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Lu X, Chen Z, Lu J, Watsky MA. Effects of 1,25-Vitamin D3 and 24,25-Vitamin D3 on Corneal Nerve Regeneration in Diabetic Mice. Biomolecules 2023; 13:1754. [PMID: 38136625 PMCID: PMC10742127 DOI: 10.3390/biom13121754] [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: 11/07/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Corneal nerve homeostasis is essential for the functional integrity of the ocular surface. Vitamin D deficiency (VDD) and vitamin D receptor knockout (VDR KO) have been found to reduce corneal nerve density in diabetic mice. This is the first study to comprehensively examine the influence of vitamin D on nerve regeneration following corneal epithelial injury in diabetic mice. Corneal nerve regeneration was significantly retarded by diabetes, VDR KO, and VDD, and it was accelerated following topical 1,25 Vit D and 24,25 Vit D administration. Furthermore, topical 1,25 Vit D and 24,25 Vit D increased nerve growth factor, glial cell line-derived neurotropic factor, and neurotropin-3 protein expression, and it increased secretion of GDNF protein from human corneal epithelial cells. CD45+ cells and macrophage numbers were significantly decreased, and vitamin D increased CD45+ cell and macrophage recruitment in these wounded diabetic mouse corneas. The accelerated nerve regeneration observed in these corneas following topical 1,25 Vit D and 24,25 Vit D administration may be related to the vitamin D-stimulated expression, secretion of neurotrophic factors, and recruitment of immune cells.
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Affiliation(s)
- Xiaowen Lu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, 1120 15th Street, CB-2901, Augusta, GA 30912, USA
| | | | | | - Mitchell A. Watsky
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, 1120 15th Street, CB-2901, Augusta, GA 30912, USA
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2
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Liu J, Qin L, Zheng J, Tong L, Lu W, Lu C, Sun J, Fan B, Wang F. Research Progress on the Relationship between Vitamins and Diabetes: Systematic Review. Int J Mol Sci 2023; 24:16371. [PMID: 38003557 PMCID: PMC10671335 DOI: 10.3390/ijms242216371] [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: 09/26/2023] [Revised: 10/27/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
Diabetes is a serious chronic metabolic disease that causes complications over time, bringing serious public health challenges that affect different countries across the world. The current clinical drugs for diabetes may lead to adverse effects such as hypoglycemia and liver and abdominal distension and pain, which prompt people to explore new treatments for diabetes without side effects. The research objective of this review article is to systematically review studies on vitamins and diabetes and to explain their possible mechanism of action, as well as to assess the role of vitamins as drugs for the prevention and treatment of diabetes. To achieve our objective, we searched scientific databases in PubMed Central, Medline databases and Web of Science for articles, using "vitamin" and "diabetes" as key words. The results of numerous scientific investigations revealed that vitamin levels were decreased in humans and animals with diabetes, and vitamins show promise for the prevention and/or control of diabetes through anti-inflammation, antioxidation and the regulation of lipid metabolism. However, a few studies showed that vitamins had no positive effect on the development of diabetes. Currently, studies on vitamins in the treatment of diabetes are still very limited, and there are no clinical data to clarify the dose-effect relationship between vitamins and diabetes; therefore, vitamins are not recommended as routine drugs for the treatment of diabetes. However, we still emphasize the great potential of vitamins in the prevention and treatment of diabetes, and higher quality studies are needed in the future to reveal the role of vitamins in the development of diabetes.
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Affiliation(s)
| | | | | | | | | | | | | | - Bei Fan
- Key Laboratory of Agro-Products Quality and Safety Control in Storage and Transport Process, Ministry of Agriculture and Rural Affairs, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Fengzhong Wang
- Key Laboratory of Agro-Products Quality and Safety Control in Storage and Transport Process, Ministry of Agriculture and Rural Affairs, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing 100193, China
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3
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Lei F, Ni J, Hu JL, Guo DN, Fan J. Different doses of vitamin D supplementation to nonsurgical treatment for vitamin-D-insufficient patients with diabetic periodontitis and the effect on gingival BMP-2 levels. Kaohsiung J Med Sci 2023; 39:1030-1037. [PMID: 37395326 DOI: 10.1002/kjm2.12726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/03/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Abstract
Epidemiological data show people with diabetes mellitus (DM) have three-fold increase in risk of periodontitis. A vitamin D insufficiency can affect the progression of DM and periodontitis. This study evaluated the effects of different-dose vitamin D supplementation to nonsurgical periodontal therapy for vitamin-D-insufficient diabetic patients coexisting with periodontitis and changes of gingival bone morphogenetic protein-2 (BMP-2) levels. The study included 30 vitamin-D-insufficient patients receiving nonsurgical treatment followed by administration of 25,000 international units (IU) vitamin D3 per week (the low-VD group) and 30 patients receiving 50,000 UI vitamin D per week (the high-VD group). The decreases of probing pocket depth, clinical attachment loss, bleeding index, and periodontal plaque index values of patients after the six-month supplementation of 50,000 UI vitamin D3 per week to nonsurgical treatment were more significant than those after the six-month supplementation of 25,000 UI vitamin D3 per week to nonsurgical treatment. It was found that 50,000 IU per week vitamin D supplementation for 6 months could lead to a better glycemic control for vitamin-D-insufficient diabetic patients coexisting with periodontitis after nonsurgical periodontal therapy. Increased levels of serum 25(OH) vitamin D3 and gingival BMP-2 were found in both low- and high-dose VD groups, and the high-dose VD group exhibited higher levels than the low-dose VD group. Vitamin D supplementation in large doses for 6 months tended to improve the treatment of periodontitis and increase gingival BMP-2 levels in diabetic patients coexisting with periodontitis who were vitamin D deficient.
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Affiliation(s)
- Fei Lei
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jing Ni
- Clinical Medicine, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jin-Long Hu
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Dan-Ni Guo
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jing Fan
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
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4
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Le Y, Wang B, Xue M. Nutraceuticals use and type 2 diabetes mellitus. Curr Opin Pharmacol 2022; 62:168-176. [DOI: 10.1016/j.coph.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/05/2021] [Accepted: 12/05/2021] [Indexed: 12/22/2022]
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Ambient Air Pollutions Are Associated with Vitamin D Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136887. [PMID: 34198962 PMCID: PMC8297026 DOI: 10.3390/ijerph18136887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
Evidence on the effect of ambient air pollution on vitamin D is limited. This study aimed to examine the association of air pollution exposure with serum levels of 25-hydroxyvitamin D (25OHD) using UK Biobank health datasets. A total of 448,337 subjects were included in this analysis. Land Use Regression was applied to assess individual exposures to particulate matter with diameters ≤2.5 µm (PM2.5), ≤10 µm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Linear regression models evaluated the associations between air pollutants and serum vitamin D levels after adjustment of a series of confounders. All analyzed air pollutants were negatively associated with serum vitamin 25OHD levels. After adjusting for potential confounders, a 10 μg/m3 increase in concentrations of PM2.5, PM10, NOx, and NO2 was associated with −9.11 (95%CI: −13.25 to −4.97), −2.47 (95%CI: −4.51 to −0.43), −0.56 (95%CI: −0.82 to −0.30), and −1.64 (95%CI: −2.17 to −1.10) nmol/L decrease in serum vitamin 25OHD levels, respectively. Interaction analyses suggested that the effects of air pollution were more pronounced in females. In conclusion, long-term exposures to ambient PM2.5, PM10, NOx, and NO2 were associated with vitamin D status in a large UK cohort.
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Lu X, Chen Z, Watsky MA. Effects of 1,25 and 24,25 Vitamin D on Corneal Fibroblast VDR and Vitamin D Metabolizing and Catabolizing Enzymes. Curr Eye Res 2021; 46:1271-1282. [PMID: 33535006 DOI: 10.1080/02713683.2021.1884726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To investigate the effects of 1,25-Vit D3 and 24,25-Vit D3 on corneal fibroblast expression of the vitamin D-associated enzymes CYP27B1 and CYP24A1 and the roles of the vitamin D receptor (VDR) and protein disulfide isomerase, family A, member 3 (Pdia3) in these cells.Methods: CYP24A1, CYP27B1, VDR, and Pdia3 expression in corneas was detected using immunohistochemistry. Western blotting was used to measure protein expression in human and mouse fibroblasts, including VDR KO mouse cells, treated with 1,25-Vit D3 (20 nM) and 24,25-Vit D3 (100 nM). The Pdia3 inhibitor LOC14 was used to explore the role of Pdia3 as a Vit D3 receptor in these cells.Results: CYP24A1, CYP27B1, VDR, and Pdia3 were all expressed in mouse and human corneal fibroblasts. 1,25-Vit D3 significantly increased VDR expression in human and mouse fibroblasts. 1,25-Vit D3 and 24,25-VitD3 significantly increased CYP24A1 and CYP27B1 expression level in human, VDR WT mouse, and VDR KO mouse corneal fibroblasts. CYP24A1 and CYP27B1 expression was unchanged in VDR KO mouse fibroblasts treated with 1,25-Vit D3 or 24,25-Vit D3 plus LOC14. Human fibroblast VDR, CYP24A1, and CYP27B1 expression were unaffected by LOC14.Conclusions: Vitamin D metabolic enzymes, VDR, and Pdia3 are all expressed in mouse and human corneal fibroblasts. 1,25-Vit D3 modulates fibroblast vitamin D enzymes through both the VDR and Pdia3 pathways in a species-dependent manner. 24,25-Vit D3 can increase expression of fibroblast CYP24A1 and CYP27B1 in the absence of VDR and is likely involved in fibroblast regulation independent of 1,25-Vit D3 or VDR.
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Affiliation(s)
- Xiaowen Lu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Zhong Chen
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Mitchell A Watsky
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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Omran EF, Ramzy A, Shohayeb A, Farouk N, Soliman M, Baz H, Sharaf MF. Relation of serum vitamin D level in polycystic ovarian syndrome (PCOS) patients to ICSI outcome. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00034-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Recently, vitamin D was discovered to have an important role in female reproduction and IVF. However, there were no studies specifically addressed its role in polycystic ovarian syndrome (PCOS) patients undergoing ICSI cycles. Therefore, this cross-sectional study in a university hospital was conducted to evaluate the effect of serum level of vitamin D (VD) on the number of retrieved and fertilized oocytes, and chemical and clinical pregnancy rate in PCOS females undergoing ICSI cycles. The study included 80 PCOS cases undergoing ICSI cycles in the age from 20 to 39 years using antagonist protocol. Cases with severe male or tubal factors were excluded. Serum 25 (OH) D vitamin level was assessed by the ELIZA method on the day of oocyte retrieval. Correlation and regression analyses were used in the analysis.
