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Nisar M, Beigh SA, Mir AQ, Hussain SA, Dar AA, Yatoo I, Khan AM. Association of vitamin D status with redox balance and insulin resistance and its predicting ability for subclinical pregnancy toxemia in pregnant sheep. Domest Anim Endocrinol 2024; 86:106823. [PMID: 37944202 DOI: 10.1016/j.domaniend.2023.106823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/15/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
The study aimed to evaluate the role of vitamin D on redox balance, insulin resistance and its predicting value for subclinical pregnancy toxemia (SPT) in pregnant ewes. At four weeks pre-lambing, fifteen healthy pregnant ewes were divided into two groups, ewes with sufficient vitamin D (25-hydroxy-vitamin D (25VitD) (SVD, n = 9) and ewes with insufficient 25VitD (ISVD, n = 6). Blood samples were collected at 4 weeks pre-lambing using modified frequently sampled intravenous glucose tolerance test for the estimation of various metabolites. The baseline glucose, insulin, non-esterified fatty acid (NEFA), fructosamine, beta-hydroxy butyric acid (β-BHA), calcium, phosphorus concentration and total oxidant status (TOS) did not differ significantly between the two groups, however, total antioxidant capacity (TAC) was significantly (p = 0.031) low in ISVD ewes. Area under the curve for glucose, insulin, elimination rate of glucose and peak insulin also did not differ significantly between the two groups. Correlation analysis revealed, positive association of 25VitD with fructosamine, calcium and TAC, and negative correlation with NEFA and TOS. Subsequent blood sampling at 2 weeks pre-lambing and at lambing showed significant difference in NEFA (p = 0.001), β-HBA (p = 0.001), and fructosamine(p = 0.012) between the two groups. A significant time x group interaction was observed in NEFA (p = 0.019), β-HBA (p = 0.031), and fructosamine (p = 0.026) concentration. The NEFA concentrations were increased and fructosamine decreased at 2 weeks pre-lambing and at lambing along with significantly increased β-HBA at 2 weeks pre-lambing in ISVD compared to SVD. Taking 0.8 mmol/L β-HBA as the cut off limit for SPT, ISVD ewes had higher odds of developing SPT two weeks prior to lambing (OD 16.00; p = 0.042) and at lambing (OD 10; p = 0.077). This study concludes that 25VitD significantly influence redox balance and energy profile and serves as a valuable predictor for SPT in pregnant sheep.
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Affiliation(s)
- Mehak Nisar
- Division of Clinical Veterinary Medicine, Ethics and Jurisprudence, Faculty of Veterinary Science and Animal Husbandry (FVSc & AH), SKUAST-K, Jammu and Kashmir; India; 190006
| | - Shafayat Ahmad Beigh
- Division of Clinical Veterinary Medicine, Ethics and Jurisprudence, Faculty of Veterinary Science and Animal Husbandry (FVSc & AH), SKUAST-K, Jammu and Kashmir; India; 190006.
