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Xu M, Chen B, Qiao K, Liu S, Su Y, Cai S, Liu Z, Li L, Li Q. Mechanism of Takifugu bimaculatus Skin Peptides in Alleviating Hyperglycemia in Rats with Type 2 Diabetic Mellitus Based on Microbiome and Metabolome Analyses. Mar Drugs 2024; 22:377. [PMID: 39195493 DOI: 10.3390/md22080377] [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: 07/12/2024] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024] Open
Abstract
In this study, we aimed to explore the hypoglycemic effects of a hydrolysate on Takifugu bimaculatus skin (TBSH). The effect of the dipeptidyl peptidase-IV (DPP-IV) inhibitory activities from different TBSH fractions was investigated on basic indexes, gut hormones, blood lipid indexes, viscera, and the gut microbiota and its metabolites in rats with type 2 diabetes mellitus (T2DM). The results showed that the <1 kDa peptide fraction from TBSH (TBP) exhibited a more potent DPP-IV inhibitory effect (IC50 = 0.45 ± 0.01 mg/mL). T2DM rats were induced with streptozocin, followed by the administration of TBP. The 200 mg/kg TBP mitigated weight loss, lowered fasting blood glucose levels, and increased insulin secretion by 20.47%, 25.23%, and 34.55%, respectively, rectified irregular hormonal fluctuations, lipid metabolism, and tissue injuries, and effectively remedied gut microbiota imbalance. In conclusion, TBP exerts a hypoglycemic effect in rats with T2DM. This study offers the potential to develop nutritional supplements to treat T2DM and further promote the high-value utilization of processing byproducts from T. bimaculatus. It will provide information for developing nutritional supplements to treat T2DM and further promote the high-value utilization of processing byproducts from T. bimaculatus.
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Affiliation(s)
- Min Xu
- College of Ocean Food and Bioengineering, Jimei University, Xiamen 361021, China
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Bei Chen
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Kun Qiao
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Shuji Liu
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Yongchang Su
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Shuilin Cai
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Zhiyu Liu
- Key Laboratory of Cultivation and High-Value Utilization of Marine Organisms in Fujian Province, Fisheries Research Institute of Fujian, Xiamen 361013, China
| | - Lijun Li
- College of Ocean Food and Bioengineering, Jimei University, Xiamen 361021, China
| | - Qingbiao Li
- College of Ocean Food and Bioengineering, Jimei University, Xiamen 361021, China
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Cristelo C, Sá AF, Lúcio M, Sarmento B, Gama FM. Vitamin D loaded into lipid nanoparticles shows insulinotropic effect in INS-1E cells. Eur J Pharm Sci 2024; 196:106758. [PMID: 38570054 DOI: 10.1016/j.ejps.2024.106758] [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: 12/05/2023] [Revised: 03/15/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
Increasing evidence suggests a beneficial role of vitamin D (VitD) supplementation in addressing the widespread VitD deficiency, but currently used VitD3 formulations present low bioavailability and toxicity constrains. Hence, poly(L-lactide-co-glycolide) (PLGA) nanoparticles (NPs), solid-lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) were investigated to circumvent these issues. PLGA NPs prepared by emulsification or nanoprecipitation presented 74 or 200 nm, and association efficiency (AE) of 68 % and 17 %, respectively, and a rapid burst release of VitD3. Both SLN and NLCs presented higher polydispersity and larger NPs size, around 500 nm, which could be reduced to around 200 nm by use of hot high-pressure homogenization in the case of NLCs. VitD3 was efficiently loaded in both SLNs and NLCs with an AE of 82 and 99 %, respectively. While SLNs showed burst release, NLCs allowed a sustained release of VitD3 for nearly one month. Furthermore, NLCs showed high stability with maintenance of VitD3 loading for up to one month at 4 °C and no cytotoxic effects on INS-1E cells up to 72 h. A trending increase (around 30 %) on glucose-dependent insulin secretion was observed by INS-1E cells pre-treated with VitD3. This effect was consistently observed in the free form and after loading on NLCs. Overall, this work contributed to further elucidation on a suitable delivery system for VitD3 and on the effects of this metabolite on β cell function.
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Affiliation(s)
- Cecília Cristelo
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Centro de Engenharia Biológica, Universidade do Minho, Campus de Gualtar, Braga, Portugal; ICBAS, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ana Filipa Sá
- Centro de Engenharia Biológica, Universidade do Minho, Campus de Gualtar, Braga, Portugal
| | - Marlene Lúcio
- CF-UM-UP, Centro de Física das Universidades do Minho e Porto, Universidade do Minho, Campus de Gualtar, Braga, Portugal; CBMA, Centro de Biologia Molecular e Ambiental, Universidade do Minho, Campus de Gualtar, Braga, Portugal
| | - Bruno Sarmento
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; IUCS-CESPU, Instituto Universitário de Ciências da Saúde, Gandra, Portugal
| | - Francisco Miguel Gama
- Centro de Engenharia Biológica, Universidade do Minho, Campus de Gualtar, Braga, Portugal.
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Amelia CZ, Gwan CH, Qi TS, Seng JTC. Prevalence of vitamin D insufficiency in early pregnancies- a Singapore study. PLoS One 2024; 19:e0300063. [PMID: 38603703 PMCID: PMC11008890 DOI: 10.1371/journal.pone.0300063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/21/2024] [Indexed: 04/13/2024] Open
Abstract
Vitamin D plays an essential role in bone and mineral metabolism. There is increased interest in understanding prevalence of Vitamin D deficiency in pregnancy as many studies report association of low vitamin D levels with obstetric complications and neonatal sequelae. There is a paucity of studies in Singapore evaluating levels of vitamin D levels during the first trimester of pregnancies. We aim to study the prevalence of vitamin D insufficiency in this population. Our study assessed vitamin D levels in these women. Vitamin D (Plasma 25(OH)D concentration) levels in multiracial women during the first trimester were collected via venepuncture at their booking antenatal visit. They were stratified into sufficient ≥30ng/ml, insufficient ≥20ng/ml and <30ng/ml, moderately deficient ≥10ng/ml and <20ng/ml and severely deficient <10ng/ml. 93 women were included in this study. Only 2.2% of our study population had sufficient vitamin D levels. In women who had insufficient levels, the heavier the weight, the more likely to be vitamin D deficient. Interestingly, we also note that the older the patient, the less likely they are to be deficient. In women with periconceptual multivitamin supplementation, the average vitamin D level for those with supplementation was 2.10ng/ml higher than those without. Majority of patients were recruited from a single study member's patient pool who were mostly Chinese. Prevalence of Vitamin D deficiency in general obstetric patients with higher BMI and darker skinned patients may be even lower in Singapore. The high prevalence of Vitamin D insufficiency in our patients prove that it is a prominent problem in our population. We aim to implement screening of vitamin D levels as part of antenatal investigations in the first trimester and recommend supplementation as required. We also hope to evaluate the association of low vitamin D levels with obstetric or neonatal complications further understanding its implications.
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Affiliation(s)
- Chua Zu’Er Amelia
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Chan Hiu Gwan
- Obstetrics and Gynaecology Academic Clinical Programme (OBGYN ACP), SingHealth Services, Singapore, Singapore
- Department of Paediatrics, Endocrinology Service, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Tan Shu Qi
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - John Tee Chee Seng
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
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Eşsiz UE, Yüregir OH, Saraç E. Applying data mining techniques to predict vitamin D deficiency in diabetic patients. Health Informatics J 2023; 29:14604582231214864. [PMID: 37963409 DOI: 10.1177/14604582231214864] [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] [Indexed: 11/16/2023]
Abstract
Vitamin D is among the vitamins necessary for both adults' and children's health. It plays a significant role in calcium absorption, the immune system, cell proliferation and differentiation, bone protection, skeletal health, rickets, muscle health, heart health, disease pathogenesis and severity, glucose metabolism, glucose intolerance, varying insulin secretion, and diabetes. Because the 25-hydroxyvitamin D (25OHD) test, which is used to measure vitamin D is expensive and may not be covered in healthcare benefits in many countries, this study aims to predict vitamin D deficiency in diabetic patients. The prediction method is based on data mining techniques combined with feature selection by using historical electronic health records. The results were compared with a filter-based feature selection algorithm, namely relief-F. Non-valuable features were eliminated effectively with the relief-F feature selection method without any performance loss in classification. The performances of the methods were evaluated using classification accuracy (ACC), sensitivity, specificity, F1-score, precision, kappa results, and receiver operating characteristic (ROC) curves. The analyses have been conducted on a vitamin D dataset of diabetic patients and the results show that the highest classification accuracy of 97.044% was obtained for the support vector machines (SVM) model using radial kernel that contains 18 features.
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Affiliation(s)
- Uğur Engin Eşsiz
- Department of Industrial Engineering, Çukurova University, Adana, Turkey
| | - Oya Hacire Yüregir
- Department of Industrial Engineering, Çukurova University, Adana, Turkey
| | - Esra Saraç
- Department of Computer Engineering, Adana Alparslan Türkeş Science and Technology University, Adana, Turkey
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Jayedi A, Daneshvar M, Jibril AT, Sluyter JD, Waterhouse M, Romero BD, Neale RE, Manson JE, Shab-Bidar S. Serum 25(OH)D Concentration, Vitamin D Supplementation, and Risk of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes or Prediabetes: a Systematic Review and Dose-Response Meta-Analysis. Am J Clin Nutr 2023; 118:697-707. [PMID: 37467897 DOI: 10.1016/j.ajcnut.2023.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Evidence is uncertain about the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and health outcomes in people with type 2 diabetes. OBJECTIVES We aimed to assess the association between vitamin D status and all-cause mortality and cardiovascular disease in people with type 2 diabetes. METHODS We did a systematic search in PubMed, Scopus, CENTRAL, and Web of Science until May 2022. We selected 1) cohort studies investigating the association between serum 25(OH)D concentration and mortality or cardiovascular disease in people with type 2 diabetes or prediabetes and 2) randomized trials of vitamin D supplementation in these patients. We used random-effects pairwise meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CI). RESULTS 21 cohort studies and 6 randomized trials were included. Compared with sufficient vitamin D status (≥50 nmol/L), the RR of all-cause mortality was 1.36 (95% CI: 1.23, 1.49; n = 11 studies, GRADE = moderate) for vitamin D insufficiency (25 to <50 nmol/L), and 1.58 (1.33, 1.83; n = 16, GRADE = moderate) for deficiency (<25 nmol/L). Similar findings were observed for cardiovascular mortality and morbidity but not for cancer mortality. The certainty of evidence ranged from very low to moderate. Dose-response meta-analyses indicated nonlinear associations, with the lowest risk at 25(OH)D ∼60 nmol/L for all-cause and cardiovascular mortality. Supplementation with vitamin D did not reduce the risk of all-cause mortality (RR: 0.96, 95% CI: 0.79, 1.16; risk difference per 1000 patients: 3 fewer, 95% CI: 16 fewer, 12 more; n = 6 trials with 7316 participants; GRADE = low) or the risk of cardiovascular mortality and morbidity (very low- to low-certainty evidence). CONCLUSIONS Vitamin D deficiency and insufficiency are associated with a higher risk of all-cause and cardiovascular mortality in patients with type 2 diabetes or prediabetes. Vitamin D deficiency should be corrected in patients with type 2 diabetes to reach normal serum 25(OH)D concentrations, preferably 60 nmol/L. SYSTEMATIC REVIEW REGISTRATION This systemic review was registered at PROSPERO as CRD42022326429 (=https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=326429).
