemia. Moreover, administration of FGF21 reduced the levels of TG and LDL levels while increasing those of HDL and adiponectin. Importantly, the levels of 45 metabolites, including amino acids and lipids, were significantly altered, suggesting their potential as biomarkers. We speculated that FGF21 may treat T2DM through the regulation of fatty acid biosynthesis, the TCA cycle, and vitamin digestion and absorption. These findings provide insight into the mechanism of FGF21 in diabetes and suggest its potential for treating diabetes.
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Affiliation(s)
- Shuai Li
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China; State Key Laboratory of New-Tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Parmaceutical CO. LTD, Lianyungang 222001, People s Republic of China
| | - Zilong Song
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China
| | - Chunxiang Fan
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China
| | - Weiwei Zhang
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China
| | - Tianyi Ma
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China
| | - Xu Li
- State Key Laboratory of New-Tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Parmaceutical CO. LTD, Lianyungang 222001, People s Republic of China
| | - Qi Zhang
- President's Office, Qiqihar University, Qiqihar 161006, China.
| | - Ming Zhao
- College of Chemistry and Chemical Engineering, Qiqihar University, Qiqihar 161006, China.
| | - Tianfei Yu
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China.
| | - Shanshan Li
- College of Life Sciences and Agriculture and Forestry, Qiqihar University, Qiqihar 161006, China.
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Raharinavalona SA, Raherison RE, Miandrisoa RM, Andrianasolo RL, Rakotomalala ADP. Vitamin D Status and Cardiovascular Risk Factors in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in a Tertiary-Level Hospital in Antananarivo, Madagascar. Diabetes Metab Syndr Obes 2024; 17:2191-2198. [PMID: 38835729 PMCID: PMC11149705 DOI: 10.2147/dmso.s467316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
Background Diabetes mellitus is already a major cardiovascular risk factor (CRF). Hypovitaminosis D is common in patients with type 2 diabetes mellitus (T2DM). It also increases the cardiovascular risk of these subjects. Objective To determine the vitamin D status of Malagasy with T2DM seen at the Soavinandriana Hospital Center, and the association between hypovitaminosis D and CRF. Methods This was a cross-sectional study, carried out over a period of 2 years. Assayed by the chemiluminescence technique, vitamin D was "normal", "insufficient" and "deficient" if the 25-hydroxyvitamin D plasma was ≥30 ng/mL, 20-29 ng/mL and ≤19 ng/mL, respectively. Hypovitaminosis D was the set of vitamin D insufficiency and deficiency. Results Among the 318 T2DM, the prevalence of hypovitaminosis D was 66.0% (45.2% insufficiency and 20.8% deficiency). Their factors associated were age ≥70 years (OR = 2.15 [1.26-3.66]), glycated haemoglobin ≥7% (4.97 [2.97-8.39]), and retinopathy (OR = 4.15 [1.85-9.32]). After adjustment for age, Hb A1c ≥7% and retinopathy, hypovitaminosis D was associated with hypertension (OR = 8.77 [4.76-16.2]), dyslipidaemia (OR = 8.05 [3.98-14.5]), ex-smoking (OR = 6.07 [2.78-13.3]), microalbuminuria (OR = 2.95 [1.25-6.97]) and carotid atherosclerosis (OR = 2.96 [1.83-4.35]). Conclusion Hypovitaminosis D was common in T2DM. Its treatment is primarily preventive. It is also important to control associated CRF, diabetes and its complications.
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Affiliation(s)
| | - Rija Eric Raherison
- Endocrinology Department, Joseph Raseta Befelatanana University Hospital Center, Antananarivo, Madagascar
| | - Rija Mikhaël Miandrisoa
- Cardiovascular Diseases and Internal Medicine Departments, Soavinandriana Hospital Center, Antananarivo, Madagascar
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Mavar M, Sorić T, Bagarić E, Sarić A, Matek Sarić M. The Power of Vitamin D: Is the Future in Precision Nutrition through Personalized Supplementation Plans? Nutrients 2024; 16:1176. [PMID: 38674867 PMCID: PMC11054101 DOI: 10.3390/nu16081176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
In the last few decades, vitamin D has undeniably been one of the most studied nutrients. Despite our ability to produce vitamin D through sunlight exposure, its presence in several natural food sources and fortified foods, and its widespread availability as a dietary supplement, vitamin D deficiency is a serious public health problem, affecting nearly 50% of the global population. Low serum levels of vitamin D are being associated with increased susceptibility to numerous health conditions, including respiratory infections, mental health, autoimmune diseases, and different cancer types. Although the association between vitamin D status and health is well-established, the exact beneficial effects of vitamin D are still inconclusive and indefinite, especially when considering the prevention and treatment of different health conditions and the determination of an appropriate dosage to exert those beneficial effects in various population groups. Therefore, further research is needed. With constant improvements in our understanding of individual variations in vitamin D metabolism and requirements, in the future, precision nutrition and personalized supplementation plans could prove beneficial.
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Affiliation(s)
- Mladen Mavar
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Tamara Sorić
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Ena Bagarić
- Almagea Ltd., Ulica Julija Knifera 4, 10020 Zagreb, Croatia;
| | - Ana Sarić
- School of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia;
| | - Marijana Matek Sarić
- Department of Health Studies, University of Zadar, Splitska 1, 23000 Zadar, Croatia;
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Nor MA, Keles E, Hassan-Kadle MA, Hassan MA, Baydili KN, Eker HH. Vitamin D levels in patients attending a tertiary care hospital in Mogadishu, Somalia: a retrospective review of 28,125 cases. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231100. [PMID: 38511759 PMCID: PMC10941876 DOI: 10.1590/1806-9282.20231100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 03/22/2024]
Abstract
OBJECTIVE The objective of this study was to identify the prevalence and risk factors for vitamin D deficiency among patients attending a tertiary hospital in Mogadishu, Somalia. METHODS This retrospective study examined the results of serum 25-hydroxy-vitamin D tests of 28,125 patients admitted to Somalia Mogadishu-Turkey Training and Research Hospital between January 2017 and December 2021. Vitamin D insufficiency is defined as 20-30 ng/mL, deficiency as 10-19 ng/mL, and severe deficiency as <10 ng/mL. RESULTS A total of 28,125 patients with a mean age of 44.27±20.4 years were included in the study. The majority of patients were in the age group of 19-40 years. The mean serum level of 25-hydroxy-vitamin D was 28.42±15.34 ng/mL. Of the patients included in the study, 5.8% (1,618/28,125) had vitamin D sufficiency, 6.5% (1,826/28,125) had vitamin D insufficiency, 41.8% (11,761/28,125) had vitamin D deficiency, and 45.9% (12,920/28,125) had severe vitamin D deficiency. The mean serum 25-hydroxy-vitamin D levels were lower in females than in males (p<0.001). CONCLUSION The study indicated a high prevalence of vitamin deficiency among patients attending the largest tertiary care hospital, particularly female patients and older people. It is recommended to develop educational and awareness programs, and campaigns to reduce vitamin D deficiency in the population, especially those at high risk.
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Affiliation(s)
- Mosab Ahmed Nor
- University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Internal Medicine – Mogadishu, Somalia
| | - Esra Keles
- University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Department of Gynecologic Oncology – İstanbul, Turkey
| | - Mohamed Abdulkadir Hassan-Kadle
- Abrar University, College of Medicine and Health Science, Center For Digestive and Liver Diseases, SomGastro Clinic – Mogadishu, Somalia
| | - Mohamed Abdulahi Hassan
- SIMAD University, Dr. Sumait Hospital, Faculty of Medicine and Health Sciences, Department of Internal Medicine – Mogadishu, Somalia
| | - Kursad Nuri Baydili
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Biostatistics – İstanbul, Turkey
| | - Hasan Huseyin Eker
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Public Health – İstanbul, Turkey
- University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Public Health – Mogadishu, Somalia
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Chen HJ, Wang M, Zou DM, Liang GY, Yang SY. Effects of vitamin family members on insulin resistance and diabetes complications. World J Diabetes 2024; 15:568-571. [PMID: 38591081 PMCID: PMC10999036 DOI: 10.4239/wjd.v15.i3.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/17/2024] [Accepted: 02/06/2024] [Indexed: 03/15/2024] Open
Abstract
The following letter to the editor highlights the article "Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance" in World J Diabetes 2023 Oct 15; 14 (10): 1514-1523. It is necessary to explore the role of vitamin family members in insulin resistance and diabetes complications.
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Affiliation(s)
- Hong-Jin Chen
- Division of Cardiac Surgery, Guizhou Institute of Precision Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550009, Guizhou Province, China
- Translational Medicine Research Center, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Min Wang
- Translational Medicine Research Center, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
- School of Basic Medical Sciences/School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Ding-Min Zou
- Translational Medicine Research Center, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
- School of Basic Medical Sciences/School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Gui-You Liang
- Division of Cardiac Surgery, Guizhou Institute of Precision Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550009, Guizhou Province, China
- Translational Medicine Research Center, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Si-Yuan Yang
- Division of Cardiac Surgery, Guizhou Institute of Precision Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550009, Guizhou Province, China
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Valer-Martinez A, Sayon-Orea C, Martinez JA, Basterra-Gortari FJ, Martinez-Gonzalez MA, Bes-Rastrollo M. Vitamin D and risk of developing type 2 diabetes in the SUN project: a prospective cohort study. J Endocrinol Invest 2024:10.1007/s40618-024-02324-3. [PMID: 38459212 DOI: 10.1007/s40618-024-02324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/28/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Vitamin D deficiency has been associated with multiple chronic diseases, including metabolic disorders such as insulin resistance and type 2 diabetes (T2D). The aim of the study was to analyze the association between validated predicted serum vitamin D status and the risk of developing T2D in a large prospective cohort based on a Mediterranean population. METHODS The SUN project is a prospective and dynamic Spanish cohort that gathers university graduates who have answered lifestyle questionnaires, including a validated Food Frequency Questionnaire. The association between predicted serum vitamin D and the risk of T2D was assessed through Cox regression models according to quartiles (Q) of predicted vitamin D at baseline. The models were adjusted for potential confounders and sensitivity analyses were performed to ensure the robustness of our findings. RESULTS Our study included a total of 18,594 participants and after a total follow-up of 238,078 person-years (median follow-up of 13.5 years), 209 individuals were diagnosed with incident T2D. We found a significant inverse association between predicted levels of serum vitamin D and the risk of developing T2D, after adjusting for potential confounders and performing different sensitivity analyses (hazard ratio Q4 vs. Q1: 0.48, 95% CI 0.26-0.88; p for trend = 0.032). CONCLUSION The outcomes suggest that higher levels of vitamin D at baseline may be associated with a reduced risk of developing T2D.
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Affiliation(s)
- A Valer-Martinez
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Department of Family Medicine, Aragon Health Service (SALUD), Zaragoza, Spain
| | - C Sayon-Orea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain.
- Navarra Public Health Institute, Pamplona, Spain.
| | - J A Martinez
- Institute IMDEA Food, Madrid, Spain
- Department of Nutrition, Food Science and Physiology/Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - F J Basterra-Gortari
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
| | - M A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
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Akhter A, Alouffi S, Shahab U, Akasha R, Fazal-Ur-Rehman M, Ghoniem ME, Ahmad N, Kaur K, Pandey RP, Alshammari A, Akhter F, Ahmad S. Vitamin D supplementation modulates glycated hemoglobin (HBA1c) in diabetes mellitus. Arch Biochem Biophys 2024; 753:109911. [PMID: 38280562 DOI: 10.1016/j.abb.2024.109911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Diabetes is a metabolic illness that increases protein glycosylation in hyperglycemic conditions, which can have an impact on almost every organ system in the body. The role of vitamin D in the etiology of diabetes under RAGE (receptor for advanced glycation end products) stress has recently received some attention on a global scale. Vitamin D's other skeletal benefits have generated a great deal of research. Vitamin D's function in the development of type 1 and type 2 diabetes is supported by the discovery of 1,25 (OH)2D3 and 1-Alpha-Hydroylase expression in immune cells, pancreatic beta cells, and several other organs besides the bone system. A lower HBA1c level, metabolic syndrome, and diabetes mellitus all seems to be associated with vitamin D insufficiency. Most of the cross-sectional and prospective observational studies that were used to gather human evidence revealed an inverse relationship between vitamin D level and the prevalence or incidence of elevated HBA1c in type 2 diabetes. Several trials have reported on the impact of vitamin D supplementation for glycemia or incidence of type 2 diabetes, with varying degrees of success. The current paper examines the available data for a relationship between vitamin D supplementation and HBA1c level in diabetes and discusses the biological plausibility of such a relationship.