Results
VD was positively correlated to both numbers of retrieved and fertilized oocytes (r = 0.35, 95% CI 0.15, 0.53, P = 0.001; r = 0.33; 95% CI 0.03, 0.57, P = 0.03, respectively). It was still significantly correlated to the number of oocytes (coefficient 0.47; 95% CI 0.1, 0.9; P = 0.018) and to the number of fertilized eggs (coefficient 0.3; 95% CI 0.02, 0.58; P = 0.03) after adjusting for age, BMI, and type of ovulation-triggering agent. This means with each 2 ng/mL increase in serum VD level, around one more egg will be retrieved. In addition, there will be one more fertilized oocyte with each 3 ng/mL increase in the vitamin level. However, no significant correlation was found between the vitamin level and the occurrence of chemical or clinical pregnancy.
Conclusions
Serum vitamin D level is positively correlated with the number of retrieved and fertilized oocytes in PCOS patients undergoing ICSI cycles.
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Asbaghi O, Sadeghian M, Mozaffari-Khosravi H, Maleki V, Shokri A, Hajizadeh-Sharafabad F, Alizadeh M, Sadeghi O. The effect of vitamin d-calcium co-supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials. Cytokine 2020; 129:155050. [DOI: 10.1016/j.cyto.2020.155050] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/14/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023]
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Lu X, Vick S, Chen Z, Chen J, Watsky MA. Effects of Vitamin D Receptor Knockout and Vitamin D Deficiency on Corneal Epithelial Wound Healing and Nerve Density in Diabetic Mice. Diabetes 2020; 69:1042-1051. [PMID: 32139594 PMCID: PMC7171964 DOI: 10.2337/db19-1051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/23/2020] [Indexed: 12/20/2022]
Abstract
Diabetic keratopathy occurs in ∼70% of all people with diabetes. This study was designed to examine the effects of vitamin D receptor knockout (VDR-/-) and vitamin D deficiency (VDD) on corneal epithelial wound healing and nerve density in diabetic mice. Diabetes was induced using the low-dose streptozotocin method. Corneal epithelial wounds were created using an Algerbrush, and wound healing was monitored over time. Corneal nerve density was measured in unwounded mice. VDR-/- and VDD diabetic mice (diabetic for 8 and 20 weeks, respectively) had slower healing ratios than wild-type diabetic mice. VDR-/- and VDD diabetic mice also showed significantly decreased nerve density. Reduced wound healing ratios and nerve densities were not fully rescued by a supplemental diet rich in calcium, lactose, and phosphate. We conclude that VDR-/- and VDD significantly reduce both corneal epithelial wound healing and nerve density in diabetic mice. Because the supplemental diet did not rescue wound healing or nerve density, these effects are likely not specifically related to hypocalcemia. This work supports the hypothesis that low vitamin D levels can exacerbate preexisting ophthalmic conditions, such as diabetes.
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Affiliation(s)
- Xiaowen Lu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
| | - Sarah Vick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
| | - Zhong Chen
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
| | - Jie Chen
- Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
| | - Mitchell A Watsky
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
- The Graduate School, Augusta University, Augusta, GA
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10
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VDR regulates energy metabolism by modulating remodeling in adipose tissue. Eur J Pharmacol 2019; 865:172761. [DOI: 10.1016/j.ejphar.2019.172761] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/18/2019] [Accepted: 10/25/2019] [Indexed: 01/19/2023]
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Zhang B, Zhao W, Tu J, Wang X, Hao Y, Wang H, Zhao Y, Mizuno K, Tseng Y, Bu H. The relationship between serum 25-hydroxyvitamin D concentration and type 2 diabetic peripheral neuropathy: A systematic review and a meta-analysis. Medicine (Baltimore) 2019; 98:e18118. [PMID: 31770239 PMCID: PMC6890351 DOI: 10.1097/md.0000000000018118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vitamin D is a fat-soluble vitamin that is related to the health of the human body and is an indispensable nutrient for human beings. Some studies indicated that type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) may be associated with vitamin D deficiency, but the current understanding of this point of view remains controversial. This study aimed to evaluate the correlation between serum 25-hydroxyl vitamin D (25 [OH] D) concentration and DPN in patients with T2DM by a meta-analysis, and to provide a reference for doctors. METHODS Relevant studies were selected from the PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP databases, and Wanfang Data Knowledge Service Platform databases dating from 2000 to December 2017. A total of 75 articles related to serum 25 (OH) D and DPN were selected from 2000 to December 2017. Based on the inclusion and exclusion criteria of the literature, a quality assessment was conducted using the Newcastle-Ottawa scale, and a meta-analysis was performed by RevMan5.3 statistical software. RESULTS Thirteen studies that involved a total of 2814 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis results, heterogeneity test showed that, P < .000 01, I = 92%, calculation by random effect model revealed that, the serum concentration of 25 (OH) D in T2DM combined with DPN group was lower than that in the group without DPN (weighted mean difference = -0.74, 95% confidence interval: -1.03 to -0.46) CONCLUSIONS:: Vitamin D is associated with type 2 DPN (DPN), and vitamin D deficiency can lead to an increased risk of type 2 DPN. However, more high-quality research is needed.
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Affiliation(s)
- Binjie Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine
| | - Wenli Zhao
- Department of Neurology, Nankai Hospital, Tianjin Academy of Integrative Medicine, Tianjin, China
- Department of Acupuncture and Moxibustion, Suzuka University of Medical Science, Suzuka, Japan
| | - Jinli Tu
- Department of Language and Culture
| | - Xueying Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine
| | | | - Hongwu Wang
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ye Zhao
- Department of Research and Development, Hangzhou DeBuYou Health Technology Co. Ltd., Hangzhou, Zhejiang, China
| | - Kaito Mizuno
- Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Yiider Tseng
- Department of Chemical Engineering, University of Florida, 1006 Center Drive, Gainesville, FL
| | - Huaien Bu
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin
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12
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Leung PS. The Modulatory Action of Vitamin D on the Renin-Angiotensin System and the Determination of Hepatic Insulin Resistance. Molecules 2019; 24:molecules24132479. [PMID: 31284538 PMCID: PMC6651371 DOI: 10.3390/molecules24132479] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/16/2022] Open
Abstract
Vitamin D deficiency or hypovitaminosis D is associated with increased risks of insulin resistance, type 2 diabetes mellitus (T2DM) and its related non-alcoholic fatty liver disease (NAFLD). Meanwhile, inappropriate over-activation of the renin–angiotensin system (RAS) in the liver leads to the hepatic dysfunction and increased risk of T2DM, such as abnormalities in lipid and glucose metabolism. Our previous findings have shown that calcitriol, an active metabolite of vitamin D, reduces hepatic triglyceride accumulation and glucose output in diabetic db/db mice and human hepatocellular cell HepG2 cells under insulin-resistant conditions. Notwithstanding the existence of this evidence, the protective action of vitamin D in the modulation of overexpressed RAS-induced metabolic abnormalities in the liver under insulin resistance remains to be elusive and investigated. Herein, we have reported the potential interaction between vitamin D and RAS; and its beneficial effects on the expression and function of the RAS components in HepG2 cells and primary hepatocytes under insulin-resistance states. Our study findings suggest that hormonal vitamin D (calcitriol) has modulatory action on the inappropriate upregulation of the hepatic RAS under insulin-resistant conditions. If confirmed, vitamin D supplementation might provide a nutraceutical potential as a cost-effective approach for the management of hepatic metabolic dysfunction as observed in T2DM and related NAFLD.
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Affiliation(s)
- Po Sing Leung
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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13
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Abstract
Vitamin D, a fat-soluble vitamin, plays a role not only in calcium and phosphate homeostasis but also in several other functions, including cell growth and neuromuscular and immune function. The deficiency of vitamin D is highly prevalent throughout the world and has been suggested to be associated with an enhanced risk of major depressive disorder (MDD) and anxiety disorders. Therefore, vitamin D supplementation has been investigated for the prevention and treatment of these disorders. This review presents preclinical and clinical evidence of the effects of vitamin D supplementation in these disorders. Although preclinical studies provide limited evidence on the possible mechanisms underlying the beneficial effects of vitamin D for the management of these disorders, most of the clinical studies have indicated that vitamin D supplementation is associated with the reduction of symptoms of depression and anxiety, particularly when the supplementation was carried out in individuals with an MDD diagnosis (of the 13 studies in which MDD diagnosis was established, 12 had positive results with vitamin supplementation). However, some heterogeneity in the outcomes was observed and might be associated with an absence of overt psychiatric symptoms in several studies, genetic polymorphisms that alter vitamin D metabolism and bioavailability, differences in the supplementation regimen (monotherapy, adjunctive therapy, or large bolus dosing), and levels of 25-hydroxyvitamin D3 (25(OH)D) at baseline (individuals with low vitamin D status may respond better) and attained after supplementation. Additionally, factors such as sex, age, and symptom severity also need to be further explored in relation to the effects of vitamin D. Therefore, although vitamin D may hold significant potential for mental health, further preclinical and clinical studies are clearly necessary to better understand its role on mood/affect modulation.
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Aatsinki SM, Elkhwanky MS, Kummu O, Karpale M, Buler M, Viitala P, Rinne V, Mutikainen M, Tavi P, Franko A, Wiesner RJ, Chambers KT, Finck BN, Hakkola J. Fasting-Induced Transcription Factors Repress Vitamin D Bioactivation, a Mechanism for Vitamin D Deficiency in Diabetes. Diabetes 2019; 68:918-931. [PMID: 30833469 PMCID: PMC6477896 DOI: 10.2337/db18-1050] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/26/2019] [Indexed: 12/19/2022]
Abstract
Low 25-hydroxyvitamin D levels correlate with the prevalence of diabetes; however, the mechanisms remain uncertain. Here, we show that nutritional deprivation-responsive mechanisms regulate vitamin D metabolism. Both fasting and diabetes suppressed hepatic cytochrome P450 (CYP) 2R1, the main vitamin D 25-hydroxylase responsible for the first bioactivation step. Overexpression of coactivator peroxisome proliferator-activated receptor γ coactivator 1-α (PGC-1α), induced physiologically by fasting and pathologically in diabetes, resulted in dramatic downregulation of CYP2R1 in mouse hepatocytes in an estrogen-related receptor α (ERRα)-dependent manner. However, PGC-1α knockout did not prevent fasting-induced suppression of CYP2R1 in the liver, indicating that additional factors contribute to the CYP2R1 repression. Furthermore, glucocorticoid receptor (GR) activation repressed the liver CYP2R1, suggesting GR involvement in the regulation of CYP2R1. GR antagonist mifepristone partially prevented CYP2R1 repression during fasting, suggesting that glucocorticoids and GR contribute to the CYP2R1 repression during fasting. Moreover, fasting upregulated the vitamin D catabolizing CYP24A1 in the kidney through the PGC-1α-ERRα pathway. Our study uncovers a molecular mechanism for vitamin D deficiency in diabetes and reveals a novel negative feedback mechanism that controls crosstalk between energy homeostasis and the vitamin D pathway.