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - John D Sluyter
- School of Population Health, University of Auckland, New Zealand
| | - Mary Waterhouse
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Briony Duarte Romero
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Sharafi SM, Yazdi M, Goodarzi-Khoigani M, Kelishadi R. Effect of Vitamin D Supplementation on Serum 25-Hydroxyvitamin D and Homeostatic Model of Insulin Resistance Levels in Healthy Pregnancy: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:4-12. [PMID: 36688198 PMCID: PMC9843454 DOI: 10.30476/ijms.2021.90586.2166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/16/2021] [Accepted: 11/01/2021] [Indexed: 01/24/2023]
Abstract
Background Progressive insulin resistance is a physiological condition during pregnancy that can lead to gestational diabetes. Given the association between low blood vitamin D levels and insulin resistance, the present meta-analysis evaluated the effect of vitamin D supplementation on serum 25-hydroxyvitamin D (25[OH]D) and the homeostatic model of insulin resistance (HOMA-IR) levels in non-diabetic pregnant women. Methods A comprehensive literature search was conducted using electronic databases and gateways such as Cochrane Library, Medline, Google Scholar, Science Direct, Web of Sciences, Embase, and Scopus. Articles up to 2020 in both English and Persian were included in the study. The effect of vitamin D supplementation on 25(OH)D and HOMA-IR was determined based on the differences in mean changes from baseline to post-intervention. Weighted mean and 95% confidence intervals (CI) were pooled using a random-effects model. Data were analyzed using STATA software. Results Four studies, including six trials with 380 participants, reported that vitamin D supplementation increased 25(OH)D (mean change: 13.72, 95% CI: 7.28-20.17) and decreased HOMA-IR (mean change: 1.46, 95% CI: 0.56-2.37) levels compared with the placebo group. A high weekly dose of vitamin D further reduced HOMA-IR levels (adjusted R2=77.99, I2 residuals=80.49%, P=0.047). There was no significant association between the dose of vitamin D and 25(OH)D (P=0.974). Intervention duration was not associated with an increase in 25(OH)D (P=0.102), nor with a decrease in HOMA-IR (P=0.623). Conclusion Vitamin D supplementation increased 25(OH)D and decreased HOMA-IR levels in non-diabetic pregnant women. Vitamin D in high doses further reduced HOMA-IR, but did not affect 25(OH)D concentrations.
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Affiliation(s)
- Seyedeh Maryam Sharafi
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Yazdi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoomeh Goodarzi-Khoigani
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Wang C, Li H, Huo L, Wang Q, Zhang T, He X, Hao J, Luo Y, Ren L. Serum 25-Hydroxyvitamin D Levels in Type 2 Diabetes Patients in North China: Seasonality and the Association between Vitamin D Status and Glycosylated Hemoglobin Levels. Int J Clin Pract 2023; 2023:4151224. [PMID: 37188155 PMCID: PMC10181903 DOI: 10.1155/2023/4151224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/17/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Background and Aims Previous studies have reported a correlation between vitamin D levels and seasonality in healthy populations. However, there are few studies on the seasonal variation in vitamin D levels and its relationship with glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to investigate seasonal changes in serum 25-hydroxyvitamin D [25(OH)D] levels and the associations between these vitamin D concentrations and HbA1c levels in T2DM patients in Hebei, China. Methods A cross-sectional study of 1,074 individuals with T2DM was conducted from May 2018 to September 2021. Levels of 25(OH)D in these patients were assessed based on both sex and season, and relevant clinical or laboratory variables that could impact vitamin D status were also considered. Results In the T2DM patient cohort, the mean blood 25(OH)D levels were 17.05 ng/mL. A total of 698 patients (65.0%) had insufficient serum 25(OH)D levels. The vitamin D deficiency rates were significantly higher in the winter and spring compared to the autumn (P < 0.05), indicating that seasonal fluctuations can have a significant impact on 25(OH)D levels. The levels of vitamin D inadequacy were highest in the winter (74%), and females were more likely than males to be deficient (73.4% vs. 59.5%, P < 0.001). In comparison to the winter and spring, both males and females showed higher 25(OH)D levels in the summer (P < 0.001). HbA1c levels were 8.9% higher in those with vitamin D deficiencies than in nondeficient patients (P < 0.001). HbA1c and vitamin D levels were negatively correlated (r = -0.119, P < 0.001). Conclusion Vitamin D deficiencies are particularly prevalent among T2DM patients in Hebei, China, with exceptionally high rates in the winter and spring. Female T2DM patients were at an elevated risk of vitamin D deficiency, and vitamin D levels were negatively correlated with HbA1c.
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Affiliation(s)
- Chang Wang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Huan Li
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Lijing Huo
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang 050051, China
| | - Qing Wang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Tian Zhang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Xiaoyu He
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Jianan Hao
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Yu Luo
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
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Burr AM, Zuckerman PC, Castillo AB, Partridge NC, Parekkadan B. Bioactive, full-length parathyroid hormone delivered using an adeno-associated viral vector. Exp Biol Med (Maywood) 2022; 247:1885-1897. [PMID: 35666091 PMCID: PMC9742744 DOI: 10.1177/15353702221097087] [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: 12/29/2022] Open
Abstract
Delivering the parathyroid hormone (PTH) gene has been attempted preclinically in a handful of studies, but delivering full-length PTH (1-84) using adeno-associated viral (AAV) vectors has not. Given the difficulty in achieving therapeutic levels of secreted proteins using gene therapy, this study seeks to determine the feasibility of doing so with PTH. An AAV vector was used to deliver human PTH driven by a strong promoter. We demonstrate the ability to secrete full-length PTH from various cell types in vitro. PTH secretion from hepatocytes was measured over time and a fluorescent marker was used to compare the secretion rate of PTH in various cell types. Potency was measured by the ability of PTH to act on the PTH receptors of osteosarcoma cells and induced proliferation. PTH showed potency in vitro by inducing proliferation in two osteosarcoma cell lines. In vivo, AAV was administered systemically in immunocompromised mice which received xenografts of osteosarcoma cells. Animals that received the highest dose of AAV-PTH had higher liver and plasma concentrations of PTH. All dosing groups achieved measurable plasma concentrations of human PTH that were above the normal range. The high-dose group also had significantly larger tumors compared to control groups on the final day of the study. The tumors also showed dose-dependent differences in morphology. When looking at endocrine signaling and endogenous bone turnover, we observed a significant difference in tibial growth plate width in animals that received the high-dose AAV as well as dose-dependent changes in blood biomarkers related to PTH. This proof-of-concept study shows promise for further exploration of an AAV gene therapy to deliver full-length PTH for hypoparathyroidism. Additional investigation will determine efficacy in a disease model, but data shown establish bioactivity in well-established models of osteosarcoma.
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Affiliation(s)
- Alexandra M Burr
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Pamela Cabahug Zuckerman
- Department of Orthopedic Surgery, NYU Langone Health, New York University, New York, NY 10016, USA.,Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA.,Rehabilitation Research and Development, Veterans Affairs New York Harbor Healthcare System, New York, NY 11209, USA
| | - Alesha B Castillo
- Department of Orthopedic Surgery, NYU Langone Health, New York University, New York, NY 10016, USA.,Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA.,Rehabilitation Research and Development, Veterans Affairs New York Harbor Healthcare System, New York, NY 11209, USA
| | - Nicola C Partridge
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY 10010, USA
| | - Biju Parekkadan
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
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Associations of Serum Total 25OHD, 25OHD3, and epi-25OHD3 with Insulin Resistance: Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2011–2016. Nutrients 2022; 14:nu14173526. [PMID: 36079784 PMCID: PMC9459885 DOI: 10.3390/nu14173526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Vitamin D may have a role in insulin sensitivity. However, the data on the association between various metabolites of Vitamin D and insulin-related parameters have been limited. Methods: We identified 6026 adults aged 20–80 years who participated in the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Serum total 25OHD, 25OHD3, and epi-25OHD3, fasting glucose, insulin, and HOMA2-IR were obtained from the NHANES data. The association between serum Vitamin D-related values and insulin resistance was analyzed using a generalized linear model. For risk analysis, multifactorial logistic regression was used. Results: The median total 25-hydroxyvitamin D level, 25-hydroxyvitamin D3 level, and 3-epi-25-hydroxyvitamin D3 level were 62.5 nmol/L, 58.8 nmol/L, and 3.3 nmol/L, respectively. After adjustment for sex, age, race, ethnicity, and education status, the ORs for the insulin resistance of participants of total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.32 (95% CI 0.24, 0.43), 0.34 (95% CI 0.26, 0.44), and 0.64 (95% CI 0.53, 0.77), respectively. After an adjustment for body mass index, diabetes, and drinking and smoking, the ORs for the insulin resistance of the participants for total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.56 (95% CI 0.40, 0.78), 0.63 (95% CI 0.46, 0.85), and 0.99 (95% CI 0.80, 1.24), respectively. Conclusions: Our study provides suggestive evidence for the association between Vitamin D concentrations and a lower risk of insulin resistance. Evidence from larger and more adequately powered cohort studies is needed to confirm our results.
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10
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Shao R, Liao X, Lan Y, Zhang H, Jiao L, Du Q, Han D, Ai Q, Mai K, Wan M. Vitamin D regulates insulin pathway and glucose metabolism in zebrafish (Danio rerio). FASEB J 2022; 36:e22330. [PMID: 35474468 DOI: 10.1096/fj.202200334rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/20/2022]
Abstract
1,25-dihydroxyvitamin D3 [1,25(OH)2 D3 ], the most active vitamin D (VD) metabolite, is a steroid hormone playing an important role in many physiological functions in addition to maintaining mineral homeostasis. In this study, we explored the mechanism that the VD regulated insulin pathway and glucose metabolism in zebrafish in vitro and in vivo. Our results show that 1,25(OH)2 D3 significantly enhances the expression of insulin receptor a (insra), insulin receptor substrate 1 (irs1) and glucose transporter 2 (glut2), and promotes glycolysis and glycogenesis, while suppressing gluconeogenesis in zebrafish liver cell line (ZFL) under the condition of high glucose (20 mM), instead of the normal glucose (10 mM). Moreover, consistent results were obtained from the zebrafish fed with VD3 -deficient diet, as well as the cyp2r1-/- zebrafish, in which endogenous VD metabolism is blocked. Furthermore, results from dual-luciferase reporting system exhibited that 1,25(OH)2 D3 directly activated the transcription of insra, rather than insrb in zebrafish by binding to vitamin D response element (VDRE) located at -181 to -167 bp in the promoter region of insra. Importantly, the 1,25(OH)2 D3 treatment significantly alleviated the symptoms of hyperglycemia in diabetic zebrafish. In conclusion, our study demonstrated that VD activates VDRE located in the promoter area of insra in zebrafish to promote insulin/insra signaling pathway, thereby contributing to the maintenance of glucose homeostasis.
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Affiliation(s)
- Rui Shao
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Xinmeng Liao
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Yawen Lan
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Hui Zhang
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Lin Jiao
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Qingyang Du
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China
| | - Dong Han
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
| | - Qinghui Ai
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China.,Pilot National Laboratory of Marine Science and Technology, Qingdao, China
| | - Kangsen Mai
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China.,Pilot National Laboratory of Marine Science and Technology, Qingdao, China
| | - Min Wan
- Key Laboratory of Aquaculture Nutrition and Feed, Ministry of Agriculture & Key Laboratory of Mariculture, Ministry of Education, College of Fisheries, Ocean University of China, Qingdao, China.,Pilot National Laboratory of Marine Science and Technology, Qingdao, China
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11
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KARTAL BAYKAN E, YILDIRIMER Y, DURMAZATAR İ. Tip 2 diyabetli bireylerde serum vitamin D düzeyleri ile mikroalbüminüri arasındaki ilişkinin değerlendirilmesi. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1086114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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12
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Zhang J, Li Y, Lai D, Lu D, Lan Z, Kang J, Xu Y, Cai S. Vitamin D Status Is Negatively Related to Insulin Resistance and Bone Turnover in Chinese Non-Osteoporosis Patients With Type 2 Diabetes: A Retrospective Cross-Section Research. Front Public Health 2022; 9:727132. [PMID: 35223754 PMCID: PMC8873521 DOI: 10.3389/fpubh.2021.727132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives Vitamin D status is closely related to blood glucose and bone metabolism in patients with type 2 diabetes (T2DM). Vitamin D affects bone density and bone metabolism, leading to osteopenia and osteoporosis. Insulin resistance increases the risk of osteoporosis in patients with T2DM. Our previous studies have shown a negative correlation between insulin resistance and 25-hydroxy vitamin D [25(OH)D] levels. The aim of the present study was to determine the association between vitamin D status and insulin resistance and bone metabolism in patients with T2DM. Subjects and Methods A retrospective cross-section research was carried out among 109 non-osteoporosis patients with T2DM. Their fasting blood glucose (FBG), 25(OH)D, fasting blood insulin (FINS), glycosylated hemoglobin (HbA1c), serum creatinine (SCr), calcium (Ca), phosphorus (P), insulin-like growth factor-1 (IGF-1), bone alkaline phosphatase (BALP), body mass index (BMI), glomerular filtration rate (eGFR), homeostatic model estimates of insulin resistance (HOMA-IR), and calcium-phosphorus product were measured routinely. Results Both in men and women, 25(OH)D was negatively correlated with BALP (β = −0. 369, p ≤ 0.001)and HOMA-IR (β = −0.349, p ≤ 0.001), and positively associated with IGF-1(β = 0.672, p ≤ 0.05). There was a negative correlation between HOMA-IR and IGF-1 (β = −0.464, p ≤ 0.001), and a positive correlation between HOMA-IR and BALP (β = 0.344, p ≤ 0.05), adjusted by confounding factors. Conclusion Our study demonstrates that 25(OH)D concentrations are negatively correlated with insulin resistance and bone turnover. Insulin resistance increases with the decrease of 25(OH)D concentration, which can enhance bone turnover, and increases the risk of osteoporosis in non-osteoporosis patients with T2DM. This is the first study to clarify the relationship between serum vitamin D status, insulin resistance, and bone metabolism in non-osteoporosis patients with T2DM in China.