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Affiliation(s)
- Asma Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11790, United States.
| | - Sultan Alouffi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
| | - Uzma Shahab
- Department of Biochemistry, King George Medical University, Lucknow, U.P., India.
| | - Rihab Akasha
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
| | | | - Mohamed E Ghoniem
- Department of Internal Medicine, College of Medicine, University of Hail, 2440, Saudi Arabia; Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
| | - Naved Ahmad
- Department of Computer Science and Information System, College of Applied Sciences, AlMaarefa University, P.O.Box 71666, Riyadh, 13713, Saudi Arabia.
| | - Kirtanjot Kaur
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India.
| | - Ramendra Pati Pandey
- School of Health Sciences and Technology (SOHST), UPES, Dehradun, 248007, Uttarakhand, India.
| | - Ahmed Alshammari
- Department of Internal Medicine, College of Medicine, University of Hail, Saudi Arabia.
| | - Firoz Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11790, United States.
| | - Saheem Ahmad
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Dinesh S, Sharma S, Chourasiya R. Therapeutic Applications of Plant and Nutraceutical-Based Compounds for the Management of Type 2 Diabetes Mellitus: A Narrative Review. Curr Diabetes Rev 2024; 20:e050523216593. [PMID: 37151065 DOI: 10.2174/1573399819666230505140206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 05/09/2023]
Abstract
Diabetes mellitus is a condition caused by a deficiency in insulin production or sensitivity that is defined by persistent hyperglycemia as well as disturbances in glucose, lipid, and protein metabolism. Uncurbed diabetes or incessant hyperglycemic condition can lead to severe complications, including renal damage, visual impairment, cardiovascular disease, neuropathy, etc., which promotes diabetes-associated morbidity and mortality rates. The therapeutic management of diabetes includes conventional medications and nutraceuticals as complementary therapies. Nutraceuticals are bioactive compounds derived from food sources that have health-promoting properties and are instrumental in the management and treatment of various maladies. Nutraceuticals are clinically exploited to tackle DM pathogenesis, and the clinical evidence suggests that nutraceuticals can modulate biochemical parameters related to diabetes pathogenesis and comorbidities. Hypoglycemic medicines are designed to mitigate DM in traditional medicinal practice. This review intends to emphasize and comment on the various therapeutic strategies available to manage this chronic condition, conventional drugs, and the potential role of nutraceuticals in managing the complexity of the disease and reducing the risk of complications. In contrast to conventional antihyperglycemic drugs, nutraceutical supplements offer a higher efficacy and lesser adverse effects. To substantiate the efficacy and safety of various functional foods in conjunction with conventional hypoglycemic medicines, additional data from clinical studies are required.
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Affiliation(s)
- Susha Dinesh
- Department of Bioinformatics, BioNome, Bengaluru, 560043, India
| | - Sameer Sharma
- Department of Bioinformatics, BioNome, Bengaluru, 560043, India
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Tajali R, Eidi A, Tafti HA, Pazouki A, Kamarul T, Sharifi AM. Transplantation of adipose derived stem cells in diabetes mellitus; limitations and achievements. J Diabetes Metab Disord 2023; 22:1039-1052. [PMID: 37975135 PMCID: PMC10638327 DOI: 10.1007/s40200-023-01280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/10/2023] [Indexed: 11/19/2023]
Abstract
Objectives Diabetes mellitus (DM) is a complex metabolic disease that results from impaired insulin secreting pancreatic β-cells or insulin resistance. Although available medications help control the disease, patients suffer from its complications. Therefore, finding effective therapeutic approaches to treat DM is a priority. Adipose Derived Stem Cells (ADSCs) based therapy is a promising strategy in various regenerative medicine applications, but its systematic translational use is still somewhat out of reach. This review is aimed at clarifying achievements as well as challenges facing the application of ADSCs for the treatment of DM, with a special focus on the mechanisms involved. Methods Literature searches were carried out on "Scopus", "PubMed" and "Google Scholar" up to September 2022 to find relevant articles in the English language for the scope of this review. Results Recent evidence showed a significant role of ADSC therapies in DM by ameliorating insulin resistance and hyperglycemia, regulating hepatic glucose metabolism, promoting β cell function and regeneration, and functioning as a gene delivery tool. In addition, ADSCs could improve diabetic wound healing by promoting collagen deposition, inhibiting inflammation, and enhancing angiogenesis. Conclusion Overall, this literature review revealed the great clinical implications of ADSCs for translating into the clinical setting for the treatment of diabetes. However, further large-scale and controlled studies are needed to overcome challenges and confirm the safety and optimal therapeutic scheme before daily clinical application. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01280-8.
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Affiliation(s)
- Raziye Tajali
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Akram Eidi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hosein Ahmadi Tafti
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery research center, IRAN University of Medical Sciences Tehran, Tehran, Iran
| | - Tunku Kamarul
- Tissue Engineering Group, (NOCERAL), Department of Orthopedics Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ali Mohammad Sharifi
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Stem cell and regenerative Medicine research center, Iran University of medical Sciences, Tehran, Iran
- Tissue Engineering Group, (NOCERAL), Department of Orthopedics Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Zhong P, Zhu Z, Wang Y, Huang W, He M, Wang W. Cardiovascular and microvascular outcomes according to vitamin D level and genetic variants among individuals with prediabetes: a prospective study. J Transl Med 2023; 21:724. [PMID: 37845735 PMCID: PMC10577927 DOI: 10.1186/s12967-023-04557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Whether serum vitamin D mediate vascular diseases in prediabetic populations remains unclear. This study aimed to determine the associations between circulating 25-hydroxyvitamin D [25(OH)D] levels and vitamin D receptor (VDR) polymorphisms with the risk of macrovascular complications, including myocardial infarction and stroke, and microvascular complications such as diabetic nephropathy and retinopathy, among adults with prediabetes. METHODS Participants with prediabetes in UK Biobank were included (N = 56,387). Multivariable dose-response and Cox proportion models were used to explore the relationship of serum 25(OH)D status and the risks of vascular complications. The interaction of VDR polymorphisms with serum 25(OH)D level on risks of vascular events was also assessed. RESULTS During a median follow-up of 12 years, higher levels of 25(OH)D were significantly and nonlinearly associated with a lower risk of macrovascular diseases among prediabetic individuals. The adjusted hazard ratios (95% confidential interval) of serum 25(OH)D levels of ≥ 75.0 nmol/L versus < 25 nmol/L were 0.75 (0.63-0.88) for myocardial infarction, 0.74 (0.55-1.00) for stroke, 1.02 (0.60-1.74) for diabetic nephropathy, and 1.30 (0.92-1.84) for diabetic retinopathy, respectively. The rs2228570 (FokI) polymorphisms significantly interacted with 25(OH)D on incident myocardial infarction (P-interaction = 0.042) and stroke (P-interaction = 0.033). The individuals with serum 25(OH)D level of 50.0-74.9 nmol/L and rs2228570 (FokI) homozygotes had the lowest risks of vascular complications. CONCLUSIONS Lower serum 25(OH)D levels are significantly and nonlinearly associated with an increased risk of cardiocerebrovascular diseases in prediabetic individuals, with VDR polymorphisms of rs2228570 (FokI) modify such associations. Monitoring a safe 25(OH)D concentration is suggested to prevent the vascular complications for prediabetes.
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Affiliation(s)
- Pingting Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Yunlong Wang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China.
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China.
- Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China.
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China.
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12
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Tarfeen N, Nisa KU, Ahmad MB, Waza AA, Ganai BA. Metabolic and Genetic Association of Vitamin D with Calcium Signaling and Insulin Resistance. Indian J Clin Biochem 2023; 38:407-417. [PMID: 37746541 PMCID: PMC10516840 DOI: 10.1007/s12291-022-01105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
Various evidences have unveiled the significance of Vitamin D in diverse processes which include its action in prevention of immune dysfunction, cancer and cardiometabolic disorders. Studies have confirmed the function of VD in controlling the expression of approximately nine hundred genes including gene expression of insulin. VD insufficiency may be linked with the pathogenesis of diseases that are associated with insulin resistance (IR) including diabetes as well as obesity. Thus, VD lowers IR-related disorders such as inflammation and oxidative stress. This review provides an insight regarding the molecular mechanism manifesting, how insufficiency of VD may be connected with the IR and diabetes. It also discusses the effect of VD in maintaining the Ca2+ levels in beta cells of the pancreas and in the tissues that are responsive to insulin.
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Affiliation(s)
- Najeebul Tarfeen
- Centre of Research for Development, University of Kashmir, Srinagar, India
| | - Khair Ul Nisa
- Department of Environmental Science, University of Kashmir, Srinagar, India
| | - Mir Bilal Ahmad
- Department of Biochemistry, University of Kashmir, Srinagar, India
| | - Ajaz Ahmad Waza
- Multidisciplinary Research Unit (MRU), Government Medical Collage (GMC) Srinagar, Srinagar, J & K 190010 India
| | - Bashir Ahmad Ganai
- Centre of Research for Development, University of Kashmir, Srinagar, India
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13
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Zhou L, Zhang J, Zhang D, Yu Y, Jiang M, Liu H, Li J, Li M, Zhang Z, Guo L. Co-exposure to multiple vitamins and the risk of all-cause mortality in patients with diabetes. Front Endocrinol (Lausanne) 2023; 14:1254133. [PMID: 37795357 PMCID: PMC10546318 DOI: 10.3389/fendo.2023.1254133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Objective Although the effect of vitamins on the risk of mortality in diabetic patients has been reported, most studies focus on individual vitamins. However, humans are often exposed to multiple vitamins simultaneously in daily life. Therefore, it is worth exploring the effects of co-exposure to multiple vitamins on the risk of mortality in diabetic patients. Methods This study included diabetic patients aged ≥20WD years who participated in NHANES from 2003 to 2006. An unsupervised K-means clustering method was used to cluster eight vitamins in serum into several patterns of co-exposure to multiple vitamins, and the Cox proportional hazards model was used to evaluate the impact of different patterns of co-exposure to multiple vitamins on the risk of all-cause mortality in diabetic patients. Results Three patterns of co-exposure to multiple vitamins were generated based on K-means clustering, namely, low-level, moderate-level, and high-level. Among the 484 diabetic patients, with a median follow-up of 13.7 years, a total of 211 deaths occurred. After adjusting for covariates, the individual vitamins had varying effects on the risk of all-cause mortality in diabetic patients. Compared to the low-level group of co-exposure to multiple vitamins, the high-level group significantly reduced the risk of all-cause mortality in diabetic patients, with a HR of 0.42 (95% CI: 0.20, 0.87). Subgroup analysis demonstrated that high levels of co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in males, individuals aged ≥ 60 years, and non-Hispanic White people with diabetes compared to the low-level group, with HR of 0.42 (95% CI: 0.18, 0.98), 0.53 (95% CI: 0.26, 0.98), and 0.26 (95% CI: 0.12, 0.58) respectively. Conclusion While individual vitamins had different effects on the risk of all-cause mortality in patients with diabetes, high-level co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in patients with diabetes, with differences observed among genders, ages, and race. This suggests that when developing vitamin intervention strategies for patients with diabetes, consideration should be given not only to the dosage of individual vitamins but also to the variations between different population groups.
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Affiliation(s)
- Lin Zhou
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Jianing Zhang
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Dan Zhang
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Ye Yu
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Mengqi Jiang
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Huiying Liu
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Jiatong Li
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Minghui Li
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Zhuo Zhang
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Lianying Guo
- School of Public Health, Shenyang Medical College, Shenyang, China
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14
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Navaei S, Nazemi S, Emamian MH, Hashemi H, Fotouhi A. Vitamin D deficiency and diabetic retinopathy risk. J Fr Ophtalmol 2023; 46:737-741. [PMID: 37085359 DOI: 10.1016/j.jfo.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/16/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE Vitamin D deficiency may play an important role in the development and progression of diabetic retinopathy. The present study aimed to assess the relationship between vitamin D deficiency and the likelihood of diabetic retinopathy. METHODS This nested case-control study was conducted on all type II diabetic patients among the participants of the third phase of the Shahroud eye cohort study. Overall, 278 patients aged 50 to 74 years, 101 in the case group (diabetic retinopathy) and 178 in the control group (diabetic without retinopathy), were assessed. Serum levels of vitamin D on admission were measured for all participants by a radio immunoassay (RIA) technique. RESULTS The overall prevalence of vitamin D deficiency (defined as a vitamin D level of less than or equal to 20mg/dL) was 30.7%. Comparison of the serum level of vitamin D across the three groups - without retinopathy, with non-proliferative retinopathy, and with proliferative retinopathy - showed a significantly lower level of this marker in the latter group (P=0.036). Reducing vitamin D to less than or equal to 20ng/mL increased the odds of proliferative retinopathy by 6.25 times (P value: 0.027). CONCLUSION Vitamin D deficiency is a potential risk factor for diabetes-related proliferative retinopathy.