| | - Abdul Qayoom Mir
- Mountain research for Sheep and Goat, FVSc and AH. SKUAST-K, Jammu and Kashmir; India; 190006
| | - Syed Ashaq Hussain
- Division of Clinical Veterinary Medicine, Ethics and Jurisprudence, Faculty of Veterinary Science and Animal Husbandry (FVSc & AH), SKUAST-K, Jammu and Kashmir; India; 190006
| | - Aijaz Ahmad Dar
- Division of Veterinary Preventive Medicine and Epidemiology, FVSc & AH, SKUAST-K, Jammu and Kashmir; India; 190006
| | - Iqbal Yatoo
- Division of Teaching Veterinary Clinical Complex, FVSc & AH, SKUAST-K, Jammu and Kashmir; India; 190006
| | - Adil Mehraj Khan
- Division of Veterinary Pharmacology and Toxicology, FVSc & AH, SKUAST-K, Jammu and Kashmir; India; 190006
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Upadhyay PK, Thakur N, Vishwakarma VK, Srivastav RK, Ansari TM. Role of Vitamin D in Management of Diabetes and Unresolved Cardiovascular Diseases. Curr Diabetes Rev 2024; 20:e010923220647. [PMID: 37680158 DOI: 10.2174/1573399820666230901151019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Vitamin D deficiency is becoming a widely recognized global health issue. Serum values of 25-(OH) vitamin D (<20 ng/ml) are used to identify vitamin D deficiency. By prompting vascular endothelial cells to activate their nuclear receptor in cardio-myocytes, Vitamin D regulates obesity, Renin-angiotensin system (RAS), energy consumption, and pancreatic cell function. Vitamin D deficiency has been associated with diabetes, asthma, hyperlipidaemia, and pulmonary hypertension in humans. METHODS PubMed and Google Scholar databases were utilised to search the literature on vitamin D and related diseases. RESULT It is also linked to an elevated risk of death and heart disease. On the other hand, metaanalyses of vitamin D intervention and trials have found no substantial changes in insulin sensitivity, lipid markers, or blood pressure, which result in the association between deficiency of vitamin D and cardiovascular disease. CONCLUSION In this review, we present the most recent research on the effects of Vitamin D therapy on various cardiovascular diseases and diabetes, and explain the underlying mechanisms.
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Affiliation(s)
- Prabhat Kumar Upadhyay
- Institute of Pharmaceutical Research, GLA University, Mathura 281406, Uttar Pradesh, India
| | - Navneet Thakur
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ritesh Kumar Srivastav
- Faculty of Pharmacy, Kamla Nehru Institute of Management and Technology, Sultanpur 228119, India
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Farahmand MA, Daneshzad E, Fung TT, Zahidi F, Muhammadi M, Bellissimo N, Azadbakht L. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord 2023; 23:15. [PMID: 36647067 PMCID: PMC9841647 DOI: 10.1186/s12902-022-01209-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/10/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is conflicting evidence on the effect of vitamin D on glycemic control. Therefore, in the current meta-analyses, we aimed to assess the effect of vitamin D supplementation on the glycemic control of type 2 diabetes (T2D) patients. METHODS We conducted a comprehensive search in electronic databases including; PubMed/Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and NIH's Clinical Trials Registry, from the inception of each database up to January first, 2021. RESULTS A total of 46 randomized controlled trials (RCTs) consisting of 2164 intervention subjects and 2149 placebo controls were included in this meta-analysis. Pooled analyses for HbA1c showed a significant change between the intervention and placebo group, the weighted mean difference (WMD)(95% confidence interval(CI)) was -0.20%(-0.29, -0.11) with P < 0.001. Analyses for assessing changes in FPG found a significant reduction in the intervention group after vitamin D supplementation, the WMD (95%CI) was -5.02 mg/dl (-6.75,-3.28) with P < 0.001. The result of pooled analyses for HOMA-IR revealed a significant change between the intervention and control group, the WMD (95%CI) was -0.42(-0.76, -0.07) with P = 0.019. The subgroup analyses showed the most efficacy in a higher dose and short intervention period and in subjects with deficient vitamin D status. CONCLUSION Vitamin D supplementation might be beneficial for the reduction of FPG, HbA1c, and HOMA-IR in type 2 diabetes patients with deficient vitamin D status. This effect was especially prominent when vitamin D was given in large doses and for a short period of time albeit with substantial heterogeneity between studies and a probability of publication bias.
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Affiliation(s)
- Mohammad Ashraf Farahmand
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
- Public Health Faculty, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Teresa T Fung
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Fawzia Zahidi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
| | - Maryam Muhammadi
- Critical Nursing Care Department, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Nick Bellissimo
- School of Nutrition, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran.