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Affiliation(s)
- Sanna-Mari Aatsinki
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Admescope Ltd., Oulu, Finland
| | - Mahmoud-Sobhy Elkhwanky
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Outi Kummu
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mikko Karpale
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marcin Buler
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pirkko Viitala
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
| | | | - Maija Mutikainen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pasi Tavi
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Andras Franko
- Institute of Vegetative Physiology, Medical Faculty, University of Köln, Köln, Germany
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Rudolf J Wiesner
- Institute of Vegetative Physiology, Medical Faculty, University of Köln, Köln, Germany
| | - Kari T Chambers
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Brian N Finck
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Jukka Hakkola
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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15
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Casseb GAS, Ambrósio G, Rodrigues ALS, Kaster MP. Levels of 25-hydroxyvitamin D 3, biochemical parameters and symptoms of depression and anxiety in healthy individuals. Metab Brain Dis 2019; 34:527-535. [PMID: 30604028 DOI: 10.1007/s11011-018-0371-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/11/2018] [Indexed: 01/17/2023]
Abstract
Growing evidence support the role of vitamin D in brain function and behavior. This study investigated the relationship between 25-hydroxyvitamin D3 [25(OH)D3] levels, biochemical profile and symptoms of depression and anxiety in healthy individuals. Symptoms of depression were assessed by the Beck Depression Inventory (BDI) and anxiety was evaluated with the State-Trait Anxiety Inventory (STAI). Our sample included 36 individuals, mostly women 27(75%), 36.39 ± 9.72 years old, non-smokers 31(86.1%), body mass index of 26.57 ± 3.92 kg/m2, 27.95 ± 7.50% body fat. Participants were divided into those with 25(OH)D3 levels lower than 40 ng/mL (mean 28.16 ± 7.07) and equal or higher than 40 ng/mL (mean 53.19 ± 6.32). Those with lower 25(OH)D3 had higher levels of triacylglycerol, triacylglycerol/high density lipoprotein (HDL) ratio, high glucose and homeostatic model assessment of insulin resistance (HOMA-IR) index. No changes were observed in sociodemographic variables, body composition, inflammatory parameters and cortisol. Additionally, in the groups with low and high 25(OH)D3 levels, STAI state, STAI trait and BDI scores were not statistically different. Levels of 25(OH)D3 were inversely and independently associated with glucose and HOMA-IR, but not associated with triacylglycerol, depression and anxiety scores. Lower levels of 25(OH)D3 were associated with dysfunction in glucose metabolism but not with depression and anxiety in healthy individuals.
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Affiliation(s)
- Gleicilaine A S Casseb
- Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040900, Brazil
| | - Gabriela Ambrósio
- Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040900, Brazil
| | - Ana Lúcia S Rodrigues
- Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040900, Brazil
| | - Manuella P Kaster
- Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040900, Brazil.
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16
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Grammatiki M, Karras S, Kotsa K. The role of vitamin D in the pathogenesis and treatment of diabetes mellitus: a narrative review. Hormones (Athens) 2019; 18:37-48. [PMID: 30255482 DOI: 10.1007/s42000-018-0063-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/09/2018] [Indexed: 12/21/2022]
Abstract
Diabetes mellitus, a metabolic disorder associated with chronic complications, is traditionally classified into two main subtypes. Type 1 diabetes mellitus (T1DM) results from gradual pancreatic islet β cell autoimmune destruction, extending over months or years. Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, with both insulin resistance and impairment in insulin secretion contributing to its pathogenesis. Vitamin D is a fat-soluble vitamin with an established role in calcium metabolism. Recently, several studies have provided evidence suggesting a role for it in various non-skeletal metabolic conditions, including both types of diabetes mellitus. Preclinical studies of vitamin D action on insulin secretion, insulin action, inflammatory processes, and immune regulation, along with evidence of an increase of hypovitaminosis D worldwide, have prompted several epidemiological, observational, and supplementation clinical studies investigating a potential biological interaction between hypovitaminosis D and diabetes. This narrative review aims to summarize current knowledge on the effect of vitamin D on T1DM and T2DM pathogenesis, prevention, and treatment, as well as on micro- and macrovascular complications of the disease. Furthermore, on the basis of current existing evidence, we aim to highlight areas for potential future research.
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Affiliation(s)
- Maria Grammatiki
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Spiros Karras
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece.
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17
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Ziaei-Kajbaf T, Aminzadeh M, Fatahinezhad E, Aletayeb SMH. Vitamin D status in diabetic children and adolescents. Diabetes Metab Syndr 2018; 12:849-852. [PMID: 29789223 DOI: 10.1016/j.dsx.2018.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/15/2018] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Besides its role in calcium homeostasis, vitamin D (VD) has an important immuno-mudulation effect. However, its role in autoimmune diseases such as type 1 diabetes is under discussion. This study designed to investigate serum VD status in children and adolescents with and without diabetes. MATERIALS AND METHODS In a case-control study, 85 diabetic and 85 non-diabetic control (total 170) aged 1-15 yr. were enrolled. History of breast feeding and vitamin supplementation was obtained; growth indices and serum levels of Calcium, phosphorous, Alkaline-Phosphatase (ALP), Hemoglobin-A1c and VD were measured and analyzed. RESULTS The mean values for VD in case and control groups were 12.80 ± 10.59 and 15.85 ± 9.92 nmol/L, respectively (p = 0.057). Serum VD status in these two groups was sufficient in 5.88% and 9.41%, insufficient in 18% and 14%, and deficient in 75.29% and 76.74%, respectively. Compared to the controls, diabetics had more history of breast-feeding (62.35% vs. 42.35%; p = 0.017) and higher serum ALP levels (772.34 ± 309.89 vs. 657.99 ± 395.11 U/L; p = 0.032). CONCLUSION More frequency of breast-feeding, higher serum ALP and mildly lower serum level of VD in diabetics suggests a significant difference in VD status in diabetics compared to the healthy peers indicating a potential role of this deficiency in the disease process.
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Affiliation(s)
- Tahereh Ziaei-Kajbaf
- Pediatric Department, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Aminzadeh
- Diabetes Research Center, Ahvaz Jundishapu University of Medical Sciences, Ahvaz, Iran.
| | - Elham Fatahinezhad
- Pediatric Department, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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18
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Bener A, Ozdenkaya Y, Al-Hamaq AO, Barisik CC, Ozturk M. Low Vitamin D Deficiency Associated With Thyroid Disease Among Type 2 Diabetic Mellitus Patients. J Clin Med Res 2018; 10:707-714. [PMID: 30116441 PMCID: PMC6089577 DOI: 10.14740/jocmr3507w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationship between vitamin D deficiency and thyroid diseases among type 2 diabetes mellitus (T2DM) patients. METHODS This was a cohort case and control study, 546 T2DM patients and 546 control study participants were enrolled, aged between 25 and 65 years. The subjects were also investigated for fasting blood glucose levels (FBG), post prandial glucose (PPG,) glycosylated hemoglobin (HbA1c), thyroid stimulating hormone (TSH), T3, T4, and presence of other comorbid conditions. Thyroid fine needle aspiration biopsy was suggested to patients whose thyroid nodules were greater than 1.00 cm. RESULTS There were significant differences between T2DM patients and control subjects regarding BMI (kg/m2), physical activity, cigarette smoking, sheesha smoking, family history of diabetes, hypertension and family history of thyroid nodules. The clinical biochemistry values among T2DM for vitamin D, calcium, magnesium, potassium, phosphorous, fasting blood glucose, cholesterol, HbA1c, HLDL, LDL, triglyceride, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower than control subjects, but higher in creatinine, albumin, TSH, T3, and T4 which appeared statistically significant differences (P < 0.001). Also, the study revealed statistically significant differences between subjects vitamin D deficiency and with thyroid nodules for calcium, magnesium, phosphorous, HbA1c, high density lipoprotein (HDL), SBP and DBP, TSH, T3, and T4 among T2DM patients and control subjects (P < 0.001). Multivariable stepwise logistic regression analysis showed that TSH, HbA1c, vitamin D deficiency, SBP (mm Hg), BMI, family history of DM, serum calcium level and family history of thyroid were considered at higher risk as predictors of thyroid among T2DM patients. CONCLUSIONS This study suggests that obesity, HbA1c, the environment, and genetic susceptibility among T2DM, may increase the risk of thyroid disease and cancer. Although evidence has shown that thyroid cancer incidence has been rising more rapidly over time than the occurrence of cancers of other sites, due to an increase of obesity, diabetes and lack of physical activity, this study lacks of direct evidence supporting this conclusion.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The university of Manchester, Manchester, UK
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yasar Ozdenkaya
- Qatar Diabetic Associations and Qatar National Research Foundation, Doha, Qatar
| | - Abdulla O.A.A. Al-Hamaq
- Department of Surgery, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Cem Cahit Barisik
- Department of Radiology and Pathology, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Ozturk
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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19
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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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20
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Wimalawansa SJ. Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J Steroid Biochem Mol Biol 2018; 175:177-189. [PMID: 27662816 DOI: 10.1016/j.jsbmb.2016.09.017] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 12/23/2022]
Abstract
The aim of this study is to determine the relationships of vitamin D with diabetes, insulin resistance obesity, and metabolic syndrome. Intra cellular vitamin D receptors and the 1-α hydroxylase enzyme are distributed ubiquitously in all tissues suggesting a multitude of functions of vitamin D. It plays an indirect but an important role in carbohydrate and lipid metabolism as reflected by its association with type 2 diabetes (T2D), metabolic syndrome, insulin secretion, insulin resistance, polycystic ovarian syndrome, and obesity. Peer-reviewed papers, related to the topic were extracted using key words, from PubMed, Medline, and other research databases. Correlations of vitamin D with diabetes, insulin resistance and metabolic syndrome were examined for this evidence-based review. In addition to the well-studied musculoskeletal effects, vitamin D decreases the insulin resistance, severity of T2D, prediabetes, metabolic syndrome, inflammation, and autoimmunity. Vitamin D exerts autocrine and paracrine effects such as direct intra-cellular effects via its receptors and the local production of 1,25(OH)2D3, especially in muscle and pancreatic β-cells. It also regulates calcium homeostasis and calcium flux through cell membranes, and activation of a cascade of key enzymes and cofactors associated with metabolic pathways. Cross-sectional, observational, and ecological studies reported inverse correlations between vitamin D status with hyperglycemia and glycemic control in patients with T2D, decrease the rate of conversion of prediabetes to diabetes, and obesity. However, no firm conclusions can be drawn from current studies, because (A) studies were underpowered; (B) few were designed for glycemic outcomes, (C) the minimum (or median) serum 25(OH) D levels achieved are not measured or reported; (D) most did not report the use of diabetes medications; (E) some trials used too little (F) others used too large, unphysiological and infrequent doses of vitamin D; and (G) relative paucity of rigorous clinical data on the effects of vitamin D sufficiency on non-calcium endpoints. Although a large number of observational studies support improving T2D, insulin resistance, obesity, and metabolic syndrome with vitamin D adequacy, there is a lack of conclusive evidence from randomized control clinical trials that, these disorders are prevented following optimization of serum levels of 25(OH)D. However, none of the currently conducted clinical studies would resolve these issues. Thus, specifically designed, new clinical studies are needed to be conducted in well-defined populations, following normalizing the serum vitamin D levels in vitamin D deficient prediabetes subjects, to test the hypothesis that hypovitaminosis D worsens these disorders and correction would alleviate it.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology, Metabolisum & Nutrition, Cardio Metabolic Institute, NJ, USA.