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Affiliation(s)
- S Navaei
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - S Nazemi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - M H Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - H Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - A Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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15
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Lei X, Zhou Q, Wang Y, Fu S, Li Z, Chen Q. Serum and supplemental vitamin D levels and insulin resistance in T2DM populations: a meta-analysis and systematic review. Sci Rep 2023; 13:12343. [PMID: 37524765 PMCID: PMC10390579 DOI: 10.1038/s41598-023-39469-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023] Open
Abstract
Observational studies have shown a negative correlation between Vitamin D level and the likelihood of developing insulin resistance (IR) and/or diabetes over time, yet evidence remains inconsistent. In this meta-analysis and systematic review, we strive to define the potential association between serum or supplemental Vitamin D Levels and insulin resistance respectively, as well as the contribution of Vitamin D to type 2 diabetes, and to summarize the biologic plausibility of Vitamin D. Four databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched for this Systematic Literature Review (SLR) to find appropriate observational studies and clinical trials published in English through to July 2022. EndNote (version X9) is used to manage the literature search results. We calculated Standard Mean Differences (SMDs) and Risk Ratios (RRs) with their 95% Confidence Intervals (CIs), separately, for continuous and dichotomous outcomes. The correlation coefficients were normalized to z values through Fisher's z-transformation to calculate the relevant statistics. Meta-analyses were carried out for all comparisons, based on a random-effects pooling model. Data analysis was performed using RevMan (version 5.3) and STATA (version 15.1). All statistical tests were two-sided, with P < 0.05 were regarded as significant. In our current meta-analysis, there are 18 RCTs and 20 observational studies including 1243 and 11,063 participants respectively. In the overall analysis, the diabetic with Vitamin D supplement treatment group showed significantly improve serum insulin (SMD = - 0.265, 95% CI - 0.394 to - 0.136, P < 0.05), glucose (SMD = - 0.17, 95% CI - 0.301to - 0.039, P < 0.05) and HOMA-IR (SMD = - 0.441, 95% CI - 0.582 to - 0.3, P < 0.05) compared with the routine treatment group. Correlation analysis results showed that all three outcomes were significantly correlated in a negative manner with raised Vitamin D (insulin: r = - 0.08 95% = - 0.12 to - 0.04; glucose: r = - 0.06 95% = - 0.11 to - 0.01; HOMA-IR: r = - 0.08 95% = - 0.09 to - 0.06). Results of overall analysis proved that vitamin D has shown significant effect on regulates insulin resistance, and there is a significant inverse association between serum Vitamin D level and IR. Vitamin D supplementation is expected to be integrated into conventional medical approaches to prevent type 2 diabetes and to mitigate the burden of diabetes for individuals and society.PROSPERO registration number: CRD42022348295.
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Affiliation(s)
- Xingxing Lei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Qian Zhou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yanmei Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Shunlian Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Zinan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Province, No. 39, Shi-er-Qiao Road, Chengdu, 610072, People's Republic of China.
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16
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He M, Yang T, Zhou P, Bu P, Yang X, Zou Y, Zhong A. A Mendelian randomization study on causal effects of 25(OH) vitamin D levels on diabetic nephropathy. BMC Nephrol 2023; 24:192. [PMID: 37369991 DOI: 10.1186/s12882-023-03186-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 04/27/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Vitamin D supplementation is associated with a lower incidence of diabetic nephropathy (DN); however, whether this association is causative is uncertain. METHODS We used two-sample Mendelian randomization to examine the causal influence of vitamin D on diabetic nephropathy in 7,751 individuals with type I diabetes-related nephropathy (T1DN) and 9,933 individuals with type II diabetes-related nephropathy (T2DN). Meanwhile, we repeated some previous studies on the influence of KIM-1 (kidney injury molecule 1) and body mass index (BMI) on DN. Additionally, to test the validity of the instruments variable for vitamin D, we conducted two negative controls Mendelian randomization (MR) on breast and prostate cancer, and a positive control MR on multiple sclerosis. RESULTS Results of the MR analysis showed that there was no causal association between 25(OH)D with the early/later stage of T1DN (early: OR = 0.903, 95%CI: 0.229 to 3.555; later: OR = 1.213, 95%CI: 0.367 to 4.010) and T2DN (early: OR = 0.588, 95%CI: 0.182 to 1.904; later: OR = 0.904, 95%CI: 0.376 to 2.173), nor with the kidney function of patients with diabetes mellitus: eGFRcyea (creatinine-based estimated GFR) (Beta = 0.007, 95%CI: -0.355 to 0.369)) or UACR (urinary albumin creatinine ratio) (Beta = 0.186, 95%CI: -0.961 to 1.333)). CONCLUSIONS We found no evidence that Vitamin D was causally associated with DN or kidney function in diabetic patients.
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Affiliation(s)
- Mingjie He
- Jiangxi Provincial Key Laboratory of Nephrology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Ting Yang
- Jiangxi Provincial Key Laboratory of Nephrology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Ping Zhou
- Jiangxi Provincial Key Laboratory of Nephrology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Peiyan Bu
- Medical College of Nanchang University, Nanchang University, 330006, Nanchang City, China
| | - Xionghui Yang
- Medical College of Nanchang University, Nanchang University, 330006, Nanchang City, China
| | - Yan Zou
- Jiangxi Provincial Key Laboratory of Nephrology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Aimin Zhong
- Jiangxi Provincial Key Laboratory of Nephrology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
- Medical College of Nanchang University, Nanchang University, 330006, Nanchang City, China.
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Nemeth Z, Patonai A, Simon-Szabó L, Takács I. Interplay of Vitamin D and SIRT1 in Tissue-Specific Metabolism-Potential Roles in Prevention and Treatment of Non-Communicable Diseases Including Cancer. Int J Mol Sci 2023; 24:ijms24076154. [PMID: 37047134 PMCID: PMC10094444 DOI: 10.3390/ijms24076154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
The importance of the prevention and control of non-communicable diseases, including obesity, metabolic syndrome, type 2 diabetes, cardiovascular diseases, and cancer, is increasing as a requirement of the aging population in developed countries and the sustainability of healthcare. Similarly, the 2013-2030 action plan of the WHO for the prevention and control of non-communicable diseases seeks these achievements. Adequate lifestyle changes, alone or with the necessary treatments, could reduce the risk of mortality or the deterioration of quality of life. In our recent work, we summarized the role of two central factors, i.e., appropriate levels of vitamin D and SIRT1, which are connected to adequate lifestyles with beneficial effects on the prevention and control of non-communicable diseases. Both of these factors have received increased attention in relation to the COVID-19 pandemic as they both take part in regulation of the main metabolic processes, i.e., lipid/glucose/energy homeostasis, oxidative stress, redox balance, and cell fate, as well as in the healthy regulation of the immune system. Vitamin D and SIRT1 have direct and indirect influence of the regulation of transcription and epigenetic changes and are related to cytoplasmic signaling pathways such as PLC/DAG/IP3/PKC/MAPK, MEK/Erk, insulin/mTOR/cell growth, proliferation; leptin/PI3K-Akt-mTORC1, Akt/NFĸB/COX-2, NFĸB/TNFα, IL-6, IL-8, IL-1β, and AMPK/PGC-1α/GLUT4, among others. Through their proper regulation, they maintain normal body weight, lipid profile, insulin secretion and sensitivity, balance between the pro- and anti-inflammatory processes under normal conditions and infections, maintain endothelial health; balance cell differentiation, proliferation, and fate; and balance the circadian rhythm of the cellular metabolism. The role of these two molecules is interconnected in the molecular network, and they regulate each other in several layers of the homeostasis of energy and the cellular metabolism. Both have a central role in the maintenance of healthy and balanced immune regulation and redox reactions; therefore, they could constitute promising targets either for prevention or as complementary therapies to achieve a better quality of life, at any age, for healthy people and patients under chronic conditions.
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Affiliation(s)
- Zsuzsanna Nemeth
- Department of Internal Medicine and Oncology, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
| | - Attila Patonai
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Ulloi u. 78, 1082 Budapest, Hungary
| | - Laura Simon-Szabó
- Department of Molecular Biology, Semmelweis University, Tuzolto u. 37-47, 1094 Budapest, Hungary
| | - István Takács
- Department of Internal Medicine and Oncology, Semmelweis University, Koranyi S. u 2/a, 1083 Budapest, Hungary
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Bignardi PR, de Andrade Castello P, de Matos Aquino B, Delfino VDA. Is the vitamin D status of patients with COVID-19 associated with reduced mortality? A systematic review and meta-analysis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:276-288. [PMID: 36913680 PMCID: PMC10689034 DOI: 10.20945/2359-3997000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/05/2022] [Indexed: 02/08/2023]
Abstract
To conduct a systematic review and meta-analysis of studies assessing the association between serum vitamin D status and mortality in patients with COVID- 19. We searched PubMed and Embase for studies addressing the association of serum vitamin D levels and COVID-19 mortality published until April 24, 2022. Risk ratios (RRs) and 95% confidence interval (CIs) were pooled using fixed or random effects models. The risk of bias was assessed using the Newcastle-Ottawa Scale. The meta-analysis included 21 studies that measured serum vitamin D levels close to the date of admission, of which 2 were case-control and 19 were cohort studies. Vitamin D deficiency was associated with COVID-19 mortality in the overall analysis but not when the analysis was adjusted to vitamin D cutoff levels < 10 or < 12 ng/mL (RR 1.60, 95% CI 0.93-2.27, I2 60.2%). Similarly, analyses including only studies that adjusted measures of effect for confounders showed no association between vitamin D status and death. However, when the analysis included studies without adjustments for confounding factors, the RR was 1.51 (95% CI 1.28-1.74, I2 0.0%), suggesting that confounders may have led to many observational studies incorrectly estimating the association between vitamin D status and mortality in patients with COVID-19. Deficient vitamin D levels were not associated with increased mortality rate in patients with COVID-19 when the analysis included studies with adjustments for confounders. Randomized clinical trials are needed to assess this association.
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Affiliation(s)
- Paulo R Bignardi
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil,
| | | | - Bruno de Matos Aquino
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil
| | - Vinicius Daher Alvares Delfino
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil
- Universidade Estadual de Londrina, Londrina, PR, Brasil
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Farahmand MA, Daneshzad E, Fung TT, Zahidi F, Muhammadi M, Bellissimo N, Azadbakht L. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord 2023; 23:15. [PMID: 36647067 PMCID: PMC9841647 DOI: 10.1186/s12902-022-01209-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/10/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is conflicting evidence on the effect of vitamin D on glycemic control. Therefore, in the current meta-analyses, we aimed to assess the effect of vitamin D supplementation on the glycemic control of type 2 diabetes (T2D) patients. METHODS We conducted a comprehensive search in electronic databases including; PubMed/Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and NIH's Clinical Trials Registry, from the inception of each database up to January first, 2021. RESULTS A total of 46 randomized controlled trials (RCTs) consisting of 2164 intervention subjects and 2149 placebo controls were included in this meta-analysis. Pooled analyses for HbA1c showed a significant change between the intervention and placebo group, the weighted mean difference (WMD)(95% confidence interval(CI)) was -0.20%(-0.29, -0.11) with P < 0.001. Analyses for assessing changes in FPG found a significant reduction in the intervention group after vitamin D supplementation, the WMD (95%CI) was -5.02 mg/dl (-6.75,-3.28) with P < 0.001. The result of pooled analyses for HOMA-IR revealed a significant change between the intervention and control group, the WMD (95%CI) was -0.42(-0.76, -0.07) with P = 0.019. The subgroup analyses showed the most efficacy in a higher dose and short intervention period and in subjects with deficient vitamin D status. CONCLUSION Vitamin D supplementation might be beneficial for the reduction of FPG, HbA1c, and HOMA-IR in type 2 diabetes patients with deficient vitamin D status. This effect was especially prominent when vitamin D was given in large doses and for a short period of time albeit with substantial heterogeneity between studies and a probability of publication bias.
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Affiliation(s)
- Mohammad Ashraf Farahmand
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
- Public Health Faculty, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Teresa T Fung
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Fawzia Zahidi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
| | - Maryam Muhammadi
- Critical Nursing Care Department, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Nick Bellissimo
- School of Nutrition, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran.