- Diabetes Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Khoshnaw M, Dizaye K. Beneficial effects of vitamin D in the management of untreated hyperlipidemia in diabetic patients in Erbil, Iraq. PHARMACIA 2022. [DOI: 10.3897/pharmacia.69.e90908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hyperlipidemia is highly prevalent among type 2 diabetes mellitus (T2DM) patients. As hyperlipidemia plays a major part in atherosclerosis development and progression, this occurrence is linked to a significantly raised risk of cardiovascular disease. This study aims to assess the effects of vitamin D supplementation on lipid parameters in T2DM patients with untreated hyperlipidemia. Thirty-five T2DM patients with hyperlipidemia and vitamin D deficiency were supplemented with vitamin D for three months. Serum 25-hydroxyvitamin D (25[OH]D), calcium, lipid parameters, atherogenic indices, glucose, and HbA1c were recorded before and after the intervention. After supplementation, there was a statistically significant reduction in VLDL-C and triglycerides. Triglycerides showed a significant negative correlation with 25(OH)D. Atherogenic indices and HDL-C also improved significantly. Vitamin D supplementation had beneficial effects on the lipid profile of T2DM patients with untreated hyperlipidemia and vitamin D deficiency. Thus, vitamin D could be a valuable adjuvant therapy for these patients.
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Associations of Serum Total 25OHD, 25OHD3, and epi-25OHD3 with Insulin Resistance: Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2011–2016. Nutrients 2022; 14:nu14173526. [PMID: 36079784 PMCID: PMC9459885 DOI: 10.3390/nu14173526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Vitamin D may have a role in insulin sensitivity. However, the data on the association between various metabolites of Vitamin D and insulin-related parameters have been limited. Methods: We identified 6026 adults aged 20–80 years who participated in the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Serum total 25OHD, 25OHD3, and epi-25OHD3, fasting glucose, insulin, and HOMA2-IR were obtained from the NHANES data. The association between serum Vitamin D-related values and insulin resistance was analyzed using a generalized linear model. For risk analysis, multifactorial logistic regression was used. Results: The median total 25-hydroxyvitamin D level, 25-hydroxyvitamin D3 level, and 3-epi-25-hydroxyvitamin D3 level were 62.5 nmol/L, 58.8 nmol/L, and 3.3 nmol/L, respectively. After adjustment for sex, age, race, ethnicity, and education status, the ORs for the insulin resistance of participants of total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.32 (95% CI 0.24, 0.43), 0.34 (95% CI 0.26, 0.44), and 0.64 (95% CI 0.53, 0.77), respectively. After an adjustment for body mass index, diabetes, and drinking and smoking, the ORs for the insulin resistance of the participants for total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.56 (95% CI 0.40, 0.78), 0.63 (95% CI 0.46, 0.85), and 0.99 (95% CI 0.80, 1.24), respectively. Conclusions: Our study provides suggestive evidence for the association between Vitamin D concentrations and a lower risk of insulin resistance. Evidence from larger and more adequately powered cohort studies is needed to confirm our results.
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Kim Y, Oh YK, Lee J, Kim E. Could nutrient supplements provide additional glycemic control in diabetes management? A systematic review and meta-analysis of randomized controlled trials of as an add-on nutritional supplementation therapy. Arch Pharm Res 2022; 45:185-204. [PMID: 35304727 DOI: 10.1007/s12272-022-01374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
Abstract
This systematic review and meta-analysis assessed the antidiabetic effect of pharmaconutrients as an add-on in type 2 diabetes mellitus patients by pooling data from currently available randomized controlled trials (RCTs). Data sources included the PubMed and EMBASE, Cochrane Central Register of Controlled Trials. RCTs reporting changes in glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), or homeostasis model assessment of insulin resistance (HOMA-IR) levels following add-on pharmaconutritional therapies for T2DM patients consuming antidiabetic drugs were targeted. Using random-effects meta-analyses, we identified pharmaconutrients with effects on glycemic outcomes. Heterogeneity among studies was presented using I2 values. Among 9537 articles, 119 RCTs with nine pharmaconutrients (chromium; coenzyme Q10; omega-3 fatty acids; vitamins C, D, and E; alpha-lipoic acid; selenium; and zinc) were included. Chromium (HbA1c, FBG, and HOMA-IR), coenzyme Q10 (HbA1c and FBG), vitamin C (HbA1c and FBG), and vitamin E (HbA1c and HOMA-IR) significantly improved glycemic control. Baseline HbA1c level and study duration influenced the effects of chromium and vitamin E on HbA1c level. Sensitivity analyses did not modify the pooled effects of pharmaconutrients on glycemic control. Administration of chromium, coenzyme Q10, and vitamins C and E for T2DM significantly improved glycemic control. This study has been registered in PROSPERO (CRD42018115229).
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Affiliation(s)
- Yoonhye Kim
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Yun Kyoung Oh
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Junhee Lee
- The Graduate School for Pharmaceutical Industry Management, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Eunyoung Kim
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea. .,The Graduate School for Pharmaceutical Industry Management, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Ehrampoush E, Mirzay Razzaz J, Arjmand H, Ghaemi A, Raeisi Shahraki H, Ebrahim Babaei A, Osati S, Homayounfar R. The association of vitamin D levels and insulin resistance. Clin Nutr ESPEN 2021; 42:325-332. [PMID: 33745601 DOI: 10.1016/j.clnesp.2021.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/19/2020] [Accepted: 01/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Vitamin D deficiency and insulin resistance have great prevalence in society. The latest studies indicate an inverse association between Vitamin D levels, insulin resistance, and Type 2 diabetes. The objective of this study was to investigate the effect of vitamin D status on insulin resistance. METHODS In a cross-sectional study, 2160 participants were randomly recruited from a nutrition clinic in Tehran, Iran, 1057 (48.9%) were female and 1103 (51.1%) male. Information was gathered by a questionnaire. Following 12-h fasting, fasting plasma glucose (FPG) and insulin levels, as well as 25-hydroxy vitamin D levels were measured. 2-H glucose and insulin levels measured after consumption of 75 g glucose, HOMA2-IR, and HOMA-β indices were then calculated. RESULTS The average serum Vitamin D was 22.3 + 8.9 nmol/L and the prevalence of Vitamin D deficiency was 100%. There was an inverse relationship between Vitamin D levels and age, BMI, waist circumference, and all metabolic parameters (p < 0.001 in all) and a direct association with levels of exercise. Two logistic regression models were used to adjust for confounding variables; firstly, for age, gender, and smoking and secondly, additionally for BMI and energy intake. Both models showed a significant inverse relationship between Vitamin D levels and FPG and insulin levels, 2-h glucose and insulin levels, and HOMA2-IR. The optimum cut point for vitamin D was calculated at about 25 nmol/L for preventing insulin resistance. CONCLUSION This study illustrated that there is a statistically significant inverse relationship between Vitamin D levels and insulin resistance.
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Affiliation(s)
- Elham Ehrampoush
- Noncommunicable Diseases Research, Fasa University of Medical Sciences, Fasa, Iran
| | - Jalaledin Mirzay Razzaz
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Arjmand
- Students Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Alireza Ghaemi
- Department of Basic Sciences and Nutrition, Health Sciences Research Center, Addiction Institute, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Saeed Osati
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research, Fasa University of Medical Sciences, Fasa, Iran; National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Salih YA, Rasool MT, Ahmed IH, Mohammed AA. Impact of vitamin D level on glycemic control in diabetes mellitus type 2 in Duhok. Ann Med Surg (Lond) 2021; 64:102208. [PMID: 33786167 PMCID: PMC7988274 DOI: 10.1016/j.amsu.2021.102208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 12/26/2022] Open
Abstract
Background Vitamin D deficiency is prevalent in most parts of the world. Its insufficiency or deficiency is implicated in bone diseases, some cancers, infectious diseases, heart disease, autoimmune and metabolic diseases including type 2 diabetes mellitus. Results The mean age of patients was 49.94 ± 9.36, while the mean age the controls was 48.95 ± 10.56. Females constituted 56.1% and males 43.9% in the cases group, while for the control group females were 54.8% and males were 43.9%. Low vitamin D levels were detected in 110 (71%) of cases and 63 (40.6%) of controls. There was a significant difference in vitamin D levels among cases and controls (p < 0.001), vitamin D level was lower among females compared to males, p < 0.001 and those living in urban areas compared to rural areas, p < 0.001, BMI and dyslipidemia had a significant effect on vitamin D levels among diabetics, p values 0.002 and < 0.001 respectively. The serum 25(OH)-D level was significantly lower in patients with poor glycemic control compared to those with good glycemic control and in patients with a diabetes duration greater than 5 years, p values < 0.001 and 0.002 respectively. No significant correlation was detected with age and smoking, p values 0.181 and 0.260 respectively. Conclusion There is a high prevalence of hypo-vitaminosis D among patients with type-2 diabetes, particularly among patients with poor glycemic control and in those with longer diabetes durations. Vitamin-D deficiency is more prevalence in females, and those living in urban areas, those with obesity and patients with dyslipidemia. Vitamin D deficiency is prevalent in most parts of the world. There is a high prevalence of hypovitaminosis D among patients with type 2 diabetes. Vitamin D deficiency is implicated many diseases including type 2 diabetes mellitus.
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Affiliation(s)
- Yosuf Abdullah Salih
- Department of Internal Medicine, Duhok General Directorate of Health, Duhok City, Kurdistan Region, Iraq
| | - Mohammed T. Rasool
- Department of Medicine, College of Medicine, University of Duhok, DUHOK, Kurdistan Region, Iraq
| | - Idris Haji Ahmed
- Department of Internal Medicine, Non-communicable Disease Unit Duhok General Directorate of Health, Duhok City, Kurdistan Region, Iraq
| | - Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, DUHOK, Kurdistan Region, Iraq
- Corresponding author. Department of Surgery, College of Medicine, University of Duhok, Nakhoshkhana Road, 8 AM-1014, Duhok, Kurdistan Region, Iraq.
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Bandarian F, Namazi N, Amini MR, Pajouhi M, Mehrdad N, Larijani B. Endocrinology and Metabolism Research Institute from inception to maturity: an overview of 25-year activity. J Diabetes Metab Disord 2020:1-7. [PMID: 33042897 PMCID: PMC7532120 DOI: 10.1007/s40200-020-00645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Abstract
Endocrinology and Metabolism Research Institute (EMRI) was founded in 1993. EMRI progressed step by step from inception and reached to its maturation during the past 25 years. EMRI has expanded and progressed in different aspects including human resources and infrastructures (laboratories and new technologies) and has obtained the first rank in the country in endocrinology research. It has also collaborated with regional and international organizations such as World Health Organization (WHO), International Osteoporosis Foundation (IOF), and American Association of Clinical Endocrinologists (AACE). This article provides an overview of EMRI activities during a quarter of a century.
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Affiliation(s)
- Fatemeh Bandarian
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Evidence Based Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Amini
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Pajouhi
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Beneath Dr. Shariati Hospital, Gomnam Highway, Tehran, Iran
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The Molecular Mechanisms by Which Vitamin D Prevents Insulin Resistance and Associated Disorders. Int J Mol Sci 2020; 21:ijms21186644. [PMID: 32932777 PMCID: PMC7554927 DOI: 10.3390/ijms21186644] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
Numerous studies have shown that vitamin D deficiency is very common in modern societies and is perceived as an important risk factor in the development of insulin resistance and related diseases such as obesity and type 2 diabetes (T2DM). While it is generally accepted that vitamin D is a regulator of bone homeostasis, its ability to counteract insulin resistance is subject to debate. The goal of this communication is to review the molecular mechanism by which vitamin D reduces insulin resistance and related complications. The university library, PUBMED, and Google Scholar were searched to find relevant studies to be summarized in this review article. Insulin resistance is accompanied by chronic hyperglycaemia and inflammation. Recent studies have shown that vitamin D exhibits indirect antioxidative properties and participates in the maintenance of normal resting ROS level. Appealingly, vitamin D reduces inflammation and regulates Ca2+ level in many cell types. Therefore, the beneficial actions of vitamin D include diminished insulin resistance which is observed as an improvement of glucose and lipid metabolism in insulin-sensitive tissues.
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Safarpour P, Daneshi-Maskooni M, Vafa M, Nourbakhsh M, Janani L, Maddah M, Amiri FS, Mohammadi F, