Effect of Vitamin D Supplementation on Lipid Profile in Vitamin D-Deficient Children with Type 1 Diabetes and Dyslipidemia

Telmisartan ameliorates nephropathy and restores the hippo pathway in rats with metabolic syndrome

The main objective of this study was to determine if the telmisartan-ameliorative effects of metabolic syndrome (MetS)-evoked nephropathy are attributed to the Hippo pathway. A secondary objective was to investigate the potential of vitamin D3 to enhance telmisartan-favourable effects. A diet composed of 24% fat and 3% salt, along with drinking water containing 10% fructose, was administered for 12 weeks to induce MetS. MetS-rats were given telmisartan (5 mg/kg/day), vitamin D3 (10 μg/kg/day) or both by gavage, starting in the sixth week of experimental diet administration. Assessments performed at closure included renal function, histological examination, catalase, malondialdehyde (MDA), nuclear factor kappa-B (NF-κB), interleukin-6 (IL-6), peroxisome proliferator-activated receptor-γ (PPAR-γ), phosphatase and tensin homolog (PTEN), and transforming growth factor-β (TGF-β). Matrix metalloproteinase-9 (MMP-9) immunostaining was conducted. The expression of the Hippo pathway components, as well as that of angiotensin II type 1 and type 2 (AT1 and AT2), receptors was evaluated. Telmisartan attenuated MetS-evoked nephropathy, as demonstrated by improvement of renal function and histological features, enhancement of catalase, reduction of MDA, inflammation (NF-κB, IL-6), and renal fibrosis (increased PPAR-γ and PTEN and reduced MMP-9 and TGF-β). Telmisartan downregulated AT1-receptor, upregulated AT2-receptor and restored the Hippo pathway. Vitamin D3 replicated most of the telmisartan-elicited effects and enhanced the antifibrotic actions of telmisartan. The alleviative effects of telmisartan on MetS-evoked nephropathy may be related to the restoration of the Hippo pathway. The combination of vitamin D3 and telmisartan exerted more favourable effects on metabolic and nephropathic biomarkers compared with either one administered alone.

Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review

Nowadays, the interest in the extraskeletal effects of vitamin D is growing. In the literature, its several possible actions have been confirmed. Vitamin D seems to have a regulatory role in many different fields-inflammation, immunity, and the endocrine system-and many studies would demonstrate a possible correlation between vitamin D and cardiovascular disease. In this paper, we deepened the relationship between vitamin D and dyslipidemia by reviewing the available literature. The results are not entirely clear-cut: on the one hand, numerous observational studies suggest a link between higher serum vitamin D levels and a beneficial lipid profile, while on the other hand, interventional studies do not demonstrate a significant effect. Understanding the possible relationship between vitamin D and dyslipidemia may represent a turning point: another link between vitamin D and the cardiovascular system.

Immunomodulation through Nutrition Should Be a Key Trend in Type 2 Diabetes Treatment

An organism's ability to function properly depends not solely on its diet but also on the intake of nutrients and non-nutritive bioactive compounds that exert immunomodulatory effects. This principle applies both to healthy individuals and, in particular, to those with concomitant chronic conditions, such as type 2 diabetes. However, the current food industry and the widespread use of highly processed foods often lead to nutritional deficiencies. Numerous studies have confirmed the occurrence of immune system dysfunction in patients with type 2 diabetes. This article elucidates the impact of specific nutrients on the immune system function, which maintains homeostasis of the organism, with a particular emphasis on type 2 diabetes. The role of macronutrients, micronutrients, vitamins, and selected substances, such as omega-3 fatty acids, coenzyme Q10, and alpha-lipoic acid, was taken into consideration, which outlined the minimum range of tests that ought to be performed on patients in order to either directly or indirectly determine the severity of malnutrition in this group of patients.

The Impact of a Self-Management Program Based on the 5 A's Model on Type 1 Diabetes in School-Aged Children

INTRODUCTION

Diabetes is a chronic metabolic condition characterized by abnormally high blood glucose levels that eventually results in catastrophic damage to the heart, blood vessels, eyes, kidneys, and nerves. The available data from previous studies on the application of the 5A's model-based self-management programmer to increase knowledge and self-care practices in children is insufficient. Therefore, the purpose of this study was to determine the effect of a self-management programmer based on the 5 A's paradigm on school-aged children with type 1 diabetes.

METHODS

The research design was quasi-experimental. The investigation was conducted at EL Mogamma EL Teby AL Shamal diabetes facility. This study enrolled a convenience sample of 90 children who were accompanied by their moms. Five tools were utilized to collect the data. Questionnaire for children's examination; Questionnaire for diabetic knowledge; a Questionnaire on Diabetes Self-Care and Diabetic Attitude Scale and Self-Care Practices for Diabetics.