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Affiliation(s)
- Jie Zhang
- Xiamen Second Hospital Affiliated Xiamen Medical College, Xiamen, China
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- *Correspondence: Jie Zhang
| | - Yangjun Li
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Dong Lai
- Xiamen Second Hospital Affiliated Xiamen Medical College, Xiamen, China
| | - Di Lu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Zhenhao Lan
- Xiamen Second Hospital Affiliated Xiamen Medical College, Xiamen, China
| | - Junfei Kang
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Yidong Xu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Shaofang Cai
- Xiamen Second Hospital Affiliated Xiamen Medical College, Xiamen, China
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13
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He X, Luo Y, Hao J, Wang C, Gan K, Zhen Y, Ren L. Association Between Serum Vitamin D Levels and Ketosis Episodes in Hospitalized Patients with Newly Diagnosed Ketosis-Prone Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:3821-3829. [PMID: 36530585 PMCID: PMC9757126 DOI: 10.2147/dmso.s389609] [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: 09/20/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between 25-hydroxyvitamin D (25OHD) and the onset of ketosis in newly diagnosed patients with ketosis-prone type 2 diabetes (KPT2D). PATIENTS AND METHODS A total of 162 patients with non-autoimmune newly diagnosed diabetes mellitus were included in this cross-sectional study. Patients were classified into KPT2D (n = 71) or non-ketotic type 2 diabetes (NKT2D, n = 91). Anthropometric parameters, islet functions, biochemical parameters, and body composition were determined in both KPT2D and NKT2D groups. Correlation analysis was performed to determine the associations between 25OHD and plasma ketones. The risk factors associated with ketosis episodes in patients with new-onset KPT2D were evaluated using binary logistic regression analysis. RESULTS Vitamin D deficiency was observed in both patients with KPT2D and NKT2D. Compared with the NKT2D group, serum 25OHD values were lower in the participants of the KPT2D group [14.20 (10.68, 19.52) vs 16.98 (13.54,2.96) ng/mL, P = 0.011]. Serum 25OHD was associated with plasma ketones (R = -0.387). Serum 25OHD is an independent protective factor for ketosis or ketoacidosis episodes in patients with new onset of KPT2D (P = 0.037, OR = 0.921). CONCLUSION Vitamin D levels are associated with ketosis episodes in patients with KPT2D. Serum 25OHD is an independent protective factor for ketosis episodes in patients with KPT2D.
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Affiliation(s)
- Xiaoyu He
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yu Luo
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, North China University of Science and Technology, Tangshan, Hebei, People’s Republic of China
| | - Jianan Hao
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Cuiyu Wang
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Kexin Gan
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yunfeng Zhen
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Luping Ren
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Correspondence: Luping Ren, Department of Endocrinology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, 050051, People’ s Republic of China, Tel +86 311 859 889 75, Email
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Hamouda HA, Mansour SM, Elyamany MF. Vitamin D Combined with Pioglitazone Mitigates Type-2 Diabetes-induced Hepatic Injury Through Targeting Inflammation, Apoptosis, and Oxidative Stress. Inflammation 2021; 45:156-171. [PMID: 34468908 DOI: 10.1007/s10753-021-01535-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/04/2021] [Indexed: 12/31/2022]
Abstract
Inflammation is a major pathophysiological factor in development of type-2 diabetes mellitus (T2DM). Vitamin D (VITD) plays an imperative role in modulation of several inflammatory responses. The current study aimed to investigate the possible beneficial effects of coadministration of VITD with pioglitazone (PIO), a PPAR-γ agonist, in fructose/streptozotocin (F/STZ) T2DM model in male Wistar rats. T2DM was induced by maintaining rats on 10% (w/v) fructose in drinking water for 9 weeks with an intraperitoneal injection of sub-diabetogenic dose of STZ (35 mg/kg) by the end of the fourth week. One week after STZ injection, PIO (10 mg/kg/day) alone or with VITD (500 IU/kg/day) was administered orally to diabetic rats till the end of the experiment. Blood samples were collected, livers were homogenized to determine biochemical parameters, and samples of livers were fixed in 10% formalin in saline for histological examination. Administration of PIO alone improved diabetes-induced inflammatory and oxidative states besides controlling hyperglycemia and decreasing apoptosis. Coadministration of VIT D with PIO promoted additional improvement in glycemic and lipid profiles, provided further control on diabetic-induced hepatic inflammation evident by downregulating TLR2, TLR4, and IKK-β while upregulating IκB-α expression and reducing inflammatory cytokines namely; NF-κB, TNF-α, IL-6, and IL-1β, decreasing apoptosis and oxidative stress by hampering caspase-3 and MDA contents, respectively, and improved liver histology than PIO alone. These beneficial effects of VIT D may expand its use by diabetics combined with antidiabetic drugs due to its anti-inflammatory, antioxidant, and antiapoptotic properties.
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Affiliation(s)
- Hend A Hamouda
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt. .,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Suzan M Mansour
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.,Department of Pharmacology, Toxicology and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Mohammed F Elyamany
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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15
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Petroni ML, Brodosi L, Marchignoli F, Sasdelli AS, Caraceni P, Marchesini G, Ravaioli F. Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges. Nutrients 2021; 13:nu13082748. [PMID: 34444908 PMCID: PMC8401663 DOI: 10.3390/nu13082748] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Abstract
Unhealthy behaviours, including diet and physical activity, coupled with genetic predisposition, drive type 2 diabetes (T2D) occurrence and severity; the present review aims to summarise the most recent nutritional approaches in T2D, outlining unmet needs. Guidelines consistently suggest reducing energy intake to counteract the obesity epidemic, frequently resulting in sarcopenic obesity, a condition associated with poorer metabolic control and cardiovascular disease. Various dietary approaches have been proposed with largely similar results, with a preference for the Mediterranean diet and the best practice being the diet that patients feel confident of maintaining in the long term based on individual preferences. Patient adherence is indeed the pivotal factor for weight loss and long-term maintenance, requiring intensive lifestyle intervention. The consumption of nutritional supplements continues to increase even if international societies do not support their systematic use. Inositols and vitamin D supplementation, as well as micronutrients (zinc, chromium, magnesium) and pre/probiotics, result in modest improvement in insulin sensitivity, but their use is not systematically suggested. To reach the desired goals, patients should be actively involved in the collaborative development of a personalised meal plan associated with habitual physical activity, aiming at normal body weight and metabolic control.
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Affiliation(s)
- Maria Letizia Petroni
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
- Department of Medical and Surgical Sciences, Alma Mater University of Bologna, I-40138 Bologna, Italy
| | - Lucia Brodosi
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
- Department of Medical and Surgical Sciences, Alma Mater University of Bologna, I-40138 Bologna, Italy
| | - Francesca Marchignoli
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
| | - Anna Simona Sasdelli
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
| | - Paolo Caraceni
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
- Department of Medical and Surgical Sciences, Alma Mater University of Bologna, I-40138 Bologna, Italy
| | - Giulio Marchesini
- Department of Medical and Surgical Sciences, Alma Mater University of Bologna, I-40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-2144889
| | - Federico Ravaioli
- IRCCS-Azienda Ospedaliera di Bologna Sant’Orsola-Malpighi, I-40138 Bologna, Italy; (M.L.P.); (L.B.); (F.M.); (A.S.S.); (P.C.); (F.R.)
- Department of Medical and Surgical Sciences, Alma Mater University of Bologna, I-40138 Bologna, Italy
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Ehrampoush E, Mirzay Razzaz J, Arjmand H, Ghaemi A, Raeisi Shahraki H, Ebrahim Babaei A, Osati S, Homayounfar R. The association of vitamin D levels and insulin resistance. Clin Nutr ESPEN 2021; 42:325-332. [PMID: 33745601 DOI: 10.1016/j.clnesp.2021.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/19/2020] [Accepted: 01/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Vitamin D deficiency and insulin resistance have great prevalence in society. The latest studies indicate an inverse association between Vitamin D levels, insulin resistance, and Type 2 diabetes. The objective of this study was to investigate the effect of vitamin D status on insulin resistance. METHODS In a cross-sectional study, 2160 participants were randomly recruited from a nutrition clinic in Tehran, Iran, 1057 (48.9%) were female and 1103 (51.1%) male. Information was gathered by a questionnaire. Following 12-h fasting, fasting plasma glucose (FPG) and insulin levels, as well as 25-hydroxy vitamin D levels were measured. 2-H glucose and insulin levels measured after consumption of 75 g glucose, HOMA2-IR, and HOMA-β indices were then calculated. RESULTS The average serum Vitamin D was 22.3 + 8.9 nmol/L and the prevalence of Vitamin D deficiency was 100%. There was an inverse relationship between Vitamin D levels and age, BMI, waist circumference, and all metabolic parameters (p < 0.001 in all) and a direct association with levels of exercise. Two logistic regression models were used to adjust for confounding variables; firstly, for age, gender, and smoking and secondly, additionally for BMI and energy intake. Both models showed a significant inverse relationship between Vitamin D levels and FPG and insulin levels, 2-h glucose and insulin levels, and HOMA2-IR. The optimum cut point for vitamin D was calculated at about 25 nmol/L for preventing insulin resistance. CONCLUSION This study illustrated that there is a statistically significant inverse relationship between Vitamin D levels and insulin resistance.
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Affiliation(s)
- Elham Ehrampoush
- Noncommunicable Diseases Research, Fasa University of Medical Sciences, Fasa, Iran
| | - Jalaledin Mirzay Razzaz
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Arjmand
- Students Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Alireza Ghaemi
- Department of Basic Sciences and Nutrition, Health Sciences Research Center, Addiction Institute, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Saeed Osati
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research, Fasa University of Medical Sciences, Fasa, Iran; National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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17
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Xiao P, Dong H, Li H, Yan Y, Cheng H, Liu J, Zhao X, Hou D, Mi J. Adequate 25-hydroxyvitamin D levels are inversely associated with various cardiometabolic risk factors in Chinese children, especially obese children. BMJ Open Diabetes Res Care 2020; 8:e000846. [PMID: 32071197 PMCID: PMC7039595 DOI: 10.1136/bmjdrc-2019-000846] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Vitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population. RESEARCH DESIGN AND METHODS A cross-sectional sample of 6091 children aged 6-18 years was obtained using a cluster sampling method. The 25(OH)D concentrations, and metabolic risk factors, including waist to height ratio, blood pressure, blood lipids, fasting blood glucose (FBG), and insulin were measured. Adjusted ORs and multiplicative or additive interaction were calculated to assess the associations and effect modification, respectively. RESULTS Triglycerides, FBG, insulin, and homeostasis model assessment of insulin resistance were inversely associated with 25(OH)D concentrations (p<0.05) in both sexes. The OR of hyperglycemia among individuals with insufficient vitamin D was higher than those with adequate vitamin D after adjusting for covariates (OR: 1.47; 95% CI 1.26 to 1.70). Moreover, girls with insufficient vitamin D had significantly higher odds for hypertension and high total cholesterol than those with adequate vitamin D, which was not observed in boys. Thirty-two percent (95% CI 14% to 51%) of the increased odds of hyperglycemia can be explained by the interaction between insufficient vitamin D and obesity. CONCLUSIONS Vitamin D insufficiency is associated with increased odds of various cardiometabolic risk factors in Chinese children and has a synergistic effect on hyperglycemia with obesity.
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Affiliation(s)
- Pei Xiao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Hongbo Dong
- Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Haibo Li
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yinkun Yan
- Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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18
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Ghelani DP, Moran LJ, Johnson C, Mousa A, Naderpoor N. Mobile Apps for Weight Management: A Review of the Latest Evidence to Inform Practice. Front Endocrinol (Lausanne) 2020; 11:412. [PMID: 32670197 PMCID: PMC7326765 DOI: 10.3389/fendo.2020.00412] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Over the last decade, mobile technology has emerged as a potentially useful platform to facilitate weight management and tackle the current obesity epidemic. Clinicians are being more frequently asked to give advice about the usefulness of mobile apps and many individuals have already integrated apps into their attempts to manage weight. Hence, it is imperative for clinicians involved in weight management to be aware of the latest developments and knowledge about available mobile apps and their usefulness in this field. A number of newly published studies have demonstrated promising results of mobile-based interventions for weight management across different populations, but the extent of their effectiveness remains widely debated. This narrative literature review synthesizes the latest evidence, primarily from randomized controlled trials (RCTs), regarding the clinical use of mobile applications for weight management, as well as highlight key limitations associated with their use and directions for future research and practice. Overall, evidence suggests that mobile applications may be useful as low-intensity approaches or adjuncts to conventional weight management strategies. However, there is insufficient evidence to support their use as stand-alone intensive approaches to weight management. Further research is needed to clarify the extent of utility of these applications, as well as the measures required to maximize their potential both as stand-alone approaches and adjuncts to more intensive programs.
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Affiliation(s)
- Drishti P. Ghelani
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Cameron Johnson
- Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
- *Correspondence: Negar Naderpoor
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Gallo S, McDermid JM, Al-Nimr RI, Hakeem R, Moreschi JM, Pari-Keener M, Stahnke B, Papoutsakis C, Handu D, Cheng FW. Vitamin D Supplementation during Pregnancy: An Evidence Analysis Center Systematic Review and Meta-Analysis. J Acad Nutr Diet 2019; 120:898-924.e4. [PMID: 31669079 DOI: 10.1016/j.jand.2019.07.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Given the high rates of vitamin D deficiency among pregnant women and possible effects on offspring health, a systematic review on this topic was conducted to help inform future practice guidelines. OBJECTIVE To evaluate associations between maternal vitamin D supplementation, maternal 25-hydroxyvitamin D (25(OH)D) concentrations, and health outcomes. METHODS A PubMed literature search was conducted to identify studies that examined the health effects of vitamin D supplementation during pregnancy on maternal and infant health outcomes published from 2000 to 2016. Among 976 identified publications, 20 randomized clinical trials met the inclusion criteria. The initial search was extended to include five studies published between July 2016 and September 2018. MAIN OUTCOME MEASURES Maternal and infant 25(OH)D concentrations, gestational diabetes, preeclampsia or gestational hypertension, cesarean section, maternal parathyroid hormone and calcium concentrations, and infant gestational age, birth weight, and birth length. STATISTICAL ANALYSES Mean differences, odds ratios, and 95% CIs were calculated, only for the initial search, using separate random-effects meta-analyses for each outcome. RESULTS Evidence was good or strong that maternal vitamin D supplementation significantly increased maternal (13 studies, n=18, mean difference, 14.1 ng/mL [35.2 nmol/L]; 95% CI=9.6-18.6 ng/mL [24.0-46.4 nmol/L]) and infant (nine studies, n=12; 9.7, 5.2, 14.2 ng/mL [24.2, 12.9, 35.5 nmol/L]) 25(OH)D concentrations, although heterogeneity was significant (I2=95.9% and I2=97.4, respectively, P<0.001). Evidence was fair that vitamin D supplementation significantly decreases maternal homeostatic model assessment-insulin resistance (five studies, n=7; -1.1, -1.5, -0.7) and increases infant birth weight (nine studies, n=11, 114.2, 63.4, 165.1 g), both had insignificant heterogeneity. A null effect of maternal supplementation on other maternal (preeclampsia, cesarean section) and infant (gestational age, birth length) outcomes was found. CONCLUSIONS Results show vitamin D supplementation during pregnancy improves maternal and infant 25(OH)D concentrations and may play a role in maternal insulin resistance and fetal growth. To further inform practice and policies on the amount of vitamin D, which supports a healthy pregnancy, high quality dose-response randomized clinical trials, which assess pregnancy-specific 25(OH)D thresholds, and appropriately powered clinical outcomes are needed.
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Fonseca Valle D, Giannini DT. Correlation between vitamin D and blood pressure in adolescents. Int J Adolesc Med Health 2019; 32:/j/ijamh.ahead-of-print/ijamh-2017-0165/ijamh-2017-0165.xml. [PMID: 31562802 DOI: 10.1515/ijamh-2017-0165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/28/2018] [Indexed: 11/15/2022]
Abstract
Introduction Low serum levels of vitamin D have been associated with hypertension worldwide. Hypovitaminosis D has been observed even in countries with high incidence of sunlight all year round. Several studies demonstrated a high prevalence of deficiency/insufficiency of vitamin D in adolescents. Objective To investigate the association between the nutritional status of vitamin D with anthropometric measures and blood pressure in overweight adolescents. Methods This a descriptive and cross-sectional study with overweight adolescents of both sexes aged 12-19 years. The anthropometric data, biochemical profile, blood pressure and serum vitamin D dosage were analyzed. The chi-squared test for verification of association and Student's t-test to compare medians between variables were used. Results There were high frequencies of hypovitaminosis D (34%) and hypertension (43.3%) in overweight adolescents. We observed an inverse correlation between serum vitamin D levels and BP (r = -0.28, p = 0.005). Patients with desirable serum vitamin D had lower body mass index values (31.3 kg/m2 vs. 33.9 kg/m2; p < 0.02), waist circumference (95.2 cm vs. 101.1 cm; p < 0.03), waist-to-height ratio (0.58 vs. 0.61; p < 0.03) and systolic blood pressure (120 mm Hg vs. 127.6 mm Hg; p = 0.007). Conclusions High frequency of vitamin D deficiency is associated with increased BP and adiposity in overweight adolescents.
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Affiliation(s)
- Débora Fonseca Valle
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabe, Rio de Janeiro, Brazil
| | - Denise Tavares Giannini
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabel Rio de Janeiro, Brazil
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21
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Vranić L, Mikolašević I, Milić S. Vitamin D Deficiency: Consequence or Cause of Obesity? ACTA ACUST UNITED AC 2019; 55:medicina55090541. [PMID: 31466220 PMCID: PMC6780345 DOI: 10.3390/medicina55090541] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
Obesity is defined as an excess amount of body fat and represents a significant health problem worldwide. High prevalence of vitamin D (VD) deficiency in obese subjects is a well-documented finding, most probably due to volumetric dilution into the greater volumes of fat, serum, liver, and muscle, even though other mechanisms could not completely be excluded, as they may contribute concurrently. Low VD could not yet be excluded as a cause of obesity, due to its still incompletely explored effects through VD receptors found in adipose tissue (AT). VD deficiency in obese people does not seem to have consequences for bone tissue, but may affect other organs, even though studies have shown inconsistent results and VD supplementation has not yet been clearly shown to benefit the dysmetabolic state. Hence, more studies are needed to determine the actual role of VD deficiency in development of those disorders. Thus, targeting lifestyle through healthy diet and exercise should be the first treatment option that will affect both obesity-related dysmetabolic state and vitamin D deficiency, killing two birds with one stone. However, VD supplementation remains a treatment option in individuals with residual VD deficiency after weight loss.
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Affiliation(s)
- Luka Vranić
- Department of Gastroenterology and Hepatology, University Hospital Centre Rijeka, School of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Ivana Mikolašević
- Department of Gastroenterology and Hepatology, University Hospital Centre Rijeka, School of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Sandra Milić
- Department of Gastroenterology and Hepatology, University Hospital Centre Rijeka, School of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
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22
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Iqbal A, Hussain A, Iqbal A, Kumar V. Correlation Between Vitamin D Deficiency and Diabetic Ketoacidosis. Cureus 2019; 11:e4497. [PMID: 31259115 PMCID: PMC6581328 DOI: 10.7759/cureus.4497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/18/2019] [Indexed: 11/06/2022] Open
Abstract
Both type 1 and type 2 diabetes mellitus have been associated with vitamin D deficiency. Diabetic ketoacidosis, which is a complication of type 1 and, rarely, type 2 diabetes, is also found to be associated with vitamin D levels. This review discusses studies on the correlation between diabetic ketoacidosis and vitamin D levels. Studies show that vitamin D deficiency is associated with the occurrence of diabetic ketoacidosis. Diabetic ketoacidosis is also found to affect vitamin D levels. The possible explanation of diabetic ketoacidosis affecting vitamin D levels is the inactivity of the 1-alpha-hydroxylase enzyme and an increase in the renal excretion of vitamin D binding proteins. The presence of vitamin D receptors on pancreatic beta cells explains the role of vitamin D in the causation of diabetic ketoacidosis.
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Affiliation(s)
- Aqsa Iqbal
- Cardiology, University of Illinois at Chicago, Chicago, USA
| | - Abid Hussain
- Internal Medicine, Nishtar Medical College, Multan, PAK
| | - Anum Iqbal
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Vinesh Kumar
- Internal Medicine, Ghulam Mohammad Mahar Medical College, Sukkur, PAK
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23
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Heath AK, Williamson EJ, Hodge AM, Ebeling PR, Eyles DW, Kvaskoff D, O'Dea K, Giles GG, English DR. Vitamin D status and the risk of type 2 diabetes: The Melbourne Collaborative Cohort Study. Diabetes Res Clin Pract 2019; 149:179-187. [PMID: 29782935 DOI: 10.1016/j.diabres.2018.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/13/2018] [Accepted: 05/08/2018] [Indexed: 12/31/2022]
Abstract
AIMS Inverse associations between vitamin D status and risk of type 2 diabetes observed in epidemiological studies could be biased by confounding and reverse causality. We investigated the prospective association between vitamin D status and type 2 diabetes and the possible role of reverse causality. METHODS We conducted a case-cohort study within the Melbourne Collaborative Cohort Study (MCCS), including a random sample of 628 participants who developed diabetes and a sex-stratified random sample of the cohort (n = 1884). Concentration of 25-hydroxyvitamin D (25(OH)D) was measured using liquid chromatography-tandem mass spectrometry in samples collected at recruitment. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of type 2 diabetes for quartiles of 25(OH)D relative to the lowest quartile and per 25 nmol/L increase in 25(OH)D, adjusting for confounding variables. RESULTS The ORs for the highest versus lowest 25(OH)D quartile and per 25 nmol/L increase in 25(OH)D were 0.60 (95% CI: 0.44, 0.81) and 0.76 (95% CI: 0.63, 0.92; p = 0.004), respectively. In participants who reported being in good/very good/excellent health approximately four years after recruitment, ORs for the highest versus lowest 25(OH)D quartile and per 25 nmol/L increase in 25(OH)D were 0.46 (95% CI: 0.29, 0.72) and 0.71 (95% CI: 0.56, 0.89; p = 0.003), respectively. CONCLUSIONS In this sample of middle-aged Australians, vitamin D status was inversely associated with the risk of type 2 diabetes, and this association did not appear to be explained by reverse causality.
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Affiliation(s)
- Alicia K Heath
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010, Australia; Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia; Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Elizabeth J Williamson
- Farr Institute of Health Informatics Research, 222 Euston Rd, Kings Cross, London NW1 2DA, UK; Department of Medical Statistics, London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK
| | - Allison M Hodge
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010, Australia; Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Monash Medical Centre, Clayton, Victoria 3168, Australia
| | - Darryl W Eyles
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland 4072, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia
| | - David Kvaskoff
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland 4072, Australia
| | - Kerin O'Dea
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010, Australia; Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010, Australia; Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia.
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Deswal R, Nanda S, Dang AS. Unveiling the association between Vitamin D Receptor and Poly Cystic Ovary Syndrome - a systematic review and meta-analysis. INT J VITAM NUTR RES 2019; 87:207-218. [PMID: 30702031 DOI: 10.1024/0300-9831/a000298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Low Vitamin D status observed in the populations globally and its associations with diverse systems have kindled the interest for Vitamin D in medical literature in last two decades. Accumulating evidence manifest that deficiency of Vitamin D might be a causal factor in the pathogenesis of various features of Poly Cystic Ovary Syndrome (PCOS). This notion is supported by the fact that > 3 % of the human genome is regulated by vitamin D receptor (VDR). Therefore, this meta-analysis was carried out to quantify the magnitude of risk associated with VDR polymorphisms (BsmI, TaqI, FokI and ApaI) and PCOS susceptibility. Methods: Pub-med, EMBASE, Cochrane database, Science direct, Scirus, ISI web of knowledge and Google scholar were searched for all years until July 2016. The case control studies related to VDR polymorphism and PCOS risk were selected according to inclusion and exclusion criteria. Nine studies of the initial 553 hits reporting VDR polymorphism in PCOS were included. All statistical analysis was performed using the STATA 11.0 software and odd ratio with 95 % confidence intervals was used as effect size to assess the strength of associations. Results: Nine studies comprising 1558 cases and 1033 controls were included in this meta-analysis. Significant association between VDR Fok1 polymorphisms and PCOS risk was observed. In further stratified analysis, an increased risks were observed among Asian and African populations for Taq1 polymorphism. Apa1 and Bsm1 polymorphism was found not to be a risk factor for PCOS susceptibility. Conclusion: The FokI polymorphism is found to be a significant risk factor for PCOS.
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Affiliation(s)
- Ritu Deswal
- 1 Centre for Medical Biotechnology, Maharshi Dayanand University, Haryana, India
| | - Smiti Nanda
- 2 Department of Obstetrics and Gynecology, PGIMS, Haryana, India
| | - Amita Suneja Dang
- 1 Centre for Medical Biotechnology, Maharshi Dayanand University, Haryana, India
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25
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Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr 2018; 121:42-54. [DOI: 10.1017/s0007114518003057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractThis study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th–13th, 20th–26th and 30th–36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography–tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=−0·12; 95 % CI −0·251, 0·009;P=0·069) and adiponectin (β=−0·070; 95 % CI −0·150, 0·010;P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=−0·253; 95 % CI −0·044, 0·550;P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.
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26
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Karefylakis C, Särnblad S, Ariander A, Ehlersson G, Rask E, Rask P. Effect of Vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men-a randomized controlled trial. Endocrine 2018; 61:388-397. [PMID: 29978375 PMCID: PMC6105237 DOI: 10.1007/s12020-018-1665-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/25/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Several observational studies have shown an association between vitamin D deficiency and non-skeletal major health issues including impaired cardiorespiratory fitness and adiposity. Only a few studies have examined the impact of vitamin D supplementation on these conditions and the results are ambiguous. The aim of this study was to examine the effect of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight/obese men with vitamin D deficiency. METHODS This study was a prospective, placebo controlled, double blinded, randomized trial with a study period of 6 months. Forty overweight/obese men (BMI > 25 kg/m2) with vitamin D deficiency (25(OH)D ≤ 55 nmol/L) were randomized to receive either 2000 IU Cholecalciferol drops or the equivalent amount of drops of placebo. At baseline and follow up body composition and cardiorespiratory fitness were measured and blood samples were obtained. Body composition was measured using bioelectrical impedance analysis (BIA) and cardiorespiratory fitness using cardiopulmonary exercise test (CPET). The primary outcomes were changes in percentage body fat and in maximum oxygen uptake (VO2max). RESULTS No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat (p = 0.54) and VO2max (p = 0.90) was observed. Moreover, there was no statistically significant difference between the groups concerning changes in BMI (p = 0.26), maximum load (p = 0.89) and oxygen uptake at anaerobic threshold (AT) (p = 0.14). CONCLUSIONS We conclude that treatment with 2000 IU/d vitamin D for 6 months does not impact body composition or maximum oxygen uptake in overweight/obese men with vitamin D deficiency.
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Affiliation(s)
- Christos Karefylakis
- Department of Endocrinology, School of Medical Sciences, Örebro University, SE 70182, Örebro, Sweden.
| | - Stefan Särnblad
- Department of Pediatrics, School of Medical Sciences, Örebro University, SE 70182, Örebro, Sweden
| | | | - Gustaf Ehlersson
- School of Medical Sciences, Örebro University, SE 70182, Örebro, Sweden
| | - Eva Rask
- Department of Endocrinology, School of Medical Sciences, Örebro University, SE 70182, Örebro, Sweden
| | - Peter Rask
- Department of Clinical Physiology, Örebro University Hospital, SE 70185, Örebro, Sweden
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Kim SH, Oh JE, Song DW, Cho CY, Hong SH, Cho YJ, Yoo BW, Shin KS, Joe H, Shin HS, Son DY. The factors associated with Vitamin D deficiency in community dwelling elderly in Korea. Nutr Res Pract 2018; 12:387-395. [PMID: 30323906 PMCID: PMC6172170 DOI: 10.4162/nrp.2018.12.5.387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/04/2018] [Accepted: 07/18/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Recent studies showed vitamin D deficiency is linked to chronic diseases in addition to skeletal metabolism which could threaten the elderly. We analyzed health conditions and socio-demographic factors associated with vitamin D deficiency in community dwelling people aged 65 years and older. SUBJECTS/METHOD Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010 to 2012 were obtained. A total of 2,687 subjects aged 65 years and older were participated. The cutoff value of the Vitamin D deficiency was considered as serum 25-hydroxyvitamin D [25(OH)D] ≤ 20 ng/mL (50 nmol/L). RESULTS The overall prevalence rate of vitamin D deficiency in the elderly was 62.1%. The factors such as female, obesity, metabolic syndrome, current smoker, and skipping breakfast were positively associated with vitamin D deficiency, but high intensity of physical activity and more than 9 hours of sleep duration were negatively associated with vitamin D deficiency (all P < 0.05). CONCLUSIONS It is important that health professions know that the factors proved in this study are connected to vitamin D deficiency thus provide information and intervention strategies of vitamin D deficiency to old aged people.
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Affiliation(s)
- Sun Hea Kim
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 31, Soonchunhyang 6-gil, Donagnam-gu, Cheonan-si, Chungnam 31151, Korea
| | - Jung Eun Oh
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 31, Soonchunhyang 6-gil, Donagnam-gu, Cheonan-si, Chungnam 31151, Korea
| | - Dong Won Song
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 31, Soonchunhyang 6-gil, Donagnam-gu, Cheonan-si, Chungnam 31151, Korea
| | - Choo Yon Cho
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Sung Ho Hong
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Yong Jin Cho
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 31, Soonchunhyang 6-gil, Donagnam-gu, Cheonan-si, Chungnam 31151, Korea
| | - Byung Wook Yoo
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Kyung Suk Shin
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Gumi Hospital, Gyeongbuk 39371, Korea
| | - Hyun Joe
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Hwang Sik Shin
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 31, Soonchunhyang 6-gil, Donagnam-gu, Cheonan-si, Chungnam 31151, Korea
| | - Doo Yong Son
- Department of Family Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Gumi Hospital, Gyeongbuk 39371, Korea
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Li D, Wei H, Xue H, Zhang J, Chen M, Gong Y, Cheng G. Higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis: data from Southwest China. BMC Endocr Disord 2018; 18:25. [PMID: 29739382 PMCID: PMC5941481 DOI: 10.1186/s12902-018-0252-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/26/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Recent epidemiological studies have suggested inverse associations between vitamin D status and metabolic diseases including type 2 diabetes (T2DM). The aim of this study was to examine whether a higher serum 25-hydroxyvitamin D (25(OH)D) was associated with a more favorable glucose homeostasis among adults without diabetes in Southwest China. METHODS Serum 25(OH)D concentration was measured in a cross-sectional sample of 1514 adults without diabetes aged 25-65 years recruited from Southwest China. Indices describing glucose homeostasis included fasting plasma glucose (FPG), fasting insulin, glycated hemoglobin (HbA1c), the homeostatic model assessment 2-insulin resistance (HOMA2-IR) and odds of pre-diabetes. Data were analyzed by multivariable-adjusted regression models. RESULTS The average serum 25(OH)D was 22.66 ng/ml, and percentages of vitamin D deficiency [25(OH)D < 20 ng/ml], insufficiency [20 ≤ 25(OH)D ≤ 30 ng/ml] were 47.6 and 32.2%, respectively. Serum 25(OH)D was inversely associated with fasting insulin (P = 0.0007), HbA1c (P = 0.0001) and HOMA2-IR (P = 0.0007), but not with FPG, after adjusting for age, gender, monthly personal income, smoking status, energy intake, moderate-to-vigorous physical activity (MVPA) and waist circumference (WC). Compared with the lowest 25(OH)D tertile, the odds ratio for pre-diabetes in the highest tertile was 0.68 (95%CI: 0.47-0.99) after adjustment for cofounders. In the following stratified analyses according to weight status, we only observed this inverse association between serum 25(OH)D and pre-diabetes in overweight or obese adults (n = 629, P = 0.047), but not in their counterparts with BMI < 24 kg/m2. CONCLUSIONS Our results advocate that a higher serum 25(OH)D level is associated with decreased risk of impairment of glucose homeostasis among adults without diabetes in Southwest China. Further studies are warranted to determine the role of vitamin D in glucose homeostasis.
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Affiliation(s)
- Danting Li
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041 Sichuan China
| | - Haoche Wei
- Center of Growth, Metabolism and Aging, Collage of Life Sciences, Sichuan University, Chengdu, China
| | - Hongmei Xue
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041 Sichuan China
| | - Jieyi Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041 Sichuan China
| | - Mengxue Chen
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041 Sichuan China
| | - Yunhui Gong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Guo Cheng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041 Sichuan China
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Serum Vitamin D and Its Upregulated Protein, Thioredoxin Interacting Protein, Are Associated With Beta-Cell Dysfunction in Adult Patients With Type 1 and Type 2 Diabetes. Can J Diabetes 2018; 42:588-594. [PMID: 29980378 DOI: 10.1016/j.jcjd.2018.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/26/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Diabetes mellitus is characterized by either complete deficiency of insulin secretion, as in type 1 diabetes, or decompensation of the pancreatic beta cells in type 2 diabetes. Both vitamin D (vitD) and thioredoxin interacting protein (TXNIP) have been shown to be involved in beta-cell dysfunction. Therefore, this study was designed to examine vitD and TXNIP serum levels in patients with diabetes and to correlate these levels with beta-cell function markers in both types of diabetes. METHODS The routine biochemical parameters and the serum levels of vitD and TXNIP were measured in 20 patients with type 1 diabetes and 20 patients with type 2 diabetes. The levels were then compared to those of 15 healthy control volunteers. Insulin, C-peptide and proinsulin (PI), vitD and TXNIP were measured by ELISA. Beta-cell dysfunction was assessed by homeostatic model assessment (HOMA-beta), proinsulin-to-C-peptide (PI/C) and proinsulin-to-insulin (PI/I) ratios. Correlations among various parameters were studied. RESULTS Patients with type 1 diabetes had significantly lower HOMA-beta, vitD and TXNIP levels; however, they had higher PI/C levels than the control group. Meanwhile, patients with type 2 diabetes had significantly higher C-peptide, proinsulin, PI/C, HOMA-insulin resistance (HOMA-IR) and lower HOMA-beta and vitD levels, with no significant difference in TXNIP levels as compared to the control group. In addition, vitD was significantly correlated positively with HOMA-beta and TXNIP and negatively with PI, PI/C, PI/I and HOMA-IR. TXNIP correlated positively with HOMA-beta and negatively with PI/C. CONCLUSIONS Our data showed that vitD and TXNIP were associated with different beta-cell dysfunction markers, indicating their potential abilities to predict the beta-cell status in people with diabetes.
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Fortified yogurt with vitamin D as a cost-effective food to prevent diabetes: A randomized double-blind clinical trial. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Effect of Treating Vitamin D Deficiency in Uncontrolled Type 2 Diabetes: A Randomized, Placebo-Controlled Study. Am J Ther 2018; 26:e441-e451. [PMID: 29419533 DOI: 10.1097/mjt.0000000000000738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Literature increasingly supports the inverse relationship of vitamin D (VitD) level and type 2 diabetes (T2DM). Proposed protective mechanisms of VitD include its anti-inflammatory effects, increased insulin secretion via pancreatic β-cell stimulation, and downregulation of parathyroid hormone levels. Interventional studies show mixed results of VitD therapy in prediabetic patients with VitD deficiency or diabetic patients with normal VitD levels. STUDY QUESTION Does high-dose VitD replacement improve glycemic control and microalbuminuria (MAU) in uncontrolled T2DM and concurrent VitD deficiency? STUDY DESIGN This placebo-controlled, double-blinded study randomized 30 subjects aged 30-65 years with an elevated HbA1c level of 7.5%-10% and a low total 25-hydroxyvitamin-D value of <20 ng/mL to either placebo (n = 16) or ergocalciferol 50,000 IU (n = 14) once weekly for 8 weeks then once monthly for 4 months. MEASURES AND OUTCOMES Primary outcome was difference in HbA1c from baseline to month 6 between the VitD-intervention group and the placebo-controlled group. Secondary end points were differences in total 25-hydroxyvitamin-D and MAU. Paired t tests and linear mixed-effects models were used for statistical analysis. RESULTS No significant differences were seen in HbA1c or MAU between baseline versus postintervention visits within the placebo group (HbA1c: 8.4% ± 0.2 vs. 8.1% ± 0.3, P = 0.088; MAU: 94.1 mg/g ± 43.9 vs. 45.9 mg/g ± 20.2, P = 0.152) and the intervention group (HbA1c: 8.8% ± 0.3 vs. 8.7% ± 0.4, P = 0.692; MAU: 167.8 mg/g ± 70.1 vs. 108.5 mg/g ± 39.9, P = 0.356). The difference between placebo-slope and intervention-slope was nonsignificant for MAU (β = -0.1 mg/g ± 0.4, P = 0.835) but was significant for total 25-hydroxyvitamin-D (β = 11.7 ng/mL ± 2.5, P ≤ 0.001). Greater HbA1c reduction occurred unexpectedly in the placebo group ((Equation is included in full-text article.)= -0.4% ± 0.2) than in the intervention group ((Equation is included in full-text article.)= -0.2% ± 0.4), although the difference in slopes was not significant (β = 0.2% ± 0.4, P = 0.640). CONCLUSIONS Our proof-of-concept study found no benefit of high-dose VitD therapy in glycemic control and MAU in uncontrolled T2DM and VitD deficiency. Post hoc analyses raise concerns for high-dose VitD therapy to delay glycemic improvement. Large-scale interventional trials are much needed in this patient population to substantiate our findings and elucidate VitD's mechanisms on glucose metabolism.
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Vitamin D3-fortified milk did not affect glycemic control, lipid profile, and anthropometric measures in patients with type 2 diabetes, a triple-blind randomized clinical trial. Eur J Clin Nutr 2018; 72:1083-1092. [DOI: 10.1038/s41430-017-0062-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/06/2017] [Accepted: 08/10/2017] [Indexed: 01/29/2023]
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Altieri B, Grant WB, Della Casa S, Orio F, Pontecorvi A, Colao A, Sarno G, Muscogiuri G. Vitamin D and pancreas: The role of sunshine vitamin in the pathogenesis of diabetes mellitus and pancreatic cancer. Crit Rev Food Sci Nutr 2018; 57:3472-3488. [PMID: 27030935 DOI: 10.1080/10408398.2015.1136922] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests that vitamin D exerts multiple effects beyond bone and calcium metabolism. Vitamin D seems to play a role in pancreatic disease, including type 1 and type 2 diabetes mellitus as well as pancreatic cancer. Vitamin D's immune-modulatory action suggests that it could help prevent type 1 diabetes. In type 2 diabetes, vitamin D may influence β-cell function, insulin sensitivity, and systematic inflammation-all characteristic pathways of that disease. Data from observational studies correlated vitamin D deficiency with risk of type 1 and type 2 diabetes. Prospective and ecological studies of pancreatic cancer incidence generally support a beneficial effect of higher 25-hydroxyvitamin D concentration as well as inverse correlations between UVB dose or exposure and incidence and/or mortality rate of pancreatic cancer. This review discusses the literature regarding vitamin D's role in risk of diabetes and pancreatic cancer. The results to date generally satisfy Hill's criteria for causality regarding vitamin D and incidence of these pancreatic diseases. However, large randomized, blinded, prospective studies are required to more fully evaluate the potential therapeutic role of vitamin D in preventing pancreatic diseases.
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Affiliation(s)
- Barbara Altieri
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - William B Grant
- b Sunlight , Nutrition, and Health Research Center , San Francisco , California , USA
| | - Silvia Della Casa
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Francesco Orio
- c Endocrinology, Department of Sports Science and Wellness , Parthenope University , Naples , Italy.,d Fertility Techniques SSD , San Giovanni di Dio e Ruggi D'Aragona University Hospital , Salerno , Italy
| | - Alfredo Pontecorvi
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Annamaria Colao
- e Department of Clinical Medicine and Surgery, Section of Endocrinology , University "Federico II," Naples , Italy
| | - Gerardo Sarno
- f Department of General Surgery and Transplantation Unit , San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana , Salerno , Italy
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Tang H, Li D, Li Y, Zhang X, Song Y, Li X. Effects of Vitamin D Supplementation on Glucose and Insulin Homeostasis and Incident Diabetes among Nondiabetic Adults: A Meta-Analysis of Randomized Controlled Trials. Int J Endocrinol 2018; 2018:7908764. [PMID: 30627160 PMCID: PMC6304827 DOI: 10.1155/2018/7908764] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 01/13/2023] Open
Abstract
AIMS Emerging evidence has suggested a mechanistic link from vitamin D metabolism to glucose and insulin homeostasis. This study is aimed at specifically quantifying the direct effects of vitamin D supplementation on indexes of glucose and insulin homeostasis as well as incidence of type 2 diabetes (T2D) among nondiabetic adults. METHODS We systematically searched randomized controlled trials (RCTs) of vitamin D supplementation in nondiabetic adults in PubMed, EMBASE, and CENTRAL. Random-effects meta-analysis was conducted to pool the estimates. RESULTS Our meta-analysis included 47 RCTs involving 44,161 nondiabetic individuals with a median trial duration of 4 months and a median dose of 4000 IU/d. Vitamin D supplementation significantly reduced fasting glucose by 0.11 mmol/L, fasting insulin by 1.47 mIU/L, and HOMA-IR by 0.32 while increasing total 25 (OH) D levels by 40.14 nmol/L. We found no significant effects of vitamin D supplementation on insulin secretion or beta cell function indexes. Based on the data from six trials involving 39,633 participants and 2533 incident T2D cases, vitamin D supplementation was not associated with the risk of incident diabetes compared to placebo (pooled relative risk: 1.01, 95% confidence interval: 0.93 to 1.08). CONCLUSIONS Our meta-analysis found that vitamin D supplementation might improve glucose and insulin metabolism without affecting the risk of T2D among nondiabetic adults.
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Affiliation(s)
- Huilin Tang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
| | - Deming Li
- School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
| | - Xinli Li
- School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
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Obispo Entrenas A, Legupin Tubio D, Lucena Navarro F, Martin Carvajal F, Gandara Adan N, Redondo Bautista M, Abiles Osinaga J. Relationship Between Vitamin D Deficiency and the Components of Metabolic Syndrome in Patients with Morbid Obesity, Before and 1 Year After Laparoscopic Roux-en-Y Gastric Bypass or Sleeve Gastrectomy. Obes Surg 2017; 27:1222-1228. [PMID: 27864670 DOI: 10.1007/s11695-016-2445-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Vitamin D deficiency (VDD) is associated with obesity and metabolic syndrome (MS). After bariatric surgery (BS), high rates of VDD often persist and some patients are refractory to the resolution of comorbidities. The aim of the present study is to analyse the relationship between the levels of vitamin D and the persistence of MS components at 12 months after BS, according to the surgical technique used. METHODS We performed a retrospective study of 46 patients undergoing BS: 23 underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP) and 23 laparoscopic sleeve gastrectomy (LSG). These patients had an average BMI of 45 kg/m2 (34-63). Levels of vitamin D were classified as deficient (<20 ng/dl), insufficient (20-30 ng/dl) or normal (>30 ng/dl) and analysed in relation to the components of MS (high blood pressure (HBP), dyslipidaemia (DL) and type 2 diabetes mellitus (T2DM) preoperatively and 12 months after surgery. RESULTS VDD was observed in 77% of the patients prior to surgery. There were no significant associations between predisposing factors and baseline vitamin D. After surgery, plasma levels of vitamin D increased in both groups, but only 18% of the patients achieved normal values. Both groups had achieved significant improvements in MS components. Thus, 63% of all the patients achieved complete resolution of HBP, 54% that of DL and 77% that of T2DM. Moreover, MS was present in 11% of the patients, compared to 63% at baseline, and the MS resolution rate was 83%, with no significant differences between LRYGBP and LSG. CONCLUSIONS There is a relationship between VDD and persistence of MS, and particularly so with T2DM. VDD could represent a predictor of MS persistence at 12 months after surgery.
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Affiliation(s)
- Ana Obispo Entrenas
- Department of Bariatric Surgery, Costa del Sol Hospital, Marbella, Málaga, Spain.
| | - David Legupin Tubio
- Department of Gastroenterology Surgery, Costa del Sol Hospital, Marbella, Málaga, Spain
| | | | | | | | - Maximino Redondo Bautista
- Department of Surgical Specialties, Biochemical and Immunological, Faculty of Medicine, Malaga University, Malaga, Spain
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Sarno G, Nappi R, Altieri B, Tirabassi G, Muscogiuri E, Salvio G, Paschou SA, Ferrara A, Russo E, Vicedomini D, Vincenzo C, Vryonidou A, Della Casa S, Balercia G, Orio F, De Rosa P. Current evidence on vitamin D deficiency and kidney transplant: What's new? Rev Endocr Metab Disord 2017; 18:323-334. [PMID: 28281103 DOI: 10.1007/s11154-017-9418-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Kidney transplant is the treatment of choice for end-stage chronic kidney disease. Kidneys generate 1,25-dihydroxyvitamin D (calcitriol) from 25-hydroxyvitamin D (calcidiol) for circulation in the blood to regulate calcium levels. Transplant patients with low calcidiol levels have an increased risk of metabolic and endocrine problems, cardiovascular disease, type 2 diabetes mellitus, poor graft survival, bone disorders, cancer, and mortality rate. The recommended calcidiol level after transplant is at least 30 ng/mL (75 nmol/L), which could require 1000-3000 IU/d vitamin D3 to achieve. Vitamin D3 supplementation studies have found improved endothelial function and acute rejection episodes. However, since kidney function may still be impaired, raising calcidiol levels may not lead to normal calcitriol levels. Thus, supplementation with calcitriol or an analog, alfacalcidiol, is often employed. Some beneficial effects found include possible improved bone health and reduced risk of chronic allograft nephropathy and cancer.
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Affiliation(s)
- Gerardo Sarno
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
| | - Riccardo Nappi
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
- Nephrology and Dialisys Unit - "Santa Maria della Misericordia" Hospital, ASUIUD - Udine, Udine, Italy
| | - Barbara Altieri
- Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University, Rome, Italy
| | - Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | | | - Gianmaria Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Stavroula A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aristide Ferrara
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
| | - Enrico Russo
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
| | - Daniela Vicedomini
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
| | - Cerbone Vincenzo
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
| | - Andromachi Vryonidou
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | - Silvia Della Casa
- Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University, Rome, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Orio
- Endocrinology, Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - Paride De Rosa
- General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy
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Hernández-Sánchez F, Guzmán-Beltrán S, Herrera MT, Gonzalez Y, Salgado M, Fabian G, Torres M. High glucose induces O-GlcNAc glycosylation of the vitamin D receptor (VDR) in THP1 cells and in human macrophages derived from monocytes. Cell Biol Int 2017; 41:1065-1074. [PMID: 28710799 DOI: 10.1002/cbin.10827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 07/13/2017] [Indexed: 01/13/2023]
Abstract
Chronic hyperglycemia increases the carbon flux through the hexosamine pathway, allowing the accumulation of UDP-GlcNAc. UDP-GlcNAc is the sugar donor for the enzyme-mediated protein glycosylation event known as OGlcNAcylation. This posttranslational modification targets several transcription factors implicated in glucose toxicity, insulin resistance, and diabetes. Vitamin D plays an important role in glucose homeostasis and insulin secretion through transcriptional mechanisms mediated by its receptor (VDR). Vitamin D deficiency has been associated with higher susceptibility to bacterial diseases in diabetic patients. However, it has not been explored whether VDR is subject to OGlcNAcylation or whether high glucose affects its transcriptional or biological activities. The aim of this study was to evaluate the effect of hyperglycemia on VDR OGlcNAcylation and its effects on vitamin D-mediated transcription. We predicted potential OGlcNAcylation sites using free software. Our results showed that hyperglycemia (30 mM) induces the OGlcNAcylation of VDR in THP1 cells and in human macrophages derived from monocytes (MDM). This condition did not hamper the vitamin D-dependent activation of LL-37 gene expression, and even did not impair the macrophage bactericidal activity. Our study provides new insight into vitamin D receptor posttranslational modification that may have relevance on the physiological responses of long-term hyperglycemia.
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Affiliation(s)
- Fernando Hernández-Sánchez
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - Silvia Guzmán-Beltrán
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - María Teresa Herrera
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - Yolanda Gonzalez
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - Manuel Salgado
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - Guadalupe Fabian
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
| | - Martha Torres
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Sección XVI, México City, Mexico, 1408
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Zaki M, Kamal S, Basha WA, Youness E, Ezzat W, El-Bassyouni H, Amr K. Association of vitamin D receptor gene polymorphism (VDR) with vitamin D deficiency, metabolic and inflammatory markers in Egyptian obese women. Genes Dis 2017; 4:176-182. [PMID: 30258921 PMCID: PMC6146204 DOI: 10.1016/j.gendis.2017.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/11/2017] [Indexed: 11/26/2022] Open
Abstract
Vitamin D deficiency might contribute to the pathogenesis of metabolic syndrome and could cause immune disturbance. The aim of this study is to analyze the associations between Vitamin D receptor (VDR) gene polymorphism, serum 25-hydroxy vitamin D, metabolic and inflammatory biomarkers in Egyptian obese women. The study included 201 obese women with vitamin D deficiency and 249 obese matched age healthy controls with sufficient vitamin D levels. Their age ranged between 25 and 35 years. Inflammatory biomarkers (interleukin-6 and C-reactive protein) and serum 25(OH) D were measured by enzyme-linked immunosorbent assay. Insulin resistance (IR) was determined by the homeostasis model assessment of insulin resistance (HOMA-IR).Vitamin D receptor (VDR) gene polymorphisms of FokI, ApaI, and TaqI were studied by PCR using the restriction fragment length polymorphism (RFLP) technique. Obese women with vitamin D deficiency had significant higher values of inflammatory and metabolic parameters compared to controls. Multivariable-logistic regression showed associations between 25(OH) D deficiency and metabolic components when comparing cases with controls. Moreover, cases carrying polymorphic alleles showed significant lower levels of serum 25(OH) D and higher HOMA-IR, blood pressure levels and lipid parameters compared to those with the wild type homozygote in obese cases with vitamin D deficiency. Vitamin D deficiency in Egyptian obese women with vitamin D deficiency is associated with abnormal metabolic components and abnormal inflammatory biomarkers. Moreover, VDR polymorphisms play important role in immune and inflammation status.
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Affiliation(s)
- Moushira Zaki
- Biological Anthropology Department, National Research Centre, Giza, Egypt
| | - Sanaa Kamal
- Biological Anthropology Department, National Research Centre, Giza, Egypt
| | - Walaa A Basha
- Biological Anthropology Department, National Research Centre, Giza, Egypt
| | - Eman Youness
- Medical Biochemistry Department, National Research Centre, Giza, Egypt
| | - Wafaa Ezzat
- Internal Medicine Department, National Research Centre, Giza, Egypt
| | - Hala El-Bassyouni
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Khalda Amr
- Medical Molecular Genetics Department, National Research Centre, Egypt
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Gupta T, Rawat M, Gupta N, Arora S. Study of Effect of Vitamin D Supplementation on the Clinical, Hormonal and Metabolic Profile of the PCOS Women. J Obstet Gynaecol India 2017; 67:349-355. [PMID: 28867886 DOI: 10.1007/s13224-017-1008-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/14/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Insulin resistance is one of the most common features of polycystic ovary syndrome, and some studies suggest that vitamin D deficiency may have role in insulin resistance. OBJECTIVE To study the effect of vitamin D supplementation on the clinical, hormonal and metabolic profile of the PCOS women. STUDY DESIGN Randomized, placebo-controlled, interventional, double-blind study. MATERIALS AND METHODS PCOS women were evaluated and enrolled after considering inclusion and exclusion criteria. They were randomized by block randomization with sealed envelope system done in two groups. In the study group (n = 25), patients were supplemented with vitamin D 60,000 IU weekly for 12 weeks, whereas control group (n = 25) was given placebo weekly for the same period. Both the groups were compared pre- and post-supplementation for variables like clinical profile, biochemical profile and metabolic profile. Statistical analysis was performed by the SPSS program for Windows, version 10.1 (SPSS, Chicago, IL). RESULT In the study (n = 50), PCOS patients were enrolled; 34 patients (68%) were vitamin D deficient (≤20 ng/ml) out of which 10 patients (29%) were severely deficient (<10 ng/ml). Twelve patients (24%) were vitamin D insufficient showing high prevalence of vitamin D deficiency in the PCOS women. The difference in mean serum fasting glucose pre- and post-supplementation of vitamin D in study group was found to be statistically significant with p value of 0.041. There was significant difference seen in insulin resistance (IR) (2.38 ± 4.88-1.00 ± 0.58, p = 0.003), serum fasting insulin (10.34 ± 20.00-5.00 ± 3.25, p = 0.021), and increase in insulin sensitivity determined by QUICKI (0.37 ± 0.04-0.394 ± 0.009, p = 0.001) after supplementation with vitamin D. CONCLUSION The study concluded that there was a beneficial effect of vitamin D supplementation on ovulatory dysfunctions and blood pressure. Post-supplementation, there were decrease in insulin resistance and increase in insulin sensitivity. In the study decreased serum fasting insulin level and fasting blood sugar after vitamin D supplementation suggest underlying role of vitamin D in glucose homeostasis.
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Affiliation(s)
- Taru Gupta
- Department of Obstetrics and Gynaecology, ESI PGIMSR, Basaidarapur, New Delhi, India
| | - Mukta Rawat
- Department of Obstetrics and Gynaecology, ESI PGIMSR, Basaidarapur, New Delhi, India
| | - Nupur Gupta
- Department of Obstetrics and Gynaecology, ESI PGIMSR, Basaidarapur, New Delhi, India
| | - Sarika Arora
- Department of Biochemistry, ESI PGIMSR, Basaidarapur, New Delhi, India
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Ock SY, Ha KH, Kim BK, Kim HC, Shim JS, Lee MH, Yoon YM, Kim DJ. Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population. Diabetes Metab J 2016; 40:367-375. [PMID: 27535642 PMCID: PMC5069393 DOI: 10.4093/dmj.2016.40.5.367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/26/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population. METHODS We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile. RESULTS Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56). CONCLUSION Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.
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Affiliation(s)
- So Young Ock
- Department of Endocrinology and Metabolism, Kosin University College of Medicine, Busan, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Bu Kyung Kim
- Department of Endocrinology and Metabolism, Kosin University College of Medicine, Busan, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Seon Shim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Ha Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Young Me Yoon
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
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van Orten-Luiten ACB, Janse A, Dhonukshe-Rutten RAM, Witkamp RF. Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients. Eur J Clin Pharmacol 2016; 72:605-14. [PMID: 26873590 PMCID: PMC4834096 DOI: 10.1007/s00228-016-2016-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/19/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE Adverse drug reactions as well as vitamin D deficiency are issues of public health concern in older people. However, relatively little is known about the impact of drug use on vitamin D status. Our primary aim is to explore associations between drug use and vitamin D status in older people. Furthermore, prevalences of drug use and vitamin D deficiency are estimated. METHODS In a population of 873 community-dwelling Dutch geriatric outpatients, we explored the cross-sectional relationships of polypharmacy (≥5 medications concomitantly used), severe polypharmacy (≥10 medications), and use of twenty-one specific drug groups, with serum 25-hydroxyvitamin D (25(OH)D) by analysis of covariance. RESULTS Overall prevalence of polypharmacy was 65 %, of severe polypharmacy 22 %. Depending on the cut-off value, prevalence of vitamin D deficiency was 49 % (<50 nmol/l) or 77 % (<75 nmol/l). Of the patients using a vitamin D supplement, 17 % (<50 nmol/l) or 49 % (<75 nmol/l) were still deficient. In non-users of supplemental vitamin D, after adjustment for age and gender, negative associations were found for severe polypharmacy, metformin, sulphonamides and urea derivatives (SUDs), vitamin K antagonists, cardiac glycosides, loop diuretics, potassium-sparing diuretics, ACE inhibitors, and serotonin reuptake inhibitors; for non-selective monoamine reuptake inhibitors (NSMRIs) the association was positive. The most extreme impacts of drug use on adjusted mean 25(OH)D were -19 nmol/l for SUDs and +18 nmol/l for NSMRIs. CONCLUSION Drug use should be considered a risk factor for vitamin D deficiency amongst geriatric outpatients.
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Affiliation(s)
- A. C. B. van Orten-Luiten
- />Division of Human Nutrition, Pharmacology and Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
- />Department of Geriatric Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - A. Janse
- />Department of Geriatric Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - R. A. M. Dhonukshe-Rutten
- />Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - R. F. Witkamp
- />Division of Human Nutrition, Pharmacology and Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
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Wamberg L, Pedersen SB, Rejnmark L, Richelsen B. Causes of Vitamin D Deficiency and Effect of Vitamin D Supplementation on Metabolic Complications in Obesity: a Review. Curr Obes Rep 2015; 4:429-40. [PMID: 26353882 DOI: 10.1007/s13679-015-0176-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Obese subjects are often characterized by low plasma 25-hydroxy-vitamin D (25OHD) levels. Many explanations for this association have been proposed. Low plasma 25OHD is associated with obesity-related comorbidities such as insulin resistance, type 2 diabetes mellitus, and low-grade inflammation. In this review, we discuss the proposed mechanisms for low 25OHD in obesity and explore the results of recent RCTs on vitamin D (VD) supplementation on obesity and its metabolic complications such as insulin resistance and type 2 diabetes. Although the results from these clinical randomized controlled trials vary, the general picture is that VD treatment of obese individuals does not seem to be an effective treatment of obesity-related metabolic complications.
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Affiliation(s)
- Louise Wamberg
- Department of Internal Medicine and Endocrinology MEA, Aarhus University Hospital, Tage- Hansens Gade 2, DK-8000, Aarhus, Denmark.
| | - Steen B Pedersen
- Department of Internal Medicine and Endocrinology MEA, Aarhus University Hospital, Tage- Hansens Gade 2, DK-8000, Aarhus, Denmark.
| | - Lars Rejnmark
- Department of Internal Medicine and Endocrinology MEA, Aarhus University Hospital, Tage- Hansens Gade 2, DK-8000, Aarhus, Denmark.
| | - Bjørn Richelsen
- Department of Internal Medicine and Endocrinology MEA, Aarhus University Hospital, Tage- Hansens Gade 2, DK-8000, Aarhus, Denmark.
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Vitamin D every day to keep the infection away? Nutrients 2015; 7:4170-88. [PMID: 26035244 PMCID: PMC4488779 DOI: 10.3390/nu7064170] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/13/2015] [Accepted: 05/15/2015] [Indexed: 02/07/2023] Open
Abstract
Within the last decade, vitamin D has emerged as a central regulator of host defense against infections. In this regard, vitamin D triggers effective antimicrobial pathways against bacterial, fungal and viral pathogens in cells of the human innate immune system. However, vitamin D also mediates potent tolerogenic effects: it is generally believed that vitamin D attenuates inflammation and acquired immunity, and thus potentially limits collateral tissue damage. Nevertheless, several studies indicate that vitamin D promotes aspects of acquired host defense. Clinically, vitamin D deficiency has been associated with an increased risk for various infectious diseases in epidemiological studies; yet, robust data from controlled trials investigating the use of vitamin D as a preventive or therapeutic agent are missing. In this review, we summarize the current knowledge regarding the effect of vitamin D on innate and acquired host defense, and speculate on the difficulties to translate the available molecular medicine data into practical therapeutic or preventive recommendations.
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Arnold DL, Enquobahrie DA, Qiu C, Huang J, Grote N, VanderStoep A, Williams MA. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus. Paediatr Perinat Epidemiol 2015; 29:200-10. [PMID: 25808081 PMCID: PMC4400239 DOI: 10.1111/ppe.12182] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND While associations of vitamin D deficiency with type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM. METHODS In a nested case-cohort study (135 GDM cases and 517 non-GDM controls), we measured maternal serum vitamin D status (total 25[OH]D and 25[OH]D3 ) in early pregnancy (16 weeks on average) using liquid chromatography-tandem mass spectroscopy. GDM was diagnosed according to the American Diabetes Association guidelines. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression models. RESULTS GDM cases had lower mean total 25[OH]D (27.3 vs. 29.3 ng/mL) and 25[OH]D3 (23.9 vs. 26.7 ng/mL) concentrations compared with women who did not develop GDM (both P-values < 0.05). Overall, 25[OH]D3 concentrations, but not total 25[OH]D concentrations, were significantly associated with GDM risk. A 5-ng/mL increase in 25[OH]D3 concentration was associated with a 14% decrease in GDM risk (P-value = 0.02). Women in the lowest quartile for 25[OH]D3 concentration had a twofold [95% CI 1.15, 3.58] higher risk of GDM compared with women in the highest quartile (P-value for trend < 0.05). CONCLUSIONS Early pregnancy vitamin D status, particularly 25[OH]D3 , is inversely associated with GDM risk.
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Affiliation(s)
- Dodie L. Arnold
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
,Louisiana Public Health Institute, New Orleans, Louisiana
| | - Daniel A. Enquobahrie
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Chungfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Jonathan Huang
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
| | - Nancy Grote
- School of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Ann VanderStoep
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
| | - Michelle A. Williams
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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Links between Vitamin D Deficiency and Cardiovascular Diseases. BIOMED RESEARCH INTERNATIONAL 2015; 2015:109275. [PMID: 26000280 PMCID: PMC4427096 DOI: 10.1155/2015/109275] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/08/2015] [Indexed: 02/07/2023]
Abstract
The aim of the present paper was to review the most important mechanisms explaining the possible association of vitamin D deficiency and cardiovascular diseases, focusing on recent experimental and clinical data. Low vitamin D levels favor atherosclerosis enabling vascular inflammation, endothelial dysfunction, formation of foam cells, and proliferation of smooth muscle cells. The antihypertensive properties of vitamin D include suppression of the renin-angiotensin-aldosterone system, renoprotective effects, direct effects on endothelial cells and calcium metabolism, inhibition of growth of vascular smooth muscle cells, prevention of secondary hyperparathyroidism, and beneficial effects on cardiovascular risk factors. Vitamin D is also involved in glycemic control, lipid metabolism, insulin secretion, and sensitivity, explaining the association between vitamin D deficiency and metabolic syndrome. Vitamin D deficit was associated in some studies with the number of affected coronary arteries, postinfarction complications, inflammatory cytokines and cardiac remodeling in patients with myocardial infarction, direct electromechanical effects and inflammation in atrial fibrillation, and neuroprotective effects in stroke. In peripheral arterial disease, vitamin D status was related to the decline of the functional performance, severity, atherosclerosis and inflammatory markers, arterial stiffness, vascular calcifications, and arterial aging. Vitamin D supplementation should further consider additional factors, such as phosphates, parathormone, renin, and fibroblast growth factor 23 levels.
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Woolcott OO, Ader M, Bergman RN. Glucose homeostasis during short-term and prolonged exposure to high altitudes. Endocr Rev 2015; 36:149-73. [PMID: 25675133 PMCID: PMC4399271 DOI: 10.1210/er.2014-1063] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Most of the literature related to high altitude medicine is devoted to the short-term effects of high-altitude exposure on human physiology. However, long-term effects of living at high altitudes may be more important in relation to human disease because more than 400 million people worldwide reside above 1500 m. Interestingly, individuals living at higher altitudes have a lower fasting glycemia and better glucose tolerance compared with those who live near sea level. There is also emerging evidence of the lower prevalence of both obesity and diabetes at higher altitudes. The mechanisms underlying improved glucose control at higher altitudes remain unclear. In this review, we present the most current evidence about glucose homeostasis in residents living above 1500 m and discuss possible mechanisms that could explain the lower fasting glycemia and lower prevalence of obesity and diabetes in this population. Understanding the mechanisms that regulate and maintain the lower fasting glycemia in individuals who live at higher altitudes could lead to new therapeutics for impaired glucose homeostasis.
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Affiliation(s)
- Orison O Woolcott
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048
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Vitezova A, Zillikens MC, van Herpt TTW, Sijbrands EJG, Hofman A, Uitterlinden AG, Franco OH, Kiefte-de Jong JC. Vitamin D status and metabolic syndrome in the elderly: the Rotterdam Study. Eur J Endocrinol 2015; 172:327-35. [PMID: 25468955 DOI: 10.1530/eje-14-0580] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The effects of vitamin D in the elderly are inconsistent. The aim of this study was to evaluate the association between vitamin D status and the metabolic syndrome (MetS) in the elderly, as well as between vitamin D status and the components of MetS (i.e. serum glucose, triglycerides (TG), HDL cholesterol (HDL-C), waist circumference (WC), and blood pressure (BP)). METHODS The study was embedded in the Rotterdam Study, a population-based cohort of middle-aged and elderly adults. We analyzed data from 3240 people (median age 71.2 years) who did not have type 2 diabetes mellitus at baseline. RESULTS We found higher 25-hydroxyvitamin D (25(OH)D) concentrations associated with lower prevalence of MetS (odds ratio (OR); 95% CI: 0.61; 0.49, 0.77 for adequate levels (≥75 nmol/l) vs deficiency (<50 nmol/l). In addition, in analysis of the individual components, the ORs for adequate vs deficient vitamin D levels were: 0.66 (95% CI 0.53, 0.83) for elevated WC, 0.67 (95% CI 0.52, 0.86) for reduced HDL-C, 0.69 (95% CI 0.54, 0.88) for elevated TG, and 0.80 (95% CI 0.65, 0.99) for elevated fasting glucose. Vitamin D was not associated with elevated blood pressure, and ORs for adequacy vs deficiency were 0.82 (95% CI 0.65, 1.03). CONCLUSION Higher 25(OH)D concentrations in the elderly are associated with lower prevalence of MetS and, in particular, with more beneficial HDL-C, TG, WC, and serum glucose. Since the prevalence of vitamin D deficiency is common worldwide and its risk increases with age, if causality is proven, benefits of improving vitamin D status among the elderly may be great.
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Affiliation(s)
- A Vitezova
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - M C Zillikens
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - T T W van Herpt
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - E J G Sijbrands
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
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Pacis MM, Fortin CN, Zarek SM, Mumford SL, Segars JH. Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review. J Assist Reprod Genet 2014; 32:323-35. [PMID: 25547950 DOI: 10.1007/s10815-014-0407-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/11/2014] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART. METHODS A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars. RESULTS Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion. CONCLUSION The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.
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Affiliation(s)
- Michelle M Pacis
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA
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Sriram K, Perumal K, Alemzadeh G, Osei A, Voronov G. The relationship between immediate preoperative serum 25-hydroxy-vitamin D₃ levels and cardiac function, dysglycemia, length of stay, and 30-d readmissions in cardiac surgery patients. Nutrition 2014; 31:820-6. [PMID: 25721864 DOI: 10.1016/j.nut.2014.11.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 11/30/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Vitamin D has pleiotropic effects on cardiac, renal, and endocrine diseases like diabetes mellitus and deficiency has been correlated with increased Intensive Care Unit (ICU) morbidity and mortality. We studied the relationship between preoperative Vitamin D levels and several short-term endpoints including cardiovascular events, glucose levels, ICU, and hospital length of stay. METHODS Standard demographic data were obtained. Blood samples were drawn for 25-hydroxy-vitamin D3 (Vit D) levels at baseline (just before induction of anesthesia) and on postoperative day (POD #1). The number of inotropes used on POD # 0, 1, and 2 was recorded as well as the Cardiac Index (CI). Baseline glucose, Blood Urea Nitrogen and Creatinine (Cr) levels were obtained and repeated on POD # 1 & 2. Other variables studied are number of days of ICU and hospital stay. RESULTS Of the 64 patients included in the cohort, 3 were excluded because of inadequate data. 69% had Vit D levels <20 ng/mL and 31% had levels ≥20 ng/mL. More than 90% of the cohort had a significant decrease in POD # 1 Vit D levels (P < 0.001). Age, sex, race, and body mass index did not predict the preoperative Vit D levels; however, the timing of surgery was associated with preoperative Vit D levels, lowest in subjects who had surgery performed during winter. Preoperative Vit D levels had no effect on postoperative glycemic control, cardiac index, or composite outcome-arrhythmias, respiratory failure, or prolonged inotropic support. On regression analysis, preoperative Vit D levels did show a significant effect on ICU and hospital length of stay in this cohort. CONCLUSIONS The low levels in this study truly represent the Vit D status as they were obtained before any intervention, including surgery or fluid administration. Vit D levels decreased rapidly after surgery and hence future studies on Vit D may need to focus on premorbid levels obtained at the time of initial presentation and not those obtained after resuscitation or ICU admission. In contrast to epidemiologic reports, we found no association between low Vit D levels and postoperative cardiovascular events. However, low Vit D levels did affect the ICU and hospital length of stay in patients who were undergoing cardiac surgery. This is an important finding especially when many institutions and regulatory agencies are investigating novel therapies and processes to reduce the length of hospitalization. More studies are required to investigate the effect on hospital length of stay of early preadmission or preoperative Vit D supplementation before elective surgery.
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Affiliation(s)
- Krishnan Sriram
- Division of Surgical Critical Care, Department of Surgery, Stroger Hospital of Cook County, Chicago, Illinois, USA.
| | - Kalyani Perumal
- Division of Nephrology, Department of Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Golnaz Alemzadeh
- Department of Anesthesiology and Pain Management, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Albert Osei
- Division of Nephrology, Department of Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Gennadiy Voronov
- Department of Anesthesiology and Pain Management, Stroger Hospital of Cook County, Chicago, Illinois, USA
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50
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Yap C, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M. Vitamin D supplementation and the effects on glucose metabolism during pregnancy: a randomized controlled trial. Diabetes Care 2014; 37:1837-44. [PMID: 24760259 DOI: 10.2337/dc14-0155] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Vitamin D deficiency in pregnancy is associated with an increased risk of gestational diabetes mellitus (GDM) and neonatal vitamin D deficiency. We conducted a double-blind, randomized controlled trial of low-dose (LD) versus high-dose (HD) vitamin D supplementation to investigate the effects of vitamin D supplementation on glucose metabolism during pregnancy. RESEARCH DESIGN AND METHODS Women with plasma 25-hydroxyvitamin D (25OHD) levels <32 ng/mL before 20 weeks' gestation were randomized to oral vitamin D3 at 5,000 IU daily (HD) (n = 89) or the recommended pregnancy dose of 400 IU daily (LD) (n = 90) until delivery. The primary end point was maternal glucose levels on oral glucose tolerance test (OGTT) at 26-28 weeks' gestation. Secondary end points included neonatal 25OHD, obstetric and other neonatal outcomes, and maternal homeostasis model assessment of insulin resistance. Analysis was by intention to treat. RESULTS There was no difference in maternal glucose levels on OGTT. Twelve LD women (13%) developed GDM versus seven (8%) HD women (P = 0.25). Neonatal cord 25OHD was higher in HD offspring (46 ± 11 vs. 29 ± 12 ng/mL, P < 0.001), and deficiency was more common in LD offspring (24 vs. 10%, P = 0.06). Post hoc analysis in LD women showed an inverse relationship between pretreatment 25OHD and both fasting and 2-h blood glucose level on OGTT (both P < 0.001). Baseline 25OHD remained an independent predictor after multiple regression analysis. CONCLUSIONS HD vitamin D supplementation commencing at a mean of 14 weeks' gestation does not improve glucose levels in pregnancy. However, in women with baseline levels <32 ng/mL, 5,000 IU per day was well tolerated and highly effective at preventing neonatal vitamin D deficiency.
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Affiliation(s)
- Constance Yap
- Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, AustraliaFaculty of Medicine, Western Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - N Wah Cheung
- Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, AustraliaFaculty of Medicine, Western Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jenny E Gunton
- Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, AustraliaFaculty of Medicine, Western Clinical School, University of Sydney, Sydney, New South Wales, AustraliaDiabetes and Transcription Factors Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Neil Athayde
- Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Craig F Munns
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Anna Duke
- Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Mark McLean
- Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, AustraliaSchool of Medicine, University of Western Sydney, Sydney, New South Wales, Australia
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