- Diabetes Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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25-hydroxyvitamin D3 inhibits oxidative stress and ferroptosis in retinal microvascular endothelial cells induced by high glucose through down-regulation of miR-93. BMC Ophthalmol 2023; 23:22. [PMID: 36639741 PMCID: PMC9840274 DOI: 10.1186/s12886-022-02762-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The decrease of vitamin D plays a critical role in diabetes mellitus (DM)-induced oxidative stress and vascular endothelial injury. Therefore, we investigated the effect and mechanism of 25-hydroxyvitamin D3 (25 (OH) D3) on oxidative stress and ferroptosis induced by high glucose in human retinal microvascular endothelial cells (hRMVECs). And the objective of this paper was to propose a new strategy for the prevention and treatment of diabetic retinopathy (DR). METHODS First, hRMVECs were transfected with mimics NC or miR-93. After that, cells were treated with 100 nM / 500 nM 25 (OH) D3 and then cultured in a high glucose (30 mM) environment. Subsequently, qRT-PCR was employed to detect the expression level of miR-93; CCK-8 for the proliferation of cells in each group; biochemical tests for the level of intracellular reactive oxygen species (ROS), malondialdehyde (MDA), reduced glutathione (GSH) and ferrous ion (Fe2+); and Western blot for the expression of ferroptosis-related proteins glutathione peroxidase 4 (GPX4) and SLC7A11). RESULTS Under a high glucose environment, 25 (OH) D3 at 100 nM/500 nM could significantly promote the proliferation of hRMVECs, remarkably decrease the level of intracellular ROS/MDA, and up-regulate the level of GSH. Besides, 25 (OH) D3 greatly reduced Fe2+ level in the cells while increased protein level of GPX4 and SLC7A11. Subsequently, we found that high glucose induced miR-93 expression, while 25 (OH) D3 markedly decreased high glucose-induced miR-93 overexpression. Furthermore, overexpression of miR-93 inhibited the functions of 25 (OH) D3 by activating ROS (ROS and MDA were up-regulated while GSH was down-regulated) and inducing Fe2+ (Fe2+ level was up-regulated while GPX4 and SLC7A11 level was down-regulated) in cells. CONCLUSION 25 (OH) D3 may inhibit oxidative stress and ferroptosis in hRMVECs induced by high glucose via down-regulation of miR-93.
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Liu Z, Asuzu P, Patel A, Wan J, Dagogo-Jack S. Association of bone mineral density with prediabetes risk among African-American and European-American adult offspring of parents with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 13:1065527. [PMID: 36686435 PMCID: PMC9849381 DOI: 10.3389/fendo.2022.1065527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is associated with alterations in bone mineral density (BMD), but association between prediabetes and BMD is unclear. Methods We analyzed BMD among the initially normoglycemic participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study in relation to incident prediabetes during 5 years of follow-up. Results and Discussion A total of 343 participants (193 Black, 150 White) underwent DEXA during Year 1 of POP-ABC and were followed quarterly for 5 years. The mean age was 44.2 ± 10.6 years; BMI was 30.2 ± 7.23 kg/m2. At baseline, the mean BMD was 1.176 ± 0.135 g/cm2 (1.230 ± 0.124 g/cm2 in men vs. 1.154 ± 0.134 g/cm2 in women, P<0.0001; 1.203 ± 0.114 g/cm2 in Black vs. 1.146 ± 0.150 g/cm2 in White participants, P=0.0003). During 5 years of follow-up, 101 participants developed prediabetes and 10 subjects developed T2DM (progressors); 232 were nonprogressors. Progressors to prediabetes had numerically higher baseline BMD and experienced lower 1-year decline in BMD (P<0.0001) compared with nonprogressors. From Kaplan-Meier analysis, the time to 50% prediabetes survival was 2.15 y among participants in the lowest quartile of baseline BMD, longer than those in higher quartiles (1.31 - 1.41 y). Values for BMD correlated inversely with age and adiponectin levels, and positively with BMI. In logistic regression analysis, BMD z score significantly predicted incident prediabetes: more negative BMD z scores were associated with decreased incident prediabetes (odds ratio 0.598 [95% confidence interval 0.407 - 0.877], P=0.0085), after controlling for age, BMI, change in BMI, ethnicity, blood glucose and adiponectin. Conclusions Among initially normoglycemic individuals, higher baseline BMD was associated with higher risk of incident prediabetes during 5 years of follow-up.
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Affiliation(s)
- Zhao Liu
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Peace Asuzu
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Avnisha Patel
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Jim Wan
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
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22
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Robison B, Wright C, Smith S, Philipp T, Yoo J. Vitamin D deficiency during the perioperative period increases the rate of hardware failure and the need for revision fusion in adult patients undergoing single-level lumbar spine instrumentation surgery. NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 13:100197. [PMID: 36655115 PMCID: PMC9841266 DOI: 10.1016/j.xnsj.2022.100197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023]
Abstract
Background Vitamin D has been shown to play important roles in both calcium homeostasis and bone healing. Only three studies have directly examined the relationship between vitamin D deficiency and hardware failure, nonunion, and/or revision surgery. Results are contradictory and none were large enough to provide the statistical power necessary to make definitive conclusions. Methods A retrospective analysis was performed utilizing the PearlDiver national insurance claims database consisting of 91 million individual patient records. Patients aged 30 and over who underwent a non-segmental posterior lumbar fusion procedure (CPT-22840) in 2012-2019 were included. Data collected included, hardware failure, revision surgery occurrence, and vitamin D deficiency. Hardware failure and revision rates were compared between vitamin D deficient and non-deficient groups. We ran a logistic regression analysis using the following variables: age, Charlson Comorbidity Index (CCI), gender, vitamin D deficiency, obesity, tobacco use, diabetes, osteoporosis, rheumatoid arthritis, and Crohn's disease. Results 108,137 patients matching inclusion criteria were identified, with an overall hardware failure rate of 2.7% and revision rate of 4.1%. Failure rates were significantly higher for patients diagnosed with vitamin D deficiency during the full queried period (3.3% vs. 2.6%, OR = 1.26; p < 0.0001), as were revision rates (4.3% vs 3.5%, OR = 1.25; p < 0.0001). Patients diagnosed with deficiency pre-surgery, higher failure (3.1% vs 2.6%, OR = 1.19; p < 0.01) and rates of revision (4.4% vs 3.5%, OR = 1.27; p < 0.0001) were increased compared to the non-deficient group. In the logistic regression analysis, vitamin D deficiency remains a significant contributor to hardware failure and revision surgery. Conclusions These results demonstrate that pre- and/or post-operative vitamin D deficiency is independently correlated with risk for hardware failure and revision surgery in single-level lumbar fusion patients.
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Affiliation(s)
- Bianca Robison
- Department of Orthopedics and Rehabilitation, Oregon Health & Science University, OHSU. 3181 SW Sam Jackson Park Rd, Mail Code OP-31, Portland, OR 97239, USA
| | - Christina Wright
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Spencer Smith
- Department of Orthopedics and Rehabilitation, Oregon Health & Science University, OHSU. 3181 SW Sam Jackson Park Rd, Mail Code OP-31, Portland, OR 97239, USA
| | - Travis Philipp
- Department of Orthopedics and Rehabilitation, Oregon Health & Science University, OHSU. 3181 SW Sam Jackson Park Rd, Mail Code OP-31, Portland, OR 97239, USA
| | - Jung Yoo
- Department of Orthopedics and Rehabilitation, Oregon Health & Science University, OHSU. 3181 SW Sam Jackson Park Rd, Mail Code OP-31, Portland, OR 97239, USA,Corresponding author.
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23
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Young-Hyman D, Gabbay RA, on behalf of the American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S68-S96. [PMID: 36507648 PMCID: PMC9810478 DOI: 10.2337/dc23-s005] [Citation(s) in RCA: 119] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Li H, Xie X, Bai G, Qiang D, Zhang L, Liu H, He Y, Tang Y, Li L. Vitamin D deficiency leads to the abnormal activation of the complement system. Immunol Res 2023; 71:29-38. [PMID: 36178657 PMCID: PMC9845165 DOI: 10.1007/s12026-022-09324-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/19/2022] [Indexed: 01/21/2023]
Abstract
Vitamin D deficiency can damage the human immune system, and the complement system is a key component of the immune system. This study aimed to elucidate the mechanism by which vitamin D affects the immune system by analyzing the changes in the protein expression of the complement system under different vitamin D levels. We selected 40 participants and divided them into three groups according to their serum levels of 25-hydroxyvitamin D (25(OH)VD): group A, 25(OH)VD ≥ 40 ng/mL; group B, 30 ng/mL ≤ 25(OH)VD < 40 ng/mL; and group C, 25(OH)VD < 30 ng/mL. Serum samples were subjected to biochemical analysis, followed by proteomic analysis using high-throughput untargeted proteomic techniques. Vitamin D deficiency increased the levels of fasting blood sugar, fasting serum insulin, and homeostasis model assessment (HOMA) of insulin resistance and decreased the secretion of HOMA of β-cell function, which led to insulin resistance and glucose metabolism disorder. Moreover, vitamin D deficiency resulted in the abnormal expression of 56 differential proteins, among which the expression levels of complement factor B, complement component C9, inducible co-stimulator ligand, and peptidase inhibitor 16 significantly changed with the decrease in vitamin D content. Functional enrichment analysis of these differential proteins showed that they were mainly concentrated in functions and pathways related to insulin secretion and inflammation. In conclusion, vitamin D deficiency not only contributes to insulin resistance and glucose metabolism disorder but also causes abnormal protein expression, resulting in the abnormal activation of the complement system. This study provides a novel theoretical basis for further studies on the relationship between vitamin D and the immune system.
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Affiliation(s)
- Huan Li
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Xiaomin Xie
- Department of Endocrinology, The First People's Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001, China.
| | - Guirong Bai
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Dan Qiang
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Li Zhang
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Huili Liu
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Yanting He
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Yanpan Tang
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
| | - Ling Li
- Department of Endocrinology, The First People’s Hospital of Yinchuan, Ningxia Hui Autonomous Region, No. 2, Liqun West Street, Xingqing District, Yinchuan, 750001 China
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Singh V, Jain S, Prakash S, Thakur M. Studies on the synergistic Interplay of Vitamin D and K for Improving Bone and Cardiovascular Health. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Nutrients perform their roles either directly or through interaction with other nutrients inside our body. The nature of interactions between nutrients can be synergistic, which brings about maximum benefit to the host, or antagonistic, i.e., one nutrient affects the uptake and availability of other nutrients in the body. These interactions need to be critically analysed and acknowledged to harness their positive health benefits. Combining nutrients having a synergistic effect may help in lowering the threat of cardiovascular ailment, osteoporosis, and other health issues. This study aims to qualitatively review the information that is currently available upon the synergistic effects of co-supplementing Vitamin D and K on bone and cardiovascular health among various age groups. The methodology followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A structured search of two databases-PubMed and Google Scholar—was carried out, and articles were identified that focused upon the dual supplementation of Vitamin D and K, which has been shown to improve bone and cardiovascular health among users. The search was restricted to the English language, conducted, and published between 2006 and 2021. Overall, 12 studies involving 8216 participants were included in the qualitative analysis. Among these, 5 were randomized controlled trials, 6 were observational studies, and 1 was interventional studies. The results were interpreted based on improved bone health by assessing the progress in Bone Mineral Content (BMC), lower extremity function, Bone Mineral Density (BMD), and bone turnover. In contrast, improvement in cardiovascular health was recorded based on the Carotid Intima-media Thickness (CIMT), arterial stiffness, high systolic and diastolic blood pressure, and the structure of the heart. Out of a total 12 studies, 11 studies showed that Vitamin D work in synergy with Vitamin K and also has a significant role in improving bone fractures, low BMD, and cardiovascular disorders. Further research and clinical trials on these Vitamins in different age groups and disease conditions are warranted.
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Affiliation(s)
- Vinita Singh
- 1Amity Institute of Food Technology, Amity University Uttar Pradesh, India
| | - Shravali Jain
- 1Amity Institute of Food Technology, Amity University Uttar Pradesh, India
| | - Satya Prakash
- 2Sardar Vallabhbhai Patel University of Agriculture andTechnology, Meerut, Uttar Pradesh, India
| | - Monika Thakur
- 1Amity Institute of Food Technology, Amity University Uttar Pradesh, India
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Liu J, Fu L, Jin S, Jia Y, Zhang J, Sun C, Na L. Vitamin D status in children and its association with glucose metabolism in northern China: a combination of a cross-sectional and retrospective study. BMJ Open 2022; 12:e061146. [PMID: 36446458 PMCID: PMC9710338 DOI: 10.1136/bmjopen-2022-061146] [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] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to explore the vitamin D status of children in northern China and the association between vitamin D and glucose metabolism. DESIGN Cross-sectional study was conducted among child participants and retrospective study designs were conducted among adult participants. SETTING AND PARTICIPANTS Both studies were recruited from Harbin, 326 children were included in children's study, 8469 adults were included in adult study. PRIMARY AND SECONDARY OUTCOME MEASURES Physical examination, lifestyle and dietary habit data were recorded in all the participants. Serum insulin, glucose, 25(OH)D3 concentrations in children and serum glucose and lipids levels in adults were measured. Rickets history was also investigated in adults, which was used to define vitamin D deficiency in childhood. The associations were tested by linear regression and binary logistic regression. RESULT In the children's study, only 10.7% of participants were vitamin D sufficient (≥30 ng/mL). Inverse correlations between serum 25(OH)D3 concentration and fasting insulin and homeostasis model assessment - insulin resistance (HOMA-IR) were found, and children with lower serum 25(OH)D3 concentrations were likely to have insulin resistance (IR) (OR: 0.955, 95% CI: 0.917 to 0.995, p value: 0.027). In an adult study, rickets in childhood increased the risk of type 2 diabetes in male participants (OR=1.414, 95% CI=1.013 to 1.972; p value=0.042), but this result was not observed in female participants. CONCLUSION Our findings suggest that vitamin D deficiency is widespread in northern China. Vitamin D deficiency in childhood was associated with IR and increased the risk of type 2 diabetes in male adults.
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Affiliation(s)
- Junyi Liu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liqun Fu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shanshan Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yubing Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyi Zhang
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixin Na
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
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27
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Ahluwalia N, Raghavan R, Zhang G, Talegawkar SA, Jacques PF. Vitamin D status and prevalence of metabolic syndrome by race and Hispanic origin in US adults: findings from the 2007-2014 NHANES. Am J Clin Nutr 2022; 116:1400-1408. [PMID: 36036472 PMCID: PMC10474946 DOI: 10.1093/ajcn/nqac234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Vitamin D status has been found to be inversely associated with metabolic syndrome (MetS) in some studies. Vitamin D status varies by race and ethnicity, and the association of MetS with vitamin D status in US adults and by race and Hispanic origin has not been evaluated extensively. OBJECTIVES We aimed to examine the associations between vitamin D status and MetS overall, and across race and Hispanic origin groups, in a nationally representative sample of US adults who participated in the NHANES from 2007 to 2014. METHODS The total sample included 8639 adults, ≥20 y of age. Serum vitamin D was measured using a standardized LC-tandem MS method and was categorized using data-driven tertiles. MetS was defined using measured waist circumference, triglycerides, HDL cholesterol, blood pressure, and fasting glucose. Multivariable logistic regression models were fitted [accounting for sociodemographic and lifestyle factors, dietary supplement use, and BMI (in kg/m2)] to examine the associations of serum vitamin D with MetS among adults overall, and by race and Hispanic origin. RESULTS Serum vitamin D in the lowest tertile (≤56 nmol/L) was significantly associated with increased odds of MetS compared with the highest tertile (>77.9 nmol/L) (fully adjusted model OR: 1.85; 95% CI: 1.51, 2.27). Inverse associations were noted for all race-Hispanic origin groups: non-Hispanic white (NHW) (OR: 2.24; 95% CI: 1.67, 3.01), non-Hispanic black (OR: 1.56; 95% CI: 1.06, 2.29), and Hispanic (OR: 1.48; 95% CI: 1.03, 2.14) adults. CONCLUSIONS Lower vitamin D status was significantly associated with MetS among US adults after adjusting for sociodemographic and lifestyle factors, dietary supplement use, and BMI. This finding was noted across all race and Hispanic origin groups, although the strength of the association varied, being strongest for NHW adults.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of National Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA.
| | - Ramkripa Raghavan
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Guangyu Zhang
- Division of Research and Methodology, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Paul F Jacques
- USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Pastukhova Y, Luzza F, Shevel S, Savchuk O, Ostapchenko L, Falalyeyeva T, Molochek N, Kuryk O, Korotkyi O, Kobyliak N. Changes in Metabolic Parameters in Patients with Diabetic Kidney Disease Depending on the Status of D3. Rev Recent Clin Trials 2022; 17:280-290. [PMID: 35319388 DOI: 10.2174/1574887117666220321152855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Type 2 diabetes is a metabolic disease characterized by hyperglycemia as a result of insulin resistance and decreased insulin secretion. A relatively large number of patients with this type of diabetes have abdominal obesity, which also affects insulin resistance development. Chronic hyperglycemia can lead to damage and dysfunction of various organs, and a striking example is diabetic nephropathy. Diabetic nephropathy is a specific kind of kidney damage that occurs due to complications of diabetes and is accompanied by the formation of diffuse or nodular glomerulosclerosis, which can lead to terminal renal failure and requires immediate substitution through renal therapy or renal transplantation. Diabetic nephropathy is diagnosed with albuminuria and a decrease in the rate of glomerular filtration. METHODS This review was based on a literature search for the most important evidence of vitamin D as a possible method of prevention for obesity, type 2 diabetes, and diabetic nephropathy. Collected published articles were summarized according to their overall themes. RESULTS In this review, we considered vitamin D as a possible method of treatment for type 2 diabetes, as well as its complications, including diabetic nephropathy. CONCLUSION Studies show that vitamin D inhibits the renin-angiotensin-aldosterone system, resulting in improved renal function in diabetic nephropathy. Vitamin D also has antiinflammatory, antiproliferative, and anti-metastatic effects, which improve endothelial function.
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Affiliation(s)
| | | | | | | | | | | | | | - Olena Kuryk
- Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Nazarii Kobyliak
- Bogomolets National Medical University, Kyiv, Ukraine.,Medical Laboratory CSD, Kyiv, Ukraine
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Mehta A, Bansal R, Kaur S. Correlation of oxidative stress with vitamin D and glycated hemoglobin in patients with type 2 diabetes mellitus. Proc AMIA Symp 2022; 36:34-37. [PMID: 36578601 PMCID: PMC9762810 DOI: 10.1080/08998280.2022.2134724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) has a heavy disease burden and is one of the leading causes of death worldwide. It is considered to be evolving from a complex and multifactorial metabolic disorder to an inflammatory condition. The strong link between hyperglycemia and oxidative stress has long been established. Oxidative stress leads to the generation of inflammatory mediators and reactive oxygen species, which results in an inflammatory state, which plays a key role in the pathogenesis of diabetic complications. Vitamin D is also known to affect insulin sensitivity. We aimed to correlate the levels of glycated hemoglobin (HbA1c) and vitamin D with oxidative stress. This cross-sectional study included 100 patients with T2DM. Oxidative stress was estimated by lipid peroxidation assay for activity of malondialdehyde (MDA), as well as superoxide dismutase (SOD) levels. HbA1c was estimated using ion-exchange chromatography. Vitamin D was estimated using enzyme-linked immunosorbent assay. The data were analyzed using a t test. The results showed that as the duration of T2DM increased, the levels of SOD and MDA also increased. No significant correlation was found between SOD and MDA with HbA1c (P = 0.995 and 0.195) and vitamin D (P = 0.874 and 0.051), respectively.
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Affiliation(s)
- Aryan Mehta
- Department of Biochemistry, Government Medical College, Amritsar, Punjab, India
| | - Radha Bansal
- Department of Biochemistry, Government Medical College, Amritsar, Punjab, India
| | - Sukhraj Kaur
- Department of Biochemistry, Government Medical College, Amritsar, Punjab, India,Corresponding author: Sukhraj Kaur, PhD, MSc, Department of Biochemistry, Government Medical College, Amritsar, Circular Road Amritsar, Punjab143001, India (e-mail: )
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30
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Xu Z, Xu J, Li S, Cui H, Zhang G, Ni X, Wang J. S-Equol enhances osteoblastic bone formation and prevents bone loss through OPG/RANKL via the PI3K/Akt pathway in streptozotocin-induced diabetic rats. Front Nutr 2022; 9:986192. [PMID: 36337646 PMCID: PMC9633996 DOI: 10.3389/fnut.2022.986192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to explore whether S-Equol delays diabetes-induced osteoporosis and the molecular mechanisms underlying its therapeutic effects. Materials and methods Thirty-five male Sprague–Dawley rats were randomized into five groups. The diabetic osteoporosis (DOP) group and three S-Equol treatment groups were intraperitoneally injected with streptozotocin (STZ) to develop a DOP model. After the 12-week intervention, bone transformation indicators were detected using an enzyme-linked immunosorbent assay kit; bone mineral density (BMD) and bone microstructure were obtained using dual-energy X-ray absorptiometry and microCT; morphological changes in the bone tissue were investigated using HE staining; bone morphogenetic proteins were detected using immunohistochemical staining. ROS17/2.8 cells were cultured in vitro, and Cell Counting Kit-8 was used to test the protective effects of S-Equol in osteoblastic cells in a high-fat and high-glucose environment. Furthermore, the expression of osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), estrogen receptor β(ERβ), phosphorylated Akt (pAKT)/protein kinase B (AKT), and osteocalcin (OC) in bone tissue and ROS17/2.8 cells was assessed using reverse transcription polymerase chain reaction (RT-PCR) and western blotting. To determine whether ERβ and phosphatidylinositol 3’ -kinase (PI3K)/AKT signaling pathways are involved in the process, LY294002 (PI3K signaling pathway inhibitor) and small interfering RNA targeting ERβ mRNA (si-ERβ) were used to verify the function of the ERβ-mediated PI3K/AKT pathway in this process. Results After the 12-week intervention, S-Equol enhanced BMD, improved bone microarchitecture in DOP rats (P < 0.05), and improved markers of bone metabolism (P < 0.05). In vitro, 10–6 mmol/L S-Equol was selected to significantly protect osteoblasts from high- and high-glucose environments (P < 0.05). Gene expression of OPG, ERβ, pAKT/AKT, and OC was upregulated compared to the DOP group, and RANKL was downregulated compared to the DOP group (P < 0.05) both in bone tissue and osteoblastic cells. The promotion of OPG and pAKT/AKT is mediated by LY294002 and siERβ. Conclusion S-Equol binds to ERβ to regulate OPG/RANKL via the PI3K/AKT pathway and improve DOP. Our results demonstrate the potential role of S-Equol in the treatment of DOP by targeting ERβ. Thus, S-Equol may have the potential to be an adjuvant drug for treating DOP.
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Affiliation(s)
- Zhe Xu
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jing Xu
- Department of Endocrinology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuo Li
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hanqiang Cui
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Guiming Zhang
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiangmin Ni
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Xiangmin Ni,
| | - Jian Wang
- Department of Nutrition, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- *Correspondence: Jian Wang,
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31
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Xu E, Yin C, Yi X, Liu Y. Lifestyle Improvements and Vitamin D Supplementation Play an Important Role in the Prevention of Childhood Diabetes. DISEASE MARKERS 2022; 2022:6133908. [PMID: 36246569 PMCID: PMC9553552 DOI: 10.1155/2022/6133908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was to investigate the characteristics of insulin secretion and the 25-hydroxyvitamin D3 (25(OH)D3) levels in children with obesity. Methods A retrospective analysis was conducted among children who underwent health checkups in the pediatric healthcare department of our hospital from January 2018 to January 2021, and they were divided into a normal group and an obese group according to their BMI. The insulin secretion and the 25(OH)D3 levels of the two groups of children were compared. A total of 721 children were included in the study, including 591 in the normal group and 130 in the obese group, with an obesity rate of 18.03%. Results The blood glucose of the normal group was 4.55 ± 1.75 mmol/L, and the 2 h PG was 7.51 ± 2.11 mmol/L; in the obesity group, they were 6.03 ± 2.16 mmol/L and 8.92 ± 3.24 mmol/L, respectively. The FPG and 2 h PG in the obese group were significantly higher than those in the normal group (all P < 0.05). The incidence of IFG/IGT in the normal group was 5.24% (31/591), and the incidence of DM was 3.71% (22/591); the incidence of IFG/IGT in the obese group was 14.62% (19/130), and the incidence of DM was 13.08% (17/130). The incidences of IFG/IGT and DM in the obese group were significantly higher than those in the normal group (P < 0.05). The FINS of the children in the normal group was 18.46 ± 3.15 μU/mL, and the HOMA-IR was 2.64 ± 0.62; the above indicators in the obese group were 19.11 ± 4.72 μU/mL and 3.01 ± 0.83, respectively. The FINS and HOMA-IR in the obese group were significantly higher than those in the normal group (P < 0.05). The serum 25(OH)D3 level in the normal group was 28.15 ± 5.27 ng/mL, of which 556 cases were normal in 25(OH)D3 and 35 cases were deficient in 25(OH)D3. The serum 25(OH)D3 level in the obese group was 24.35 ± 4.51 ng/mL, of which 112 cases were normal in 25(OH)D3 and 18 cases were deficient in 25(OH)D3. The level of serum 25(OH)D3 in the normal group was significantly higher than that in the normal group, and the ratio of 25(OH)D3 deficiency was significantly lower than that in the normal group (P < 0.05). Conclusions The blood glucose level of childhood obesity was significantly increased, the incidence of abnormal glucose metabolism and diabetes was significantly increased, and the level of 25(OH) vitamin D3 was significantly decreased. Lifestyle improvements and vitamin D supplementation play an important role in the prevention of childhood diabetes. Because the major causes of childhood obesity are excessive caloric intake and lack of exercise, the most effective and direct measures to prevent obesity are a reasonable lifestyle, reasonable eating habits, and moderate exercise. Although genetics are critical, there is no reliable way to eliminate obesity genes in the human body. Therefore, the role of obesity genes is required to be ultimately eliminated by reduced caloric intake and increased physical activity.