RESULTS

72.2 %, 90.0 %, 91.1 %, 93.3 %, and 96.7 % of youngsters, respectively, lacked knowledge, engaged in ineffective self-care activities, had a negative attitude, and practiced incompetently. Differences between pre- and post-program implementation are statistically significant when a self-management programmer based on the 5A's model is implemented.

DISCUSSION/CONCLUSIONS

Self-management and self-care models, particularly the 5A model, are helpful at improving the control of these symptoms, reducing associated problems, enhancing nursing care, and enhancing patients' quality of life. Increasing the duration of a self-management programmer based on the 5 A's model for children with type 1 diabetes reduces negative attitudes and improves quality of life, but requires follow-up.

Vitamin D3 intake as modulator for the early biomarkers of myocardial tissue injury in diabetic hyperlipidaemic rats

CONTEXT

Myocardial cell death occurs within hours following the onset of myocardial ischaemia and its chief cause is atherosclerosis. There is a link between vitamin D3 deficiency and many cardiovascular risk factors.

OBJECTIVE

This study compared the effect of vitamin D3 on early biomarkers of myocardial injury, to that of atorvastatin.

METHODS

Diabetic hyperlipidaemia was induced in Wistar rats, which were divided into 3 groups: diabetic hyperlipidaemic control, diabetic hyperlipidaemic rats treated with atorvastatin and diabetic hyperlipidaemic rats treated with vitamin D3. Blood glucose, glycated haemoglobin and lipid profile were evaluated. Markers of myocardial injury were examined including cardiac troponin, heart fatty acid binding protein (HFABP) and C-terminal pro-endothelin-1 (CT-pro-ET-1).

RESULTS

Vitamin D3 and atorvastatin intake improved lipid profile and glucose homeostasis, and reduced levels of predictive biomarkers of myocardial injury.

CONCLUSION

Vitamin D3 can be used in a suitable dose as a safe and protective candidate against myocardial injury.

Vitamin D and Omega-3 Polyunsaturated Fatty Acids in Type 1 Diabetes modulation

BACKGROUND

Type 1 diabetes (T1D) is a chronic autoimmune disease that affects people globally. Usually developed during childhood, T1D is characterized by the destruction of pancreatic β-cells due to immune cell attack and the establishment of an inflammatory process.

OBJECTIVE

The study aimed to investigate the effects of vitamin D through its nuclear receptor and the ω-3 polyunsaturated fatty acids (PUFAs) through their lipid derivatives in T1D modulation. Both components exert anti-inflammatory activity and act directly on cells of the immune system, attenuating the destruction of insulin-producing cells. Furthermore, they lead to a better glycemic level, reducing the need for insulin and a normal immune state, such as C-peptide maintenance.

METHOD

Presently, our review highlights the significant studies that evaluated the supplementation of vitamin D and ω-3 PUFAs in humans and animal models in the modulation of T1D.

CONCLUSION

The data collected suggests that supplementation can provide potential benefits, mainly when done early in the diagnosis, since it reduces the need for insulin and the risk of complications generated by the disease.

Role of Vitamin D in the Metabolic Syndrome

The prevalence of hypovitaminosis D has risen in developed countries over the past few years in association with lifestyle changes and an increase in unhealthy habits. Vitamin D deficiency has been implicated in various diseases, including metabolic syndrome (MetS), which is clinically defined by a set of metabolic and vascular disorders. The objective of this study was to review scientific evidence on the relationship between MetS and vitamin D deficiency to support the development of prevention strategies and health education programs. An inverse relationship has been reported between plasma vitamin D concentrations and the features that define MetS, i.e., elevated serum concentrations of glucose, total cholesterol, low-density lipoproteins, triglycerides, glycosylated hemoglobin, and a high body mass index. Numerous studies have described the benefits of vitamin D supplementation to improve outcomes in individuals with MetS. Interventions to maintain optimal vitamin D concentrations are proposed as a preventive strategy against MetS.

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

INTRODUCTION

Pancreas transplantation is a high-risk procedure in terms of cardiovascular complications. Therefore, identification of all cardiovascular risk factors is crucial to prevent cardiovascular complications after pancreas transplantation. Vitamin D deficiency (VDD) appears to be a potential risk factor for coronary artery disease.

OBJECTIVE

To determine the prevalence of VDD in pancreas transplant candidates, and further to examine the relationship between vitamin D and the prevalence of coronary artery disease and lipid profile parameters.

MATERIALS AND METHODS

This is a prospective cross-sectional study. We enrolled consecutive patients with type 1 diabetes eligible for simultaneous pancreas-kidney transplantation or pancreas transplant alone. The laboratory tests included HbA1c, lipid profile, creatinine, and total 25-hydroxyvitamin D (25(OH)D). The diagnosis of coronary artery disease was based on coronary angiography.

RESULTS

The study population included 48 patients. VDD was revealed in 48% of patients and coronary artery disease in 35% of patients. The mean concentration of vitamin D in the entire cohort was 21.3 ± 9.48 ng/ml. The median value of 25(OH)D in patients with coronary artery disease was significantly lower than in patients without coronary artery disease (18.5 (11.6-21.5) vs. 24.8 (18.4-31.8) ng/ml, p = 0.018). There was a significant relationship between VDD and coronary artery disease (OR = 4.36; 95% confidence interval (CI): 1.22-15.64, p = 0.034). A patient's odds of having coronary artery disease while having a sufficient level of vitamin D was 4.36 times lower than if the patient had VDD. There was a significant relationship between VDD and hypertension (OR = 5.91; 95% CI: 1.12-31.20, p = 0.039) and hemodialysis (OR = 4.25; 95% CI: 1.25-14.5, p = 0.023). There was no significant correlation between 25(OH)D and lipid profile.

CONCLUSIONS

VDD is highly prevalent in pancreas transplant candidates with type 1 diabetes. There is a significant relationship between VDD and increased prevalence of coronary disease. The lack of any significant association between serum vitamin D and lipid profile suggests that the relationship between vitamin D and coronary artery disease results from other causes.

Mechanistic Effects of Vitamin D Supplementation on Metabolic Syndrome Components in Patients with or without Vitamin D Deficiency

The prevalences of metabolic syndrome (MetS) and vitamin D deficiency are increasing dramatically worldwide. MetS is a major challenge because it can increase the risk of most non-communicable diseases. The beneficial effect of vitamin D on MetS components remains controversial, so the present review focused on the clinical effects of vitamin D supplementation on MetS components. Vitamin D can inhibit the protein expression of nuclear factor beta; improve arterial stiffness; decrease renin-angiotensin-aldosterone system activity, parathyroid hormone levels, inflammatory cytokines, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, and lanosterol 14 α-demethylase enzyme activity; increase the activity of lipoprotein lipase; alter gene expression in C2C12 cells; and improve phospholipid metabolism and mitochondrial oxidation. We tried to elucidate and analyze almost all evidence from randomized controlled trial studies of the efficacy of vitamin D supplementation in patients with MetS. The findings of the present study reported beneficial effects of vitamin D supplementation on mentioned factors. Vitamin D supplementation is recommended in people with vitamin D deficiency even if it has no considerable effect on most MetS factors. However, existing data from interventional studies are insufficient to reach a definitive conclusion about the effect of vitamin D supplementation on MetS components in patients without vitamin D deficiency. Thus, new clinical studies are needed to test the hypothesis that vitamin D supplementation could alleviate MetS components in patients with sufficient intake of vitamin D.

Vitamin D status is related to severity at onset of diabetes and worse glycemic control

Objectives Our aim is to evaluate whether 25-hydroxyvitamin D at onset of type 1 diabetes mellitus (T1DM) would influence analytical variables of worse prognosis of the disease at the beginning and after one year of development. Methods A retrospective study of pediatric patients (0-14 years) diagnosed with T1DM with initial measurements of 25-hydroxyvitamin D was performed at Son Espases Hospital, between March 2012 and April 2019 (n=67). Results Vitamin D insufficiency was related to age, glycosylated hemoglobin, and creatinine. An improvement in glycosylated hemoglobin was found in subjects whose baseline serum 25(OH)D was >30 ng/mL. Bivariate correlation analysis adjusted by age showed a significantly positive correlation of vitamin D with pH (r=0.279), bicarbonate (r=0.338), and free levothyroxine (r=0.293). Independent variables associated with vitamin D insufficiency were age (odds ratio [OR]=1.2) and winter season (OR=10.52). Conclusion Hypovitaminosis D is related to biochemical variables showing greater severity and higher glycosylated hemoglobin at diagnosis: higher creatinine, lower free levothyroxine, pH, and bicarbonate. Unsupplemented patients with baseline deficiency showed persistently worse glycemic control vs. those with baseline repletion.

Association of vitamin D status with coronary artery disease in postmenopausal women

The relationship between coronary artery disease (CAD) and low serum 25-hydroxyvitamin D (25(OH)D) levels has emerged. Postmenopausal (PM) women are at increased risk of CAD and vitamin D (VitD) deficiency.To investigate the relationship between CAD and VitD levels in PM women.This case-control study included 93 consecutive female patients aged 50 to 79 years old undergoing coronary angiography for evaluation of CAD and 119 age-matched controls. Serum 25(OH)D concentrations were classed as adequate (serum 25(OH)D: ≥20 ng/mL); insufficient (serum 25(OH)D: 10 to <20 ng/mL); and deficient (serum 25(OH)D: <10 ng/mL). Major cardiovascular risk factors were also explored.CAD occurred in 67/127 (52.8%) patients with VitD deficiency; 21/66 (31.8%) patients that were VitD insufficient; and in 5/19 (26.3%) patients with adequate VitD levels. Multivariate regression analysis suggested that a deficiency of VitD increased CAD (odds ratio = 2.891; 95% confidence interval = 1.459-7.139, P < .001).VitD deficiency should be evaluated in PM women as a possible cause of CAD.