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21
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Wimalawansa SJ. Non-musculoskeletal benefits of vitamin D. J Steroid Biochem Mol Biol 2018; 175:60-81. [PMID: 27662817 DOI: 10.1016/j.jsbmb.2016.09.016] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023]
Abstract
The aim of this study is to determine and critically evaluate the plausible relationships of vitamin D with extra-skeletal tissues in humans. Severe vitamin D deficiency results in rickets in children and osteomalacia in adults; these beneficial effects in the musculoskeletal system and certain physiological functions are well understood. Nevertheless, mounting reports support additional beneficial effects of vitamin D, outside the musculoskeletal system. This review explores the recent advances in knowledge about the non-skeletal effects of vitamin D. Peer-reviewed papers were extracted from research databases using key words, to assess correlations between vitamin D and extra-skeletal diseases and conditions. As per the guidelines of the Preferred Reporting Items for Systematic Reviews (PRISMA); general interpretations of results are included; taking into consideration the broader evidence and implications. This review summarizes current knowledge of the effects of vitamin D status on extra-skeletal tissues with special attention given to relationships between vitamin D status and various diseases commonly affecting adults; the effects of intervention with vitamin D and exposure to sunlight. Evidence suggests that vitamin D facilitates the regulation of blood pressure; and cardiac; endothelial; and smooth muscle cell functions; playing an important role in cardiovascular protection. In addition; 1,25(OH)2D improves immunity; subdues inflammation; and reduces the incidence and severity of common cancers; autoimmune diseases and infectious diseases. Almost all adequately powered; epidemiological and biological studies that use; adequate doses of vitamin D supplementation in D-deficient populations have reported favorable outcomes. These studies have concluded that optimizing 25(OH)D status improves the functionality of bodily systems; reduces comorbidities; improves the quality of life; and increases survival. Although accumulating evidence supports biological associations of vitamin D sufficiency with improved physical and mental functions; no definitive evidence exists from well-designed; statistically powered; randomized controlled clinical trials. Nevertheless, most studies point to significant protective effects of vitamin D in humans when the minimum 25(OH)D serum level exceeds 30ng/mL and is maintained throughout the year.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Cardio Metabolic Institute, 661 Darmody Avenue, North Brunswick, NJ, USA.
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22
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Giri D, Pintus D, Burnside G, Ghatak A, Mehta F, Paul P, Senniappan S. Treating vitamin D deficiency in children with type I diabetes could improve their glycaemic control. BMC Res Notes 2017; 10:465. [PMID: 28882195 PMCID: PMC5590233 DOI: 10.1186/s13104-017-2794-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/31/2017] [Indexed: 12/16/2022] Open
Abstract
Background and aims The relationship between vitamin D deficiency and type I DM is an ongoing area of interest. The study aims to identify the prevalence of vitamin D deficiency in children and adolescents with T1DM and to assess the impact of treatment of vitamin D deficiency on their glycaemic control. Methods Retrospective data was collected from 271 children and adolescents with T1DM. The vitamin D deficient (25(OH)D <30 nmol/L) and insufficient (25(OH)D 30–50 nmol/L) patients were treated with 6000 units of cholecalciferol and 400 units of cholecalciferol, once daily for 3 months respectively. HbA1c and 25(OH)D concentrations were measured before and at the end of the vitamin D treatment. Results 14.8% from the whole cohort (n = 271) were vitamin D deficient and 31% were insufficient. Among the children included in the final analysis (n = 73), the mean age and plasma 25(OH)D concentration (±SD) were 7.7 years (±4.4) and 32.2 nmol/l (±8.2) respectively. The mean 25(OH)D concentration post-treatment was 65.3 nmol/l (±9.3). The mean HbA1c (±SD) before and after cholecalciferol was 73.5 mmol/mol (±14.9) and 65 mmol/mol (±11.2) respectively (p < 0.001). Children with higher pre-treatment HbA1c had greater reduction in HbA1c (p < 0.001) and those with lower 25(OH)D concentration showed higher reduction in HbA1c (p = 0.004) after treatment. Conclusions Low 25(OH)D concentrations are fairly prevalent in children and adolescents with T1DM, treatment of which, can potentially improve the glycaemic control.
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Affiliation(s)
- Dinesh Giri
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.,Institute of Child Health, University of Liverpool, Liverpool, UK
| | - Dona Pintus
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Girvan Burnside
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Atrayee Ghatak
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Fulya Mehta
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Princy Paul
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Senthil Senniappan
- Department of Paediatric Endocrinology & Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. .,Institute of Child Health, University of Liverpool, Liverpool, UK.
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23
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Muscogiuri G, Altieri B, de Angelis C, Palomba S, Pivonello R, Colao A, Orio F. Shedding new light on female fertility: The role of vitamin D. Rev Endocr Metab Disord 2017; 18:273-283. [PMID: 28102491 DOI: 10.1007/s11154-017-9407-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In the last decades several studies suggested that vitamin D is involved in the modulation of the reproductive process in women due to the expression of VDR and 1α-hydroxylase in reproductive tissues such as ovary, uterus, placenta, pituitary and hypothalamus. Vitamin D has also a role in the regulation of sex hormone steroidogenesis. Increasing evidence suggests that vitamin D might have a regulatory role in polycystic ovary syndrome (PCOS)-associated symptoms, including ovulatory dysfunction, insulin resistance and hyperandrogenism. Vitamin D deficiency also has been reported to contribute to the pathogenesis of endometriosis due to its immunomodulatory and anti-inflammatory properties. Although most of the studies supported a role of vitamin D in the onset of these diseases, randomized controlled trials to assess the efficacy of vitamin D supplementation have never been performed. In this review we critically discuss the role of vitamin D in female fertility, starting from in vitro and in vivo studies, focusing our attention on the two most frequent causes of female infertility: PCOS and endometriosis.
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Affiliation(s)
- Giovanna Muscogiuri
- Ios and Coleman Medicina Futura Medical Center, Department of Clinical Medicine and Surgery, Section of Endocrinology, University "Federico II", Via Sergio Pasini, 580121, Naples, Italy.
| | - Barbara Altieri
- Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Cristina de Angelis
- Ios and Coleman Medicina Futura Medical Center, Department of Clinical Medicine and Surgery, Section of Endocrinology, University "Federico II", Via Sergio Pasini, 580121, Naples, Italy
| | - Stefano Palomba
- Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-IRCCS, 42123, Reggio Emilia, Italy
| | - Rosario Pivonello
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
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24
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Dooley J, Lagou V, Heirman N, Dresselaers T, Himmelreich U, Liston A. Murine Pancreatic Acinar Cell Carcinoma Growth Kinetics Are Independent of Dietary Vitamin D Deficiency or Supplementation. Front Oncol 2017; 7:133. [PMID: 28702373 PMCID: PMC5488083 DOI: 10.3389/fonc.2017.00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 06/07/2017] [Indexed: 11/13/2022] Open
Abstract
Vitamin D has been proposed as a therapeutic strategy in pancreatic cancer, yet evidence for an effect of dietary vitamin D on pancreatic cancer is ambiguous, with conflicting data from human epidemiological and intervention studies. Here, we tested the role of dietary vitamin D in the in vivo context of the well-characterized Ela1-TAg transgenic mouse model of pancreatic acinar cell carcinoma. Through longitudinal magnetic resonance imaging of mice under conditions of either dietary vitamin D deficiency (<5 IU/kg vitamin D) or excess (76,500 IU/kg vitamin D), compared to control diet (1,500 IU/kg vitamin D), we measured the effect of variation of dietary vitamin D on tumor kinetics. No measurable impact of dietary vitamin D was found on pancreatic acinar cell carcinoma development, growth or mortality, casting further doubt on the already equivocal data supporting potential therapeutic use in humans. The lack of any detectable effect of vitamin D, within the physiological range of dietary deficiency or supplementation, in this model further erodes confidence in vitamin D as an effective antitumor therapeutic in pancreatic acinar cell carcinoma.
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Affiliation(s)
- James Dooley
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Vasiliki Lagou
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Nathalie Heirman
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Tom Dresselaers
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Uwe Himmelreich
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Adrian Liston
- Translational Immunology Laboratory, VIB, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
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Grammatiki M, Rapti E, Karras S, Ajjan RA, Kotsa K. Vitamin D and diabetes mellitus: Causal or casual association? Rev Endocr Metab Disord 2017; 18:227-241. [PMID: 28062940 DOI: 10.1007/s11154-016-9403-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The incidence of both type 2 and type 1 diabetes mellitus has been increasing worldwide. Vitamin D deficiency, or the awareness of its prevalence, has also been increasing. Vitamin D may have a role in the pathogenic mechanisms predisposing to type 2 diabetes by modulating insulin resistance and/or pancreatic β-cell function. Vitamin D status or elements involved in its activation or transport may also be involved in the development of type 1 diabetes mellitus through immunomodulatory role . Based on these observations a potential association between vitamin D and diabetes has been hypothesized. In this review we discuss up to date evidence linking vitamin D with the development of diabetes. Moreover, the role of vitamin D supplementation in the prevention of both types of diabetes is analysed together with its role in improving glycemic control in diabetic patients. We also address the potential role of vitamin D deficiency in the development of macro- and microvascular complications in diabetes. Finally, we provide recommendation for Vitamin D therapy in diabetes in view of current evidence and highlight areas for potential future research in this area.
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Affiliation(s)
- M Grammatiki
- Department of Endocrinology and Metabolism - Diabetes Center, 1st Clinic of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - E Rapti
- Department of Endocrinology and Metabolism - Diabetes Center, 1st Clinic of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - S Karras
- Department of Endocrinology and Metabolism - Diabetes Center, 1st Clinic of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - R A Ajjan
- Division of Cardiovascular and Diabetes Research, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds Ringgold Standard Institution, Leeds, UK
| | - Kalliopi Kotsa
- Department of Endocrinology and Metabolism - Diabetes Center, 1st Clinic of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece.
- Aristotle University, Thessaloniki, Greece.
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26
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Wang Y, Zhang H. Serum 25-Hydroxyvitamin D3 Levels Are Associated with Carotid Intima-Media Thickness and Carotid Atherosclerotic Plaque in Type 2 Diabetic Patients. J Diabetes Res 2017; 2017:3510275. [PMID: 28459072 PMCID: PMC5387802 DOI: 10.1155/2017/3510275] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 12/03/2022] Open
Abstract
Objective. To investigate the relationship between serum 25-hydroxyvitamin D3 [25(OH)D3] levels and carotid intima-media thickness (IMT) as well as carotid atherosclerotic plaque in patients with type 2 diabetes mellitus (T2DM). Methods. 314 patients with T2DM were enrolled in this study. The clinical data and laboratory examinations of subjects were recorded, such as serum 25(OH)D3, hemoglobin A1c (HbA1c), serum lipids, fasting blood glucose (FBG), and other biochemical parameters. Color Doppler ultrasound was used to measure carotid IMT and carotid atherosclerotic plaques. Patients were divided into four quartile groups according to the serum 25(OH)D3 levels from low to high: group Q1~group Q4. Results. From group Q1 to group Q4, carotid IMT and the incidence of plaque were gradually reduced. Serum 25(OH)D3 levels were lower in the plaque group compared with the nonplaque group (P < 0.01). Serum 25(OH)D3 levels were negatively correlated with the carotid IMT (r = -0.4, P < 0.01). Multiple linear stepwise regression analysis showed that serum 25(OH)D3 was independently associated with carotid IMT (β = -0.009, P < 0.01). Logistic regression analysis showed that serum 25(OH)D3 levels were independently associated with the presence of carotid plaque in T2DM (OR = 0.95; 95%CI: 0.92~0.98, P = 0.004). Conclusions. Low vitamin D status may contribute to the incidence of carotid atherosclerosis in type 2 diabetic patients.
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Affiliation(s)
- Yurong Wang
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Huijuan Zhang
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Gmiat A, Mieszkowski J, Prusik K, Prusik K, Kortas J, Kochanowicz A, Radulska A, Lipiński M, Tomczyk M, Jaworska J, Antosiewicz J, Ziemann E. Changes in pro-inflammatory markers and leucine concentrations in response to Nordic Walking training combined with vitamin D supplementation in elderly women. Biogerontology 2017; 18:535-548. [PMID: 28316011 PMCID: PMC5514208 DOI: 10.1007/s10522-017-9694-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/14/2017] [Indexed: 12/25/2022]
Abstract
Mechanisms underpinning age-related decreases in muscle strength and muscle mass relate to chronic inflammation. Physical activity induces an anti-inflammatory effect, but it is modulated by additional factors. We hypothesized that vitamin D, which has also anti-inflammatory activity will modify adaptation to exercise and reduce inflammation in elderly women. Twenty-seven women aged 67 ± 8 years were included and divided into groups with baseline vitamin D concentration more than 20 ng mL−1 (MVD) and less than 20 ng mL−1 (LVD). Both groups performed 1 h Nordic Walking (NW) training combined with vitamin D supplementation for 12 weeks. Serum concentrations of inflammation markers, branched amino acids, vitamin D, muscle strength and balance were assessed at the baseline and three days after intervention. The training caused the significant decrease in concentration of pro-inflammatory proteins HMGB1 (30 ± 156%; 90% CI) and IL-6 (−10 ± 66%; 90% CI) in MVD group. This effects in group MVD were moderate, indicating vitamin D as one of the modifiers of these exercise-induced changes. Rise of myokine irisin induced by exercise correlated inversely with HMGB1 and the correlation was more pronounced at the baseline as well as after training among MVD participants. Although the intervention caused the leucine level to rise, a comparison of the recorded response between groups and the adjusted effect indicated that the effect was 20% lower in the LVD group. Overall the applied training program was effective in reducing HMGB1 concentration. This drop was accompanied by the rise of myokine irisin and better uptake of leucine among women with higher baseline vitamin D.
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Affiliation(s)
- A Gmiat
- Department of Physiology and Pharmacology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland
| | - J Mieszkowski
- Department of Anatomy and Biomechanics, Institute of Physical Education, Kazimierz Wielki University, Bydgoszcz, Poland
| | - K Prusik
- Department of Recreation and Qualify Tourism, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - K Prusik
- Department of Recreation and Qualify Tourism, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - J Kortas
- Department of Recreation and Qualify Tourism, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - A Kochanowicz
- Department of Gymnastics and Dance, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - A Radulska
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, Poland
| | - M Lipiński
- Department of Pharmaceutical Biochemistry, Medical University of Gdańsk, Gdańsk, Poland
| | - M Tomczyk
- Department of Biochemistry, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - J Jaworska
- Department of Physiology and Pharmacology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland
| | - J Antosiewicz
- Department of Bioenergetics and Physiology of Exercise, Medical University, Gdańsk, Poland
| | - E Ziemann
- Department of Physiology and Pharmacology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland.
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Bogdanou D, Penna-Martinez M, Filmann N, Chung TL, Moran-Auth Y, Wehrle J, Cappel C, Huenecke S, Herrmann E, Koehl U, Badenhoop K. T-lymphocyte and glycemic status after vitamin D treatment in type 1 diabetes: A randomized controlled trial with sequential crossover. Diabetes Metab Res Rev 2017; 33. [PMID: 27764529 DOI: 10.1002/dmrr.2865] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/19/2016] [Accepted: 10/16/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1D) is mediated by autoaggressive T effector cells with an underlying regulatory T-cell (Treg) defect. Vitamin D deficiency is highly prevalent in T1D, which can aggravate immune dysfunction. High-dose vitamin D treatment may enhance Tregs and improve metabolism in T1D patients. METHODS In a randomized double-blind placebo-controlled trial with crossover design, patients received either for 3 months cholecalciferol 4000 IU/d followed by 3 months placebo or the sequential alternative. Thirty-nine T1D patients (19 women and 20 men) completed the trial. RESULTS Primary outcome was a change of Tregs, secondary HbA1C, and insulin demand. Effects were evaluated based on intra-individual changes between treatment and placebo periods for outcome measures. Exploratory analyses included vitamin D system variant genotyping and C-peptide measurements. Median 25(OH)D3 increased to 38.8 ng/ml with males showing a significantly stronger increase (p = .003). T-lymphocyte profiles did not change significantly (p > 2); however, the intra-individual change of Tregs between males and females was different with a significantly stronger increase in men (p = .017), as well as between genotypes of the vitamin D receptor (Apa, Taq, and Bsm: genotypes aa, TT, and bb; p = .004-0.015). Insulin demands declined significantly (p = .003-.039) and HbA1C improved (p < .001). Random C-peptide levels were low but rising (median, 0.125 ng/ml; range, 0.02-0.3) in 6 patients. No toxicity was observed. CONCLUSION A daily vitamin D dose of 4000 IU for 3 months was well tolerated and enhanced Tregs in males. Glucometabolic control improved in all. Subsequent larger trials need to address ß-cell function and genotyping for individualized vitamin D doses.
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Affiliation(s)
- D Bogdanou
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - M Penna-Martinez
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - N Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - T L Chung
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - Y Moran-Auth
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - J Wehrle
- Pharmacy of the Goethe University Hospital, Frankfurt am Main, Germany
| | - C Cappel
- Laboratory for Stem Cell Transplantation and Immunotherapy, Clinic for Pediatric and Adolescent Medicine, University Hospital Frankfurt, Germany
| | - S Huenecke
- Laboratory for Stem Cell Transplantation and Immunotherapy, Clinic for Pediatric and Adolescent Medicine, University Hospital Frankfurt, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - U Koehl
- Institute of Cellular Therapeutics, Hanover Medical School, Germany
| | - K Badenhoop
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
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Commonalities in the Association between PPARG and Vitamin D Related with Obesity and Carcinogenesis. PPAR Res 2016; 2016:2308249. [PMID: 27579030 PMCID: PMC4992792 DOI: 10.1155/2016/2308249] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 05/15/2016] [Indexed: 02/07/2023] Open
Abstract
The PPAR nuclear receptor family has acquired great relevance in the last decade, which is formed by three different isoforms (PPARα, PPARβ/δ, and PPAR ϒ). Those nuclear receptors are members of the steroid receptor superfamily which take part in essential metabolic and life-sustaining actions. Specifically, PPARG has been implicated in the regulation of processes concerning metabolism, inflammation, atherosclerosis, cell differentiation, and proliferation. Thus, a considerable amount of literature has emerged in the last ten years linking PPARG signalling with metabolic conditions such as obesity and diabetes, cardiovascular disease, and, more recently, cancer. This review paper, at crossroads of basic sciences, preclinical, and clinical data, intends to analyse the last research concerning PPARG signalling in obesity and cancer. Afterwards, possible links between four interrelated actors will be established: PPARG, the vitamin D/VDR system, obesity, and cancer, opening up the door to further investigation and new hypothesis in this fascinating area of research.
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Muscogiuri G, Altieri B, Annweiler C, Balercia G, Pal HB, Boucher BJ, Cannell JJ, Foresta C, Grübler MR, Kotsa K, Mascitelli L, März W, Orio F, Pilz S, Tirabassi G, Colao A. Vitamin D and chronic diseases: the current state of the art. Arch Toxicol 2016; 91:97-107. [PMID: 27425218 DOI: 10.1007/s00204-016-1804-x] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023]
Abstract
The objective was to provide the current state of the art regarding the role of vitamin D in chronic diseases (osteoporosis, cancer, cardiovascular diseases, dementia, autism, type 1 and type 2 diabetes mellitus, male and female fertility). The document was drawn up by panelists that provided their contribution according to their own scientific expertise. Each scientific expert supplied a first draft manuscript on a specific aspect of the document's topic that was subjected to voting by all experts as "yes" (agreement with the content and/or wording) or "no" (disagreement). The adopted rule was that statements supported by ≥75 % of votes would be immediately accepted, while those with <25 % would be rejected outright. Others would be subjected to further discussion and subsequent voting, where ≥67 % support or, in an eventual third round, a majority of ≥50 % would be needed. This document finds that the current evidence support a role for vitamin D in bone health but not in other health conditions. However, subjects with vitamin D deficiency have been found to be at high risk of developing chronic diseases. Therefore, although at the present time there is not sufficient evidence to recommend vitamin D supplementation as treatment of chronic diseases, the treatment of vitamin D deficiency should be desiderable in order to reduce the risk of developing chronic diseases.
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Affiliation(s)
- Giovanna Muscogiuri
- Ios and Coleman Medicina Futura Medical Center, University "Federico II", Naples, Italy.
| | - Barbara Altieri
- Department of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - Cedric Annweiler
- Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, University Memory Clinic, UPRES EA 4638, University of Angers, UNAM, Angers, France.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - H B Pal
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Barbara J Boucher
- The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Carlo Foresta
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padua, Italy
| | - Martin R Grübler
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism, Department of Medicine, AHEPA University Hospital, Thessaloníki, Greece
| | - Luca Mascitelli
- Comando Brigata Alpina "Julia"/Multinational Land Force, Medical Service, Udine, Italy
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Synlab Academy, Synlab Holding Germany GmbH, Mannheim, Augsburg, Germany
| | - Francesco Orio
- Department of Endocrinology and Diabetology, Fertility Techniques Structure, University Hospital "S. Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.,Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
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Billeter AT, Probst P, Fischer L, Senft J, Kenngott HG, Schulte T, Clemens G, Zech U, Büchler MW, Nawroth PP, Müller-Stich BP. Risk of Malnutrition, Trace Metal, and Vitamin Deficiency Post Roux-en-Y Gastric Bypass--a Prospective Study of 20 Patients with BMI < 35 kg/m². Obes Surg 2016; 25:2125-34. [PMID: 25904235 DOI: 10.1007/s11695-015-1676-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Due to its reliable effects on type 2 diabetes mellitus (T2DM) remission, Roux-en-Y gastric bypass (RYGB) has recently been investigated as a treatment option for nonseverely obese patients with T2DM (body mass index (BMI) <35 kg/m(2)). The purpose of this study was to investigate whether RGYB induces malnutrition of macro- and micronutrients within 24 months in these patients. METHODS A prospective cohort of 20 patients with longstanding, insulin-dependent T2DM and a BMI of 25-35 kg/m(2) were treated with RYGB. The patients were supplemented with over-the-counter, multivitamin, and micronutrient supplements. Serum concentrations of albumin, vitamins, and trace elements, hemoglobin, and bone density were measured preoperatively and over a 24-month period (DRKS00004605). RESULTS RYGB did not result in underweight or protein malnutrition. No new onset of deficiencies of water- or fat-soluble vitamins developed over the study period. However, serum selenium, zinc, and ferritin decreased significantly (selenium, 1.17 ± 0.13 to 0.89 ± 0.11 μmol/l, p = 0.018; zinc, 13.9 ± 0.5 to 10.8 ± 0.5 μmol/l, p = 0.012; ferritin, 171.7 ± 26.9 to 31.8 ± 11.2 μg/l, p = 0.018). Hemoglobin remained stable. Vitamin D (13.7 ± 1.8 to 19.1 ± 1.1 ng/ml, p = 0.017) and osteocalcin (15.3 ± 1.7 to 25.4 ± 2.7 ng/ml, p = 0.025) rose significantly, whereas the parathyroid hormone remained stable. Despite increased bone formation, bone density decreased (T score hip, 0.15 ± 0.25 to -0.71 ± 0.34, p = 0.005) resulting in a significant increase in osteopenia rates (18 to 50 %, p = 0.046). CONCLUSIONS This is the first prospective cohort to investigate malnutrition after RYGB in nonseverely obese patients. These patients are at risk of developing iron, selenium, and zinc deficiencies within 24 months, as well as osteopenia despite an increase in bone formation.
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Affiliation(s)
- Adrian T Billeter
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Pascal Probst
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Lars Fischer
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Jonas Senft
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Hannes G Kenngott
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Thilo Schulte
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Gabriella Clemens
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Ulrike Zech
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - Markus W Büchler
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Peter P Nawroth
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
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Zostautiene I, Jorde R, Schirmer H, Mathiesen EB, Njølstad I, Løchen ML, Wilsgaard T, Joakimsen RM, Kamycheva E. Genetic Variations in the Vitamin D Receptor Predict Type 2 Diabetes and Myocardial Infarction in a Community-Based Population: The Tromsø Study. PLoS One 2015; 10:e0145359. [PMID: 26699871 PMCID: PMC4689352 DOI: 10.1371/journal.pone.0145359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/01/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Though the associations between low serum 25-hydroxyvitamin D (25(OH)D) levels and health outcomes such as type 2 diabetes (T2D), myocardial infarction (MI), cancer, and mortality are well-studied, the effect of supplementation with vitamin D is uncertain. This may be related to genetic differences. Thus, rs7968585, a single nucleotide polymorphism (SNP) of the vitamin D receptor (VDR), has recently been reported as a predictor of composite health outcome. We therefore aimed to evaluate whether rs7968585 predicts separate clinical outcomes such as T2D, MI, cancer, and mortality in a community-based Norwegian population. METHODS AND FINDINGS Measurements and DNA were obtained from the participants in the Tromsø Study in 1994-1995, registered with the outcomes of interest and a randomly selected control group. The impact of the rs7968585 genotypes was evaluated with Cox proportional hazards. A total of 8,461 subjects were included among whom 1,054 subjects were registered with T2D, 2,287 with MI, 3,166 with cancer, and 4,336 with death. Mean follow-up time from birth was 60.8 years for T2D and MI, 61.2 years for cancer, while mean follow-up time from examination date was 16.5 years for survival. Mean serum 25(OH)D levels did not differ across the rs7968585 genotypes. With the major homozygote genotype as reference, the minor homozygote subjects had hazard ratios of 1.25 (95% CI 1.05-1.49) for T2D and 1.14 (1.02-1.28) for MI (P = 0.011 and 0.023, respectively, without the Bonferroni correction). No significant interaction between serum 25(OH)D status and the rs7968585 genotype was found for any of the endpoints. CONCLUSIONS The VDR-related SNP rs7968585 minor allele is a significant and positive predictor for T2D and possibly for MI. Since the functional mechanism of this SNP is not yet understood, and the association with T2D is reported for the first time, confirmatory studies are needed.
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Affiliation(s)
- Ieva Zostautiene
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- * E-mail:
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Ellisiv Bøgeberg Mathiesen
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ragnar Martin Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Elena Kamycheva
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Frei R, Haile SR, Mutsch M, Rohrmann S. Relationship of Serum Vitamin D Concentrations and Allostatic Load as a Measure of Cumulative Biological Risk among the US Population: A Cross-Sectional Study. PLoS One 2015; 10:e0139217. [PMID: 26451600 PMCID: PMC4599851 DOI: 10.1371/journal.pone.0139217] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 09/10/2015] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The allostatic load (AL) index is a multi-systemic measure of physiologic dysregulation known to be associated with chronic exposure to stress and adverse health outcomes. We examined the relationship between AL and serum 25-hydroxyvitamin D (25(OH)D) concentration in non-institutionalized US adults. METHODS Data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94) were used to calculate two versions of AL including 9 biomarkers and another two with 14 biomarkers (systolic and diastolic blood pressure, pulse rate, serum cholesterol, serum HDL-cholesterol, glycated hemoglobin, sex-specific waist-to-hip ratio, serum albumin, and serum C-reactive protein for AL1, and, additionally body mass index, serum triglyceride, serum creatinine, and serum herpes I & II antibodies for AL2), each set defined by predefined cut-offs or by quartiles. Serum vitamin D concentration was ranked into quartiles. Logistic regression, Poisson regression and linear regression were used to examine the association of serum 25(OH)D concentrations on AL, after adjusting for biological, physiological, socioeconomic, lifestyle, and health variables. RESULTS Odds Ratios (OR) for high AL of the lowest 25(OH)D serum quartile were between 1.45 (95% CI: 1.28, 1.67) and 1.79 (95% CI: 1.39, 2.32) for the fully adjusted model, depending on AL version. Inverse relationships between vitamin D serum concentrations were observed for all AL versions and every adjustment. This relationship was consistent after stratification by sex, age or ethnic background. Sensitivity to low 25(OH)D concentrations was highest among the youngest group (20-39 years) with an OR of 2.11 (95% CI: 1.63, 2.73) for the lowest vitamin D quartile Q1. CONCLUSIONS Vitamin D had a consistent and statistically significant inverse association with all tested models of high AL, which remained consistent after adjusting for biological, socioeconomic, lifestyle and health variables. Our study adds evidence linking low 25(OH)D concentrations with poorer health, further-reaching than bone health.
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Affiliation(s)
- Regina Frei
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Sarah R. Haile
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Margot Mutsch
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
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Nyagolova PV, Mitkov MD, Orbetsova MM. Role Of Vitamin D And Adipose Tissue Hormones In Women With Reproductive Disorders. Folia Med (Plovdiv) 2015; 57:5-10. [PMID: 26431089 DOI: 10.1515/folmed-2015-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/18/2014] [Indexed: 11/15/2022] Open
Abstract
The role of vitamin D beyond that it plays in bone metabolism and calcium homeostasis has been lately quite emphasized. In this respect, vitamin D deficiency has been associated with higher risk of cardiovascular disease, metabolic syndrome, and reproductive disorders. Growing evidence has suggested that vitamin D deficiency is implicated in the pathogenesis of insulin resistance and the development of metabolic disorders in the polycystic ovary syndrome. The goal of the review is to present contemporary concepts of the relationship between hormones affecting the metabolic body status, serum vitamin D levels and the reproductive function.
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Affiliation(s)
- Presiyana V Nyagolova
- Second Department of Internal Medicine, Department of Endocrinology, Medical Faculty, Medical University,
Plovdiv, Bulgaria
| | - Mitko D Mitkov
- Second Department of Internal Medicine, Department of Endocrinology, Medical Faculty, Medical University,
Plovdiv, Bulgaria
| | - Maria M Orbetsova
- Second Department of Internal Medicine, Department of Endocrinology, Medical Faculty, Medical University,
Plovdiv, Bulgaria
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Winckler K, Tarnow L, Lundby-Christensen L, Almdal TP, Wiinberg N, Eiken P, Boesgaard TW. Vitamin D, carotid intima-media thickness and bone structure in patients with type 2 diabetes. Endocr Connect 2015; 4:128-35. [PMID: 25956908 PMCID: PMC4463474 DOI: 10.1530/ec-15-0034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/30/2015] [Indexed: 12/21/2022]
Abstract
Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima-media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required.
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Affiliation(s)
- Karoline Winckler
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Lise Tarnow
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Louise Lundby-Christensen
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Thomas P Almdal
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Niels Wiinberg
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Pia Eiken
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Trine W Boesgaard
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
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Liu JJ, Foo JP, Liu S, Lim SC. The role of fibroblast growth factor 21 in diabetes and its complications: A review from clinical perspective. Diabetes Res Clin Pract 2015; 108:382-9. [PMID: 25796513 DOI: 10.1016/j.diabres.2015.02.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 02/13/2015] [Accepted: 02/22/2015] [Indexed: 01/24/2023]
Abstract
Fibroblast growth factor 21 (FGF21) has been well-recognized as a metabolic hormone and a promising target for treatment of metabolic diseases. The level of endogenous FGF21 is elevated in patients with impaired glucose tolerance and progressively increased from patients with overt type 2 diabetes to those with micro- and macro-vascular complications, presumably as a compensation or response to the deterioration of metabolic imbalance. A few exploratory in vivo studies, including a recent clinical trial, showed that exogenous FGF21 mimetics targeting FGF21 signaling can attain beneficial metabolic effects not with-standing the already elevated ambient FGF21 levels. In addition, some clinically available pharmacologic agents such as fenofibrates and metformin may modulate energy and macronutrients metabolism by acting through FGF21. This review mainly focuses on the role of FGF21 in development, progression and treatment of type 2 diabetes from a clinical perspective.
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Affiliation(s)
- Jian-Jun Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
| | - Joo Pin Foo
- Department of Medicine, Changi General Hospital, Singapore
| | - Sylvia Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Su Chi Lim
- Diabetes Center, Khoo Teck Puat Hospital, Singapore.
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Lv WS, Zhao WJ, Gong SL, Fang DD, Wang B, Fu ZJ, Yan SL, Wang YG. Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: a systematic review and meta-analysis. J Endocrinol Invest 2015; 38:513-8. [PMID: 25527161 DOI: 10.1007/s40618-014-0210-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 11/10/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Vitamin D is a multifunctional pro-hormone and has widespread actions in human body. Several studies showed a possible association between vitamin D deficiency and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes, but no definite conclusion was available. METHODS A systematic review and meta-analysis was performed to comprehensively assess the association between serum 25-hydroxyvitamin D [25(OH)D] levels and DPN in patients with type 2 diabetes. Data from eligible studies were pooled using meta-analysis. RESULTS Six studies that involved a total of 1,484 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis showed that there were obviously decreased serum 25(OH)D levels in DPN patients [weighted mean difference (WMD) = -6.36 ng/ml, 95 % confidence interval (95 % CI) -8.57 to -4.14, P < 0.00001]. Vitamin D deficiency was also significantly associated with increased risk of DPN in patients with type 2 diabetes [odds ratio (OR) 2.88, 95 % CI 1.84-4.50, P < 0.00001]. Meta-analysis of three studies with adjusted estimates showed that vitamin D deficiency was independently associated with increased risk of DPN in patients with type 2 diabetes (OR 2.68, 95 % CI 1.67-4.30, P < 0.0001). Sensitivity analysis showed that there was no obvious change in the pooled estimates. CONCLUSION Vitamin D is involved in the development of DPN in type 2 diabetic patients, and vitamin D deficiency is very likely to be associated with DPN in type 2 diabetic patients. Further studies are needed to validate the association between vitamin D deficiency and DPN.
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Affiliation(s)
- W S Lv
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - W J Zhao
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - S L Gong
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - D D Fang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - B Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.
- Essencemed Clinic, Weifang, 261000, China.
| | - Z J Fu
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - S L Yan
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - Y G Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.
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Toulis K, Tsekmekidou X, Potolidis E, Didangelos T, Gotzamani-Psarrakou A, Zebekakis P, Daniilidis M, Yovos J, Kotsa K. Thyroid Autoimmunity in the Context of Type 2 Diabetes Mellitus: Implications for Vitamin D. Int J Endocrinol 2015; 2015:710363. [PMID: 26078759 PMCID: PMC4452355 DOI: 10.1155/2015/710363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/29/2014] [Indexed: 11/17/2022] Open
Abstract
Vitamin D deficiency has been associated with both type 2 diabetes mellitus (T2DM) and autoimmune disorders. The association of vitamin D with T2DM and thyroid autoimmunity (TAI) has not been investigated. Thus, we aimed to explore the putative association between T2DM and thyroid autoimmunity (TAI) focusing on the role of 25-hydroxy-vitamin D (25(OH)D). Study population included 264 T2DM patients and 234 controls. To explore the potential association between 25(OH)D and thyroid autoimmunity while controlling for potential confounders-namely, age, gender, body mass index, and presence of T2DM-multivariate logistic regression analyses were undertaken. Patients with T2DM were younger (P < 0.001) and had significantly lower 25(OH)D levels (P < 0.001) and higher anti-TPO titers (P = 0.005). Multivariable logistic regression analyses suggested that T2DM and 25(OH)D levels were significantly associated with the presence of thyroid autoimmunity. In an elderly population of diabetic patients and controls with a high prevalence of vitamin D deficiency/insufficiency, a patient with T2DM was found to be 2.5 times more likely to have thyroid autoimmunity compared to a nondiabetic individual and the higher the serum 25(OH)D levels were, the higher this chance was.
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Affiliation(s)
- Konstantinos Toulis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Xanthippi Tsekmekidou
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Evangelos Potolidis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Triantafyllos Didangelos
- First Propaedeutic Department of Internal Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | | | - Pantelis Zebekakis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Michael Daniilidis
- First Department of Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - John Yovos
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Kalliopi Kotsa
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
- *Kalliopi Kotsa:
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40
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Malik R, Aneni EC, Roberson L, Ogunmoroti O, Ali SS, Shaharyar S, Younus A, Jamal O, Aziz MA, Martin SS, Blaha MJ, Feldman T, Agatston AS, Veledar E, Nasir K. Measuring coronary artery calcification: Is serum vitamin D relevant? Atherosclerosis 2014; 237:734-8. [DOI: 10.1016/j.atherosclerosis.2014.10.087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 11/24/2022]
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Van Belle TL, Vanherwegen AS, Feyaerts D, De Clercq P, Verstuyf A, Korf H, Gysemans C, Mathieu C. 1,25-Dihydroxyvitamin D3 and its analog TX527 promote a stable regulatory T cell phenotype in T cells from type 1 diabetes patients. PLoS One 2014; 9:e109194. [PMID: 25279717 PMCID: PMC4184870 DOI: 10.1371/journal.pone.0109194] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 09/09/2014] [Indexed: 02/08/2023] Open
Abstract
The emergence of regulatory T cells (Tregs) as central mediators of peripheral tolerance in the immune system has led to an important area of clinical investigation to target these cells for the treatment of autoimmune diseases such as type 1 diabetes. We have demonstrated earlier that in vitro treatment of T cells from healthy individuals with TX527, a low-calcemic analog of bioactive vitamin D, can promote a CD4+CD25highCD127low regulatory profile and imprint a migratory signature specific for homing to sites of inflammation. Towards clinical application of vitamin D-induced Tregs in autologous adoptive immunotherapy for type 1 diabetes, we show here that 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and TX527 similarly imprint T cells from type 1 diabetes patients with a CD4+CD25highCD127low regulatory profile, modulate surface expression of skin- and inflammation-homing receptors, and increase expression of CTLA-4 and OX-40. Also, 1,25(OH)2D3 and TX527 treatment inhibit the production of effector cytokines IFN-γ, IL-9, and IL-17. Importantly, 1,25(OH)2D3 and TX527 promote the induction of IL-10-producing CD4+CD25highCD127low T cells with a stable phenotype and the functional capacity to suppress proliferation of autologous responder T cells in vitro. These findings warrant additional validation of vitamin D-induced Tregs in view of future autologous adoptive immunotherapy in type 1 diabetes.
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Affiliation(s)
- Tom L. Van Belle
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
| | | | - Dorien Feyaerts
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
| | - Pierre De Clercq
- Laboratory for Organic Synthesis, Department of Organic Chemistry, Ghent University, Ghent, Belgium
| | - Annemieke Verstuyf
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
| | - Hannelie Korf
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
| | - Conny Gysemans
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
- * E-mail: (CG); (CM)
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
- * E-mail: (CG); (CM)
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Wong MSK, Leisegang MS, Kruse C, Vogel J, Schürmann C, Dehne N, Weigert A, Herrmann E, Brüne B, Shah AM, Steinhilber D, Offermanns S, Carmeliet G, Badenhoop K, Schröder K, Brandes RP. Vitamin D promotes vascular regeneration. Circulation 2014; 130:976-86. [PMID: 25015343 DOI: 10.1161/circulationaha.114.010650] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vitamin D deficiency in humans is frequent and has been associated with inflammation. The role of the active hormone 1,25-dihydroxycholecalciferol (1,25-dihydroxy-vitamin D3; 1,25-VitD3) in the cardiovascular system is controversial. High doses induce vascular calcification; vitamin D3 deficiency, however, has been linked to cardiovascular disease because the hormone has anti-inflammatory properties. We therefore hypothesized that 1,25-VitD3 promotes regeneration after vascular injury. METHODS AND RESULTS In healthy volunteers, supplementation of vitamin D3 (4000 IU cholecalciferol per day) increased the number of circulating CD45-CD117+Sca1+Flk1+ angiogenic myeloid cells, which are thought to promote vascular regeneration. Similarly, in mice, 1,25-VitD3 (100 ng/kg per day) increased the number of angiogenic myeloid cells and promoted reendothelialization in the carotid artery injury model. In streptozotocin-induced diabetic mice, 1,25-VitD3 also promoted reendothelialization and restored the impaired angiogenesis in the femoral artery ligation model. Angiogenic myeloid cells home through the stromal cell-derived factor 1 (SDF1) receptor CXCR4. Inhibition of CXCR4 blocked 1,25-VitD3-stimulated healing, pointing to a role of SDF1. The combination of injury and 1,25-VitD3 increased SDF1 in vessels. Conditioned medium from injured, 1,25-VitD3-treated arteries elicited a chemotactic effect on angiogenic myeloid cells, which was blocked by SDF1-neutralizing antibodies. Conditional knockout of the vitamin D receptor in myeloid cells but not the endothelium or smooth muscle cells blocked the effects of 1,25-VitD3 on healing and prevented SDF1 formation. Mechanistically, 1,25-VitD3 increased hypoxia-inducible factor 1-α through binding to its promoter. Increased hypoxia-inducible factor signaling subsequently promoted SDF1 expression, as revealed by reporter assays and knockout and inhibitory strategies of hypoxia-inducible factor 1-α. CONCLUSIONS By inducing SDF1, vitamin D3 is a novel approach to promote vascular repair.
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Affiliation(s)
- Michael Sze Ka Wong
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Matthias S Leisegang
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Christoph Kruse
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Juri Vogel
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Christoph Schürmann
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Nathalie Dehne
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Andreas Weigert
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Eva Herrmann
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Bernhard Brüne
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Ajay M Shah
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Dieter Steinhilber
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Stefan Offermanns
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Geert Carmeliet
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Klaus Badenhoop
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.)
| | - Katrin Schröder
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.).
| | - Ralf P Brandes
- From the Institute for Cardiovascular Physiology (M.S.K.W., M.S.L., C.K., J.V., C.S., K.S., R.P.B.), Institute of Biochemistry I (N.D., A.W., B.B.), Institute for Biostatistics and Mathematical Modeling (E.H.), Institute of Pharmaceutical Chemistry/Zentrum für Arzneimittelforschung, Entwicklung und Sicherheit (D.S.), Goethe University, Frankfurt, Germany; German Center for Cardiovascular Research, Partner Site RheinMain, Frankfurt, Germany (M.S.L., C.K., C.S., E.H., S.O., K.S., R.P.B.); Cardiovascular Division, King's College London British Heart Foundation Center of Excellence, London, United Kingdom (A.M.S.); Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany (S.O.); Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium (G.C.); and Department of Endocrinology and Diabetes, Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany (K.B.).
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Bendik I, Friedel A, Roos FF, Weber P, Eggersdorfer M. Vitamin D: a critical and essential micronutrient for human health. Front Physiol 2014; 5:248. [PMID: 25071593 PMCID: PMC4092358 DOI: 10.3389/fphys.2014.00248] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 06/14/2014] [Indexed: 12/11/2022] Open
Abstract
Vitamin D is a micronutrient that is needed for optimal health throughout the whole life. Vitamin D3 (cholecalciferol) can be either synthesized in the human skin upon exposure to the UV light of the sun, or it is obtained from the diet. If the photoconversion in the skin due to reduced sun exposure (e.g., in wintertime) is insufficient, intake of adequate vitamin D from the diet is essential to health. Severe vitamin D deficiency can lead to a multitude of avoidable illnesses; among them are well-known bone diseases like osteoporosis, a number of autoimmune diseases, many different cancers, and some cardiovascular diseases like hypertension are being discussed. Vitamin D is found naturally in only very few foods. Foods containing vitamin D include some fatty fish, fish liver oils, and eggs from hens that have been fed vitamin D and some fortified foods in countries with respective regulations. Based on geographic location or food availability adequate vitamin D intake might not be sufficient on a global scale. The International Osteoporosis Foundation (IOF) has collected the 25-hydroxy-vitamin D plasma levels in populations of different countries using published data and developed a global vitamin D map. This map illustrates the parts of the world, where vitamin D did not reach adequate 25-hydroxyvitamin D plasma levels: 6.7% of the papers report 25-hydroxyvitamin D plasma levels below 25 nmol/L, which indicates vitamin D deficiency, 37.3% are below 50 nmol/Land only 11.9% found 25-hydroxyvitamin D plasma levels above 75 nmol/L target as suggested by vitamin D experts. The vitamin D map is adding further evidence to the vitamin D insufficiency pandemic debate, which is also an issue in the developed world. Besides malnutrition, a condition where the diet does not match to provide the adequate levels of nutrients including micronutrients for growth and maintenance, we obviously have a situation where enough nutrients were consumed, but lacked to reach sufficient vitamin D micronutrient levels. The latter situation is known as hidden hunger. The inadequate vitamin D status impacts on health care costs, which in turn could result in significant savings, if corrected. Since little is known about the effects on the molecular level that accompany the pandemic like epigenetic imprinting, the insufficiency-triggered gene regulations or the genetic background influence on the body to maintain metabolic resilience, future research will be needed. The nutrition community is highly interested in the molecular mechanism that underlies the vitamin D insufficiency caused effect. In recent years, novel large scale technologies have become available that allow the simultaneous acquisition of transcriptome, epigenome, proteome, or metabolome data in cells of organs. These important methods are now used for nutritional approaches summarized in emerging scientific fields of nutrigenomics, nutrigenetics, or nutriepigenetics. It is believed that with the help of these novel concepts further understanding can be generated to develop future sustainable nutrition solutions to safeguard nutrition security.
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Affiliation(s)
- Igor Bendik
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Angelika Friedel
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Franz F Roos
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Peter Weber
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
| | - Manfred Eggersdorfer
- Human Nutrition and Health (IB, AF, FFR), and Nutrition Science & Advocacy (PW, ME), DSM Nutritional Products Ltd. Basel, Switzerland
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Slominski AT, Kim TK, Takeda Y, Janjetovic Z, Brozyna AA, Skobowiat C, Wang J, Postlethwaite A, Li W, Tuckey RC, Jetten AM. RORα and ROR γ are expressed in human skin and serve as receptors for endogenously produced noncalcemic 20-hydroxy- and 20,23-dihydroxyvitamin D. FASEB J 2014; 28:2775-89. [PMID: 24668754 PMCID: PMC4062828 DOI: 10.1096/fj.13-242040] [Citation(s) in RCA: 221] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/10/2014] [Indexed: 08/01/2023]
Abstract
RORα and RORγ are expressed in human skin cells that produce the noncalcemic 20-hydroxyvitamin D3 [20(OH)D3] and 20,23-dihydroxyvitamin D3 [20,23(OH)2D3]. Chinese hamster ovary (CHO) cells stably expressing a Tet-on RORα or RORγ expression vector and a ROR-responsive element (RORE)-LUC reporter, and a mammalian 2-hybrid model examining the interaction between the ligand binding domain (LBD) of RORα or RORγ with an LBD-interacting LXXLL-peptide, were used to study ROR-antagonist activities. These assays revealed that 20(OH)D3 and 20,23(OH)2D3 function as antagonists of RORα and RORγ. Moreover, 20(OH)D3 inhibited the activation of the promoter of the Bmal1 and G6pase genes, targets of RORα, and 20(OH)D3 and 20,23(OH)2D3 inhibited Il17 promoter activity in Jurkat cells overexpressing RORα or RORγ. Molecular modeling using crystal structures of the LBDs of RORα and RORγ revealed docking scores for 20(OH)D3, 20,23(OH)2D3 and 1,25(OH)2D3 similar to those of the natural ligands, predicting good binding to the receptor. Notably, 20(OH)D3, 20,23(OH)2D3, and 1,25(OH)2D3 inhibited RORE-mediated activation of a reporter in keratinocytes and melanoma cells and inhibited IL-17 production by immune cells. Our study identifies a novel signaling pathway, in which 20(OH)D3 and 20,23(OH)2D3 act as antagonists or inverse agonists of RORα and RORγ, that opens new possibilities for local (skin) or systemic regulation.-Slominski, A. T., Kim, T.-K., Takeda, Y., Janjetovic, Z., Broz˙yna, A. A., Skobowiat, C., Wang, J., Postlethwaite, A., Li, W., Tuckey, R. C., Jetten, A. M. RORα and ROR γ are expressed in human skin and serve as receptors for endogenously produced noncalcemic 20-hydroxy- and 20,23-dihydroxyvitamin D.
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MESH Headings
- ARNTL Transcription Factors/genetics
- ARNTL Transcription Factors/metabolism
- Animals
- CHO Cells
- Calcifediol/analogs & derivatives
- Calcifediol/metabolism
- Cell Line, Tumor
- Cells, Cultured
- Cricetulus
- Dihydroxycholecalciferols/metabolism
- Female
- Glucose-6-Phosphatase/antagonists & inhibitors
- Glucose-6-Phosphatase/genetics
- Humans
- Interleukin-17/genetics
- Interleukin-17/metabolism
- Jurkat Cells
- Keratinocytes/metabolism
- Melanoma/genetics
- Melanoma/metabolism
- Mice
- Mice, Inbred DBA
- Nuclear Receptor Subfamily 1, Group F, Member 1/genetics
- Nuclear Receptor Subfamily 1, Group F, Member 1/metabolism
- Nuclear Receptor Subfamily 1, Group F, Member 3/genetics
- Nuclear Receptor Subfamily 1, Group F, Member 3/metabolism
- Promoter Regions, Genetic/genetics
- Skin/metabolism
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Affiliation(s)
- Andrzej T Slominski
- Department of Pathology and Laboratory Medicine, Department of Medicine, and
| | | | - Yukimasa Takeda
- Cell Biology Section, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | | | - Anna A Brozyna
- Department of Tumor Pathology and Pathomorphology, Oncology Center, Professor Franciszek Łukaszczyk Memorial Hospital, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Jin Wang
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Arnold Postlethwaite
- Department of Medicine, and Department of Veterans Affairs Medical Center, Memphis, Tennessee, USA; and
| | - Wei Li
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Robert C Tuckey
- School of Chemistry and Biochemistry, University of Western Australia, Crawley, Western Australia, Australia
| | - Anton M Jetten
- Cell Biology Section, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA;
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45
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Bouillon R, Carmeliet G, Lieben L, Watanabe M, Perino A, Auwerx J, Schoonjans K, Verstuyf A. Vitamin D and energy homeostasis: of mice and men. Nat Rev Endocrinol 2014; 10:79-87. [PMID: 24247221 DOI: 10.1038/nrendo.2013.226] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The vitamin D endocrine system has many extraskeletal targets, including adipose tissue. 1,25-Dihydroxyvitamin D₃, the active form of vitamin D, not only increases adipogenesis and the expression of typical adipocyte genes but also decreases the expression of uncoupling proteins. Mice with disrupted vitamin D action--owing to gene deletion of the nuclear receptor vitamin D receptor (Vdr) or the gene encoding 1α-hydroxylase (Cyp27b1)--lose fat mass over time owing to an increase in energy expenditure, whereas mice with increased Vdr-mediated signalling in adipose tissue become obese. The resistance to diet-induced obesity in mice with disrupted Vdr signalling is caused at least partially by increased expression of uncoupling proteins in white adipose tissue. However, the bile acid pool is also increased in these animals, and bile acids are known to be potent inducers of energy expenditure through activation of several nuclear receptors, including Vdr, and G-protein-coupled receptors, such as GPBAR1 (also known as TGR5). By contrast, in humans, obesity is strongly associated with poor vitamin D status. A causal link has not been firmly proven, but most intervention studies have failed to demonstrate a beneficial effect of vitamin D supplementation on body weight. The reasons for the major discrepancy between mouse and human data are unclear, but understanding the link between vitamin D status and energy homeostasis could potentially be very important for the human epidemic of obesity and the metabolic syndrome.
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Affiliation(s)
- Roger Bouillon
- Clinical and Experimental Endocrinology, KU Leuven, O&NI Herestraat 49 - bus 902, 3000 Leuven, Belgium
| | - Geert Carmeliet
- Clinical and Experimental Endocrinology, KU Leuven, O&NI Herestraat 49 - bus 902, 3000 Leuven, Belgium
| | - Liesbet Lieben
- Clinical and Experimental Endocrinology, KU Leuven, O&NI Herestraat 49 - bus 902, 3000 Leuven, Belgium
| | - Mitsuhiro Watanabe
- Health Science Laboratory, Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa-shi, 252-0882 Kanagawa, Japan
| | - Alessia Perino
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Station 15, AI 1149, CH-1015 Lausanne, Switzerland
| | - Johan Auwerx
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Station 15, AI 1149, CH-1015 Lausanne, Switzerland
| | - Kristina Schoonjans
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Station 15, AI 1149, CH-1015 Lausanne, Switzerland
| | - Annemieke Verstuyf
- Clinical and Experimental Endocrinology, KU Leuven, O&NI Herestraat 49 - bus 902, 3000 Leuven, Belgium
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