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Affiliation(s)
- Erdi Xu
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chunyan Yin
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoqing Yi
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuesheng Liu
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Dimas A, Politi A, Bargiota A, Panoskaltsis T, Vlahos NF, Valsamakis G. The Gestational Effects of Maternal Bone Marker Molecules on Fetal Growth, Metabolism and Long-Term Metabolic Health: A Systematic Review. Int J Mol Sci 2022; 23:ijms23158328. [PMID: 35955462 PMCID: PMC9368754 DOI: 10.3390/ijms23158328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Fetal exposure in adverse environmental factors during intrauterine life can lead to various biological adjustments, affecting not only in utero development of the conceptus, but also its later metabolic and endocrine wellbeing. During human gestation, maternal bone turnover increases, as reflected by molecules involved in bone metabolism, such as vitamin D, osteocalcin, sclerostin, sRANKL, and osteoprotegerin; however, recent studies support their emerging role in endocrine functions and glucose homeostasis regulation. Herein, we sought to systematically review current knowledge on the effects of aforementioned maternal bone biomarkers during pregnancy on fetal intrauterine growth and metabolism, neonatal anthropometric measures at birth, as well as on future endocrine and metabolic wellbeing of the offspring. A growing body of literature converges on the view that maternal bone turnover is likely implicated in fetal growth, and at least to some extent, in neonatal and childhood body composition and metabolic wellbeing. Maternal sclerostin and sRANKL are positively linked with fetal abdominal circumference and subcutaneous fat deposition, contributing to greater birthweights. Vitamin D deficiency correlates with lower birthweights, while research is still needed on intrauterine fetal metabolism, as well as on vitamin D dosing supplementation during pregnancy, to diminish the risks of low birthweight or SGA neonates in high-risk populations.
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Affiliation(s)
- Angelos Dimas
- 3rd University Department of Obstetrics & Gynecology, Attikon University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece
- Obst & Gynae Department, University Hospital of Ioannina, Stavros Niarchos Ave., 45500 Ioannina, Greece
- Correspondence: (A.D.); (G.V.)
| | - Anastasia Politi
- Nephrology Department, University Hospital of Ioannina, Stavros Niarchos Ave., 45500 Ioannina, Greece;
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Medical School, Larissa University Hospital, University of Thessaly, 41334 Larissa, Greece;
| | - Theodoros Panoskaltsis
- 2nd University Department of Obstetrics & Gynecology, “Aretaieion” University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece; (T.P.); (N.F.V.)
| | - Nikolaos F. Vlahos
- 2nd University Department of Obstetrics & Gynecology, “Aretaieion” University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece; (T.P.); (N.F.V.)
| | - Georgios Valsamakis
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, “Aretaieion” University Hospital, 11528 Athens, Greece
- Correspondence: (A.D.); (G.V.)
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Han M, Wu H, Yang W, Chen J. Analysis of risk factors for the development of type 2 diabetes mellitus complicated with Hashimoto's thyroiditis. BMC Endocr Disord 2022; 22:173. [PMID: 35804367 PMCID: PMC9264533 DOI: 10.1186/s12902-022-01092-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS The purpose of this study is to elucidate the correlation between thyroid hormone, glycosylated hemoglobin (HbA1c), vitamin D and type 2 diabetes mellitus (T2DM) with Hashimoto's thyroiditis (HT), and to seek the independent predictors affecting disease development. METHODS The study included 44 T2DM with HT, 94 T2DM, and 112 healthy subjects. We investigated some laboratory factors like thyroid hormone and compared the levels. Independent predictors determination by logistic univariate regression analysis were analyzed. The diagnostic value of thyroid-stimulating hormone (TSH) and threshold concentration were determined by ROC curve. RESULTS In T2DM with HT group, levels of PTH, HbA1c were lower and levels of TSH were significantly higher, when compared with T2DM group. But there was no significant difference in vitamin D between these two groups. In both logistic univariate regression analysis and multiple logistic regression analysis, TSH, HbA1c were independent predictors for T2DM with HT. Based on the ROC curve, the best cut-off value of the TSH was 4 mIU/L (sensitivity 72.7%, specificity 94.6%, AUC = 0.832) for predicting T2DM with HT in T2DM patients. CONCLUSIONS TSH has increased risk for T2DM evolving into T2DM complicated with HT, so it is important to monitor the concentrations of TSH in patients with T2DM. Although vitamin D was not the independent predictor in T2DM with HT development, effect of vitamin D deficiency on the progress of diabetes and its complications should be taken into consideration.
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Affiliation(s)
- Meng Han
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, P.R. China
- Queen Mary School, Nanchang University, Nanchang, 330006, Jiangxi, P.R. China
| | - Haoneng Wu
- School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, P.R. China
| | - Weiming Yang
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, P.R. China
| | - Juanjuan Chen
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, P.R. China.
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Lau SL, Stokes RA, Ng B, Cheng K, Clifton-Bligh R, Gunton JE. Metabolic changes in vitamin D receptor knockout mice. PLoS One 2022; 17:e0267573. [PMID: 35714079 PMCID: PMC9205491 DOI: 10.1371/journal.pone.0267573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/11/2022] [Indexed: 12/02/2022] Open
Abstract
VDR expression has been found in many cell types involved in metabolism, including the beta-cells of the pancreatic islets. Activated vitamin D and its interactions with the vitamin D receptor (VDR) are implicated in glucose homeostasis. We investigated the metabolic phenotype of the VDR-null (VDRKO) mouse at early and middle age. All offspring of heterozygote VDRKO breeding-pairs were fed ‘rescue diet’ from weaning to normalize calcium and phosphate levels in VDRKO and to avoid confounding by different diets. Glucose tolerance testing was performed at 7 and 24 weeks of age. Insulin tolerance testing, glucose-stimulated insulin secretion, body-composition studies and islet isolation were performed at 25–27 weeks. Glucose-stimulated insulin secretion was tested in isolated islets. VDRKO mice had reduced bone density, subcutaneous fat mass and muscle weights compared to WT mice. Despite reduced fat mass, glucose tolerance did not differ significantly. Male but not female VDRKO had improved insulin sensitivity. Global loss of VDR has significant effects on organs involved in energy metabolism and glucose homeostasis. In the setting of decreased fat mass, a clear effect on glucose tolerance was not present.
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Affiliation(s)
- Sue Lynn Lau
- Westmead Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rebecca A. Stokes
- The Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Garvan Institute for Medical Research, Darlinghurst, New South Wales, Australia
| | - Beverly Ng
- Garvan Institute for Medical Research, Darlinghurst, New South Wales, Australia
| | - Kim Cheng
- The Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Garvan Institute for Medical Research, Darlinghurst, New South Wales, Australia
| | - Roderick Clifton-Bligh
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jenny E. Gunton
- Westmead Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Garvan Institute for Medical Research, Darlinghurst, New South Wales, Australia
- * E-mail:
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Coskun G, Sencar L, Tuli A, Dundar Yenilmez E, Polat S. The effect of Vitamin D on testosterone and uncarboxylated osteocalcin levels in aged male rats. Ultrastruct Pathol 2022; 46:368-376. [PMID: 35675386 DOI: 10.1080/01913123.2022.2083280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a well-established complex interaction between vitamin D metabolism and bone and gonad functions. In this study, we aimed to investigate the potential effects of vitamin D therapy on testosterone and osteocalcin (OC) levels in aged male rats. Forty-five adult male rats were divided into three groups in this study. Unlike the control group, the two experimental groups received 50 IU/kg/day and 100 IU/kg/day of vitamin D3 (cholecalciferol), respectively, for a 4-week period using the gavage method. Testicular tissue and blood samples from rats were collected under general anesthesia at the end of the 4-week period. Testicular tissue samples were examined using light and electron microscopy. Additionally, serum testosterone and OC levels were measured in blood samples. The 50 IU/kg dose of cholecalciferol increased testosterone and OC levels, which were lower than normal due to aging, and regulated the organization of the seminiferous tubule epithelium and interstitium more effectively than the 100 IU/kg dose of cholecalciferol. Male fertility functions and bone health, which degrade due to aging, were increased due to the use of exogenous vitamin D, although the higher dose was not associated with more effective results.
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Affiliation(s)
- Gulfidan Coskun
- Department of Histology and Embryology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Leman Sencar
- Department of Histology and Embryology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Abdullah Tuli
- Department of Biochemistry, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ebru Dundar Yenilmez
- Department of Biochemistry, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Sait Polat
- Department of Histology and Embryology, Faculty of Medicine, Cukurova University, Adana, Turkey
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Fong C, Alesi S, Mousa A, Moran LJ, Deed G, Grant S, Tapia K, Ee C. Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients 2022; 14:nu14112295. [PMID: 35684094 PMCID: PMC9182772 DOI: 10.3390/nu14112295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Nutrient supplements are widely used for type 2 diabetes (T2D), yet evidence-based guidance for clinicians is lacking. Methods: We searched the four electronic databases from November 2015−December 2021. The most recent, most comprehensive, high-ranked systematic reviews, meta-analyses, and/or umbrella reviews of randomised controlled trials in adults with T2D were included. Data were extracted on study characteristics, aggregate outcome measures per group (glycaemic control, measures of insulin sensitivity and secretion), adverse events, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessments. Quality was assessed using A Measurement Tool to Assess Systematic Reviews Version 2.0 (AMSTAR 2). Results: Twelve meta-analyses and one umbrella review were included. There was very low certainty evidence that chromium, Vitamin C, and omega-3 polyunsaturated fatty acids (Ω-3 PUFAs) were superior to placebo for the primary outcome of glycated hemoglobin (HbA1c) (Mean Difference/MD −0.54, −0.54 and ES −0.27, respectively). Probiotics were superior to placebo for HbA1c (Weighted Mean Difference/WMD −0.43%). There was very low certainty evidence that Vitamin D was superior to placebo for lowering HbA1c in trials of <6 months (MD −0.17%). Magnesium, zinc, Vitamin C, probiotics, and polyphenols were superior to placebo for FBG. Vitamin D was superior to placebo for insulin resistance. Data on safety was limited. Conclusions: Future research should identify who may benefit from nutrient supplementation, safety, and optimal regimens and formulations.
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Affiliation(s)
- Charmie Fong
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Simon Alesi
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Level 1/43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.A.); (A.M.); (L.J.M.)
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Level 1/43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.A.); (A.M.); (L.J.M.)
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Level 1/43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.A.); (A.M.); (L.J.M.)
| | - Gary Deed
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia;
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.G.); (K.T.)
| | - Kriscia Tapia
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.G.); (K.T.)
- L7/D18 Susan Wakil Health Building, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Western Avenue, Camperdown, NSW 2006, Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.G.); (K.T.)
- Correspondence:
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Maulana RA, Fulyani F, Anjani G. Nanocarriers System for Vitamin D as Nutraceutical in Type 2 Diabetes: A Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Incidence of diabetes are common among population around the world. Diabetes may lead to other complication and increasing morbidity and mortality. Many ways have been done to treat and prevent the development of diabetes. In addition of conventional pharmacotherapy, therapeutic therapy shown good opportunity to maintain and improve diabetic conditions. Vitamin D3 is known as nutraceutical and has good opportunity to develop the medication of type 2 diabetes. In another way, vitamin D3 naturally easy to damage by environmental condition. To overcome this weakness, researcher around the world have developed the method for protecting unstable compound as vitamin D3 with encapsulation. Liprotide is one of the various materials which can be used for encapsulation. Combination of lipid and protein molecules is expected to be a carrier and protector of vitamin D3 in gastrointestinal system. Here we review the research advances of liprotide as nanocarriers and vitamin D3 as nutraceuticals to discuss in applied on type 2 diabetes.
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Tucker LA. Serum, Dietary, and Supplemental Vitamin D Levels and Insulin Resistance in 6294 Randomly Selected, Non-Diabetic U.S. Adults. Nutrients 2022; 14:nu14091844. [PMID: 35565811 PMCID: PMC9100608 DOI: 10.3390/nu14091844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 12/21/2022] Open
Abstract
The primary aim of this study was to determine the associations between serum, dietary, and supplemental vitamin D levels and insulin resistance in 6294 non-diabetic U.S. adults. A total of 8 years of data from the 2011−2018 National Health and Nutrition Examination Survey (NHANES) and a cross-sectional design were utilized to answer the research questions. Serum vitamin D levels were quantified using high-performance liquid chromatography−tandem mass spectrometry. Dietary and supplemental vitamin D intakes were assessed using the average of two 24 h dietary recalls taken 3−10 days apart. The homeostatic model assessment (HOMA), based on fasting glucose and fasting insulin levels, was employed to index insulin resistance. Demographic covariates were age, sex, race, and year of assessment. Differences in physical activity, body mass index (BMI), cigarette smoking, body weight, season, and energy intake were also controlled statistically. Serum levels of vitamin D differed significantly, and in a dose−response order, across quartiles of HOMA-IR, after adjusting for year, age, sex, and race (F = 30.3, p < 0.0001) and with all the covariates controlled (F = 5.4, p = 0.0029). Dietary vitamin D levels differed similarly across HOMA-IR quartiles, but to a lesser extent, respectively (F = 8.1, p = 0.0001; F = 2.9, p = 0.0437). Likewise, supplemental vitamin D levels also differed across the HOMA-IR quartiles, respectively (F = 3.5, p = 0.0205; F = 3.3, p = 0.0272). With all the covariates controlled, the odds of having insulin resistance were significantly greater for those in the lowest quartile of serum and supplemental vitamin D intake compared to the other quartiles combined. In conclusion, in this nationally representative sample, serum, dietary, and supplemental vitamin D were each predictive of insulin resistance, especially in those with low serum levels and those with no supplemental intake of vitamin D.
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Affiliation(s)
- Larry A Tucker
- College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
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Martínez-Montoro JI, García-Fontana B, García-Fontana C, Muñoz-Torres M. Evaluation of Quality and Bone Microstructure Alterations in Patients with Type 2 Diabetes: A Narrative Review. J Clin Med 2022; 11:2206. [PMID: 35456299 PMCID: PMC9024806 DOI: 10.3390/jcm11082206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023] Open
Abstract
Bone fragility is a common complication in subjects with type 2 diabetes mellitus (T2DM). However, traditional techniques for the evaluation of bone fragility, such as dual-energy X-ray absorptiometry (DXA), do not perform well in this population. Moreover, the Fracture Risk Assessment Tool (FRAX) usually underestimates fracture risk in T2DM. Importantly, novel technologies for the assessment of one microarchitecture in patients with T2DM, such as the trabecular bone score (TBS), high-resolution peripheral quantitative computed tomography (HR-pQCT), and microindentation, are emerging. Furthermore, different serum and urine bone biomarkers may also be useful for the evaluation of bone quality in T2DM. Hence, in this article, we summarize the limitations of conventional tools for the evaluation of bone fragility and review the current evidence on novel approaches for the assessment of quality and bone microstructure alterations in patients with T2DM.
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Affiliation(s)
- José Ignacio Martínez-Montoro
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Faculty of Medicine, University of Malaga, 29010 Malaga, Spain;
| | - Beatriz García-Fontana
- Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina García-Fontana
- Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Manuel Muñoz-Torres
- Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
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Gaddas M, Latiri I, Kebaili R, Kacem I, Jaballah N, Maatoug J, Salaani M, Boughammoura L, Ben Saad H. Reversibility of pancreatic β-cells dysfunction after vitamin D and calcium supplementation: a pilot study in a population of obese and prepubescent North-African children. Libyan J Med 2022; 17:2059896. [PMID: 35388742 PMCID: PMC9004520 DOI: 10.1080/19932820.2022.2059896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The mechanisms of diabetogenesis in children remain largely obscure. This study aimed to determine the impact of vitamin D and calcium supplementation on pancreatic β-cells function in terms of insulin secretion and sensitivity. This was a quasi-experimental study involving 30 obese and prepubescent Tunisian children (57% boys). During three months, the children received calcium and vitamin D supplementation at therapeutic doses. An oral glucose tolerance test (OGTT) was performed at the beginning and at the end of the study. The following metabolic definitions were applied: i) hyperinsulinism: insulinemia sum > 300 μ UI/ml during OGTT, ii) insulin-resistance: homeostatic model assessment of insulin-resistance > 2, iii) normal glycaemic profile: normal plasma levels during OGTT without any spike, and iv) pancreatic β-cells dysfunction reversibility: disappearance of the aforementioned disorders. The means ± standard-deviation of age and body mass index were 10.87 ± 1.9 years, and 30.17 ± 4.99 kg/m2, respectively. All children were at the stage of hyperinsulinism associated with insulin-resistance. These disturbances were noted even in children having a normal glycaemic profile at OGTT. After calcium and vitamin D supplementation, glycaemic profile as well as insulin-secretion improved significantly (p < 0.0001). Hyperinsulinism and insulin-resistance decreased significantly by 56.67% (p < 0.0001) and 70.00% (p < 0.0001), respectively. Complete reversibility of these two disorders was noted in 26.6% of children. To conclude, in obese and prepubescent children, vitamin D and calcium supplementation led to the reversibility of the pancreatic β-cells dysfunction.
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Affiliation(s)
- Meriem Gaddas
- Faculté de Médecine de Sousse, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie.,University of Sousse, Farhat HACHED Hospital, Departement of physiology and functional explorations, Sousse, Tunisia Sousse
| | - Imed Latiri
- Faculté de Médecine de Sousse, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie.,Laboratoire de recherche LR12SP09 «Insuffisance cardiaque», Université de Sousse, Hôpital Farhat HACHED, Sousse, Tunisie
| | - Raoudha Kebaili
- Paediatrics Department, Farhat HACHED Hospital of Sousse, University of Sousse, Sousse, Tunisia
| | - Ilhem Kacem
- Basic Health Center «Sousse Jawhara", Outpatient consultation, Sousse, Tunisia
| | - Nesrine Jaballah
- Paediatrics Department, Farhat HACHED Hospital of Sousse, University of Sousse, Sousse, Tunisia
| | - Jihene Maatoug
- Epidemiology Department, Farhat HACHED Hospital of Sousse, University of Sousse, Sousse, Tunisia
| | - Mohamed Salaani
- Paediatrics Department, Farhat HACHED Hospital of Sousse, University of Sousse, Sousse, Tunisia
| | - Lamia Boughammoura
- Paediatrics Department, Farhat HACHED Hospital of Sousse, University of Sousse, Sousse, Tunisia
| | - Helmi Ben Saad
- Faculté de Médecine de Sousse, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie.,University of Sousse, Farhat HACHED Hospital, Departement of physiology and functional explorations, Sousse, Tunisia Sousse.,Laboratoire de recherche LR12SP09 «Insuffisance cardiaque», Université de Sousse, Hôpital Farhat HACHED, Sousse, Tunisie
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Cortese F, Costantino MF, Luzi G, Di Marino S, Giordano P, Monitillo F. Vitamin D and cardiovascular disease risk. A literature overview. Mol Biol Rep 2022; 49:8925-8942. [PMID: 35364717 DOI: 10.1007/s11033-022-07373-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Atherosclerosis and cerebro and cardiovascular disease associated represent the major cause of morbidity and mortality worldwide. Recently, vitamin D deficiency has been considered a new potential risk factor of these conditions. METHODS AND RESULTS In this reviw we briefly describe the biological role of vitamin D, analyze the pathophysiological associations between cardiovascular disease and vitamin D, summarize and synthesize the evidence from literature about the association between vitamin D and cardiovascular disease. RESULTS Vit D is an essential vitamin for bone metabolism and homeostasis. The maintenance of optimal blood levels contributes to the correct homeostasis by influencing different metabolic processes, including those underlying cardiovascular diseases. However, the evidence does not support vitamin D routine administration for the prevention and treatment of cardiovascular disease and intake to achieve specific cardiovascular effects. Evidence shows that maintaining optimal levels of vitamin D, ensures cardiovascular protection.
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Affiliation(s)
- Francesca Cortese
- Cardiology Unit, Azienda Sanitaria Locale di Matera, Viale Salerno, 74015, Policoro, Italy.
| | | | - Giampaolo Luzi
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
| | - Serena Di Marino
- Department of Cardiology, "Valle D'Itria" Hospital, Martina Franca, Taranto, Italy
| | - Paola Giordano
- Department of Pediatrics, Ospedale Pediatrico Giovanni XXIII, "Aldo Moro" University of Bari, Bari, Italy
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Takase T, Tsugawa N, Sugiyama T, Ikesue H, Eto M, Hashida T, Tomii K, Muroi N. Association between 25-hydroxyvitamin D levels and COVID-19 severity. Clin Nutr ESPEN 2022; 49:256-263. [PMID: 35623823 PMCID: PMC8994250 DOI: 10.1016/j.clnesp.2022.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/12/2022] [Accepted: 04/01/2022] [Indexed: 11/05/2022]
Abstract
Background and aims Despite reports on the impact of vitamin D status on coronavirus disease 2019 (COVID-19) severity, the association between low vitamin D status and severe COVID-19 remains unclear. Moreover, researchers have not determined the aforementioned association in Japanese patients. This study aimed to investigate the association between 25-hydroxyvitamin D [25(OH)D] levels and COVID-19 severity in Japanese patients. Methods This retrospective observational study included 117 consecutive patients with COVID-19 admitted to the Kobe City Medical Center General Hospital between October 01, 2020, and January 31, 2021. We measured the serum 25(OH)D levels using blood specimens collected within 5 days of hospital admission using liquid chromatography-tandem mass spectrometry. Results There were 21 (17.9%), 73 (62.4%), 19 (16.2%) and 4 (3.4%) patients with severe deficiency (<10 ng/mL), deficiency (10–<20 ng/mL), insufficiency (20–<30 ng/mL), and sufficiency (≥30 ng/mL) of vitamin D, respectively. In univariate logistic regression analyses, lower serum 25(OH)D levels [odds ratio (OR) 1.18 per 1 ng/mL decrease, 95% confidence interval (CI) 1.04–1.33, p = 0.007] were significantly associated with invasive mechanical ventilation (IMV) or death. In a multivariate logistic regression analysis, low serum 25(OH)D levels [OR 1.22 per 1 ng/mL decrease, 95% CI 1.06–1.40, p = 0.005] were significantly associated with IMV or death. The cut-off value of serum 25(OH)D levels was 10.4 ng/mL, calculated by the receiver operating characteristic curve to detect the requirement for IMV or death. Conclusions To the best of our knowledge, this is the first study to assess the association between vitamin D status and COVID-19 severity in Japanese patients. Low serum 25(OH)D level was detected as an independent risk factor for severe COVID-19 among Japanese patients.
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Ebeling PR, Nguyen HH, Aleksova J, Vincent AJ, Wong P, Milat F. Secondary Osteoporosis. Endocr Rev 2022; 43:240-313. [PMID: 34476488 DOI: 10.1210/endrev/bnab028] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Indexed: 02/07/2023]
Abstract
Osteoporosis is a global public health problem, with fractures contributing to significant morbidity and mortality. Although postmenopausal osteoporosis is most common, up to 30% of postmenopausal women, > 50% of premenopausal women, and between 50% and 80% of men have secondary osteoporosis. Exclusion of secondary causes is important, as treatment of such patients often commences by treating the underlying condition. These are varied but often neglected, ranging from endocrine to chronic inflammatory and genetic conditions. General screening is recommended for all patients with osteoporosis, with advanced investigations reserved for premenopausal women and men aged < 50 years, for older patients in whom classical risk factors for osteoporosis are absent, and for all patients with the lowest bone mass (Z-score ≤ -2). The response of secondary osteoporosis to conventional anti-osteoporosis therapy may be inadequate if the underlying condition is unrecognized and untreated. Bone densitometry, using dual-energy x-ray absorptiometry, may underestimate fracture risk in some chronic diseases, including glucocorticoid-induced osteoporosis, type 2 diabetes, and obesity, and may overestimate fracture risk in others (eg, Turner syndrome). FRAX and trabecular bone score may provide additional information regarding fracture risk in secondary osteoporosis, but their use is limited to adults aged ≥ 40 years and ≥ 50 years, respectively. In addition, FRAX requires adjustment in some chronic conditions, such as glucocorticoid use, type 2 diabetes, and HIV. In most conditions, evidence for antiresorptive or anabolic therapy is limited to increases in bone mass. Current osteoporosis management guidelines also neglect secondary osteoporosis and these existing evidence gaps are discussed.
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Affiliation(s)
- Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia
| | - Hanh H Nguyen
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia.,Department of Endocrinology and Diabetes, Western Health, Victoria 3011, Australia
| | - Jasna Aleksova
- Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia.,Hudson Institute of Medical Research, Clayton, Victoria 3168, Australia
| | - Amanda J Vincent
- Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia.,Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria 3168, Australia
| | - Phillip Wong
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia.,Hudson Institute of Medical Research, Clayton, Victoria 3168, Australia
| | - Frances Milat
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria 3168, Australia.,Hudson Institute of Medical Research, Clayton, Victoria 3168, Australia
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Popli H, Gupta A, Singh V, Agarwal V, Akilan R, Kumar A. Are Low Serum Vitamin D Levels a Risk Factor for Advent of COVID-19 Associated Rhinocerebral Mucormycosis: A Preliminary Case Control Study. Indian J Otolaryngol Head Neck Surg 2022; 74:3529-3533. [PMID: 35036352 PMCID: PMC8751664 DOI: 10.1007/s12070-022-03080-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/01/2022] [Indexed: 12/23/2022] Open
Abstract
To determine whether low serum vitamin D level is a risk factor for development of Rhinocerebral mucormycosis in COVID-19 afflicted patients. A case control study was conducted in a tertiary care hospital utilizing the archived records of COVID-19 afflicted Rhinocerebral mucormycosis cases and age and gender matched controls. The mean value (± standard deviation) of vitamin D level in patients with Mucormycosis was 19.65 ± 13.07 ng/ml and in control subjects it was 27.88 ± 18.04 ng/ml.There was a significant difference between groups (p = 0.02). Thus, low Vitamin D level may be implicated as a risk factor for the advent of mucormycosis in a COVID-19 afflicted patient and therefore Vitamin D supplements may be provided to such patients to achieve normal serum levels.
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Affiliation(s)
- Harsha Popli
- Department of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
| | - Ambika Gupta
- Department of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
| | - Virendra Singh
- Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
| | - Varsha Agarwal
- Department of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
| | - R Akilan
- Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
| | - Adarsh Kumar
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana India
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Qi JW, Huang B, Wang S, Song D, Xu J, Cui Y, Guo B. Association Between Plasma Vitamin D2 and Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne) 2022; 13:897316. [PMID: 35721707 PMCID: PMC9198404 DOI: 10.3389/fendo.2022.897316] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the relationship between plasma vitamin D2(VD2) and type 2 diabetes(T2DM). METHOD Data from electronic medical records of 797 inpatients treated at Sun Yat Sen Memorial Hospital, Sun Yat-sen University between June 24, 2019 and December 24, 2020 were collected, and a total of 596 patients were enrolled after screening based on inclusion and exclusion criteria. Patients were divided into diabetic and non-diabetic groups according to whether they had T2DM. The Wilcoxon rank sum test was finally selected for the analysis of differences between groups according to the distribution of patients' plasma VD2, and logistic regression models were used to find the corresponding influencing factors. RESULT Of the 596 hospitalized patients, 138 (23.15%) were diagnosed with T2DM. The Wilcoxon test showed no statistically significant difference in plasma VD2 concentrations between the T2DM and non-T2DM groups (p=0.833). After adjustment for confounders by multivariate logistic regression, there was still no significant difference in plasma VD2 concentrations between the two groups (P=0.316, OR: 1.15 (0.88,1.49)). The uncorrelated relationship between VD2 and T2DM was not found to change after incorporating 12 indicators, including demographic characteristics, laboratory indicators and complications, into the logistic regression model by 3 steps, even the OR (1.08 (0.92,1.26)) did not change in the 3 models. Similarly, the adjusted ORs agreed that there was no statistical association between VD2 and T2DM. CONCLUSION VD2 levels are similar in patients with T2DM compared to those without T2DM. Clinical caution should be exercised in giving VD2 supplementation to patients with T2DM unless other diseases requiring VD2 supplementation (e.g., rickets, osteoporosis) are present.
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Affiliation(s)
- Jing-Wan Qi
- Department of Microbiology and Biochemical Pharmacy, Pharmaceutical Sciences School of Jinzhou Medical University, Jinzhou, China
| | - Bing Huang
- Research Department, Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian, China
- Research Department, Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Jinzhou, China
| | - Shuang Wang
- Research Department, Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian, China
- Research Department, Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Jinzhou, China
| | - Dan Song
- Research Department, Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian, China
- Research Department, Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Jinzhou, China
| | - Jing Xu
- Research Department, Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian, China
- Research Department, Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Jinzhou, China
| | - Ying Cui
- Research Department, Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian, China
- Research Department, Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Jinzhou, China
| | - Bin Guo
- Department of Microbiology and Biochemical Pharmacy, Pharmaceutical Sciences School of Jinzhou Medical University, Jinzhou, China
- *Correspondence: Bin Guo,
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Mohd Ghozali N, Giribabu N, Salleh N. Mechanisms Linking Vitamin D Deficiency to Impaired Metabolism: An Overview. Int J Endocrinol 2022; 2022:6453882. [PMID: 35859985 PMCID: PMC9293580 DOI: 10.1155/2022/6453882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/19/2022] [Accepted: 06/13/2022] [Indexed: 12/12/2022] Open
Abstract
Vitamin D deficiency is a common health problem worldwide. Despite its known skeletal effects, studies have begun to explore its extra-skeletal effects, that is, in preventing metabolic diseases such as obesity, hyperlipidemia, and diabetes mellitus. The mechanisms by which vitamin D deficiency led to these unfavorable metabolic consequences have been explored. Current evidence indicates that the deficiency of vitamin D could impair the pancreatic β-cell functions, thus compromising its insulin secretion. Besides, vitamin D deficiency could also exacerbate inflammation, oxidative stress, and apoptosis in the pancreas and many organs, which leads to insulin resistance. Together, these will contribute to impairment in glucose homeostasis. This review summarizes the reported metabolic effects of vitamin D, in order to identify its potential use to prevent and overcome metabolic diseases.
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Affiliation(s)
- Nurulmuna Mohd Ghozali
- Department of Physiology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 59100, Malaysia
| | - Nelli Giribabu
- Department of Physiology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 59100, Malaysia
| | - Naguib Salleh
- Department of Physiology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 59100, Malaysia
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Alemam HM, ElJilani MM, Bashein AM. Effect of Intramuscular Injection of Vitamin D on 25-Hydroxyvitamin D Levels, Glycaemic Control, and Liver Enzymes in Libyan Patients with Type 2 Diabetes Mellitus. LIBYAN INTERNATIONAL MEDICAL UNIVERSITY JOURNAL 2022. [DOI: 10.1055/s-0042-1749117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Background Vitamin D is a fat-soluble hormone that plays an important role in glycaemic control. In addition, it has a positive effect on improving liver enzyme function.
Aim This study was performed to examine the effect of intramuscular injection of vitamin D on serum 25-hydroxyvitamin D [25(OH)D] levels, glycemic control, and liver enzymes in Libyan patients suffering from type 2 diabetes mellitus (T2DM) with vitamin D deficiency.
Methods and Materials This cross-sectional study enrolled 100 T2DM (50 males and 50 females). Their serum 25(OH)D, fasting blood glucose (FBG), and liver enzymes were measured at the baseline and 12 weeks after treatment with vitamin D (200,000 IU) injection monthly for 3 months. Data analysis involved the estimation of mean ± standard error (SE) and comparison of means between pre and post-treatment values using paired t-test. Independent t-test was used to compare the means between males and females. The level of significance was set at p < 0.05.
Results Females had a lower 25(OH)D blood levels than males at baseline (7.03 ± 0.25 ng/mL versus 7.86 ± 0.26 ng/mL, respectively p < 0.02). 25(OH)D levels in both sexes was increased significantly from 7.45 ± 0.18 ng/mL to 26.69 ± 0.24 ng/mL after 12 weeks of vitamin D injections (p < 0.001), with no significant differences between male and females. FBG levels in both sexes was significantly decreased from 144.68 ± 1.84 mg/dL to 85.96 ± 0.34 mg/dL post treatment (p < 0.001). Alanine aminotransferase (ALT) was increased from 10.24 ± 0.17 U/L at baseline to 20.34 ± 1.15 U/L post treatment (p < 0.001). Similarly, aspartate aminotransferase (AST) was increased from 11.23 ± 0.21 to 20.57 ± 0.22 U/L (p < 0.001), and alkaline phosphatase (ALP) was decreased from 124.95 ± 1.15 U/L to 111.17 ± 1.27 U/L (p < 0.001). There were no significant differences between male and female liver enzymes either pre- or post-vitamin D injections
Conclusion Treatment with vitamin D injection showed a significant increase in 25(OH)D accompanied by decreased FBG and ALP levels and increased ALT and AST levels. Vitamin D levels should be monitored and adjusted in diabetic patients.
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Affiliation(s)
- Hafsa M. Alemam
- Department of Environment, Food, and Biological Applications, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Mouna M. ElJilani
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Abdulla M. Bashein
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45:S60-S82. [PMID: 34964866 DOI: 10.2337/dc22-s005] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Wang B, Dong H, Li H, Yue X, Xie L. A Probable Way Vitamin D Affects Autism Spectrum Disorder: The Nitric Oxide Signaling Pathway. Front Psychiatry 2022; 13:908895. [PMID: 35722582 PMCID: PMC9199365 DOI: 10.3389/fpsyt.2022.908895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Vitamin D (VD) deficiency during pregnancy and early brain development is an important environmental risk factor for autism spectrum disorder (ASD). Its specific mechanism of action is still unclear. However, one study on the correlation between metabolomics and VD levels in children with ASD has found that the whole-blood arginine (Arg) levels of children with ASD are significantly negatively correlated with serum VD levels, suggesting that the effect of VD on ASD may be related to the signaling pathway involving Arg. Arg is a precursor of nitric oxide (NO), and changes in its levels most directly affect NO levels and signal transduction pathways. NO, a biologically active free radical, is both a neurotransmitter and a neuromodulator in the central nervous system and is related to the pathogeneses of various neurological diseases. The NO signaling pathway is not only affected by VD levels but also closely related to ASD through a series of mechanisms, such as neurotransmitter imbalance, immune disorders, and oxidative stress. Therefore, the effect of VD on ASD may be achieved via regulation of the NO signaling pathway. The current review discusses the relationship among VD, NO, and ASD as suggested by a large body of evidence in the literature in an effort to provide clues for researchers on the pathogenesis of ASD and the mechanism of VD's impact on ASD.
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Affiliation(s)
- Bing Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China.,Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - HanYu Dong
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - HongHua Li
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - XiaoJing Yue
- Department of Developmental and Behavioral Pediatrics, First Affiliated Hospital of Jilin University, Changchun, China
| | - Lin Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
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50
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de Melo FTC, Felício KM, de Queiroz NNM, de Rider Brito HA, Neto JFA, Janaú LC, de Souza Neto NJK, Silva ALA, de Lemos MN, de Oliveira MCNI, de Alcântara AL, de Moraes LV, de Souza ÍJA, Said NM, da Silva WM, de Lemos GN, Dos Santos MC, De Souza D Albuquerque Silva L, Motta ARB, de Figueiredo PBB, de Souza ACCB, Piani PPF, Felício JS. High-dose Vitamin D Supplementation on Type 1 Diabetes Mellitus Patients: Is there an Improvement in Glycemic Control? Curr Diabetes Rev 2022; 18:e010521189964. [PMID: 33413064 DOI: 10.2174/1573399817666210106102643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Some authors evaluated the effect of VD on hyperglycemia in T1DM, but the results remain controversial. This study aims to analyze the effects of high-dose VD supplementation on T1DM patients' glycemic levels, maintaining stable doses of insulin. METHODS Prospective, 12-week clinical trial including 67 T1DM patients, supplemented with high doses of cholecalciferol according to participants' VD value. Patients with VD levels below 30 ng/mL received 10,000 IU/day; those with levels between 30-60 ng/mL received 4,000 IU/day. Patients who had not achieved 25(OH)D levels > 30 ng/ml or presented insulin dose variation during the study were not analyzed. RESULTS Only 46 out of 67 patients accomplished the criteria at the end of the study. There was no general improvement in the glycemic control evaluated by HbA1c (9.4 ± 2.4 vs 9.4 ± 2.6, p=NS) after VD supplementation. However, a post-hoc analysis, based on HbA1c variation, identified patients who had HbA1c reduced at least 0.6% (group 1, N = 13 (28%)). In addition, a correlation between 25(OH)D levels with HbA1c and total insulin dose at the end of the study was observed (r = -0.3, p<0.05; r=-0.4, p<0.05, respectively), and a regression model demonstrated that 25(OH)D was independent of BMI, duration of T1DM and final total insulin dose, being capable of determining 9.2% of HbA1c final levels (Unstandardized B coefficient = -0.033 (CI 95%: -0.064 to -0.002), r2 = 0.1, p <0.05). CONCLUSION Our data suggest that VD is not widely recommended for glycemic control. Nevertheless, specific patients might benefit from this approach.
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Affiliation(s)
- Franciane Trindade Cunha de Melo
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Karem Mileo Felício
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Natércia Neves Marques de Queiroz
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Hana Andrade de Rider Brito
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - João Felício Abrahão Neto
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Luísa Corrêa Janaú
- State University of Pará, Platter Perebebuí, 2623, Marco, Belém, Pará,Brazil
| | - Norberto Jorge Kzan de Souza Neto
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Ana Luíza Aires Silva
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Manuela Nascimento de Lemos
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Maria Clara Neres Iunes de Oliveira
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Angélica Leite de Alcântara
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Lorena Vilhena de Moraes
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Ícaro José Araújo de Souza
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Nivin Mazen Said
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Wanderson Maia da Silva
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Gabriela Nascimento de Lemos
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Márcia Costa Dos Santos
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Lilian De Souza D Albuquerque Silva
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Ana Regina Bastos Motta
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | | | - Ana Carolina Contente Braga de Souza
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - Pedro Paulo Freire Piani
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
| | - João Soares Felício
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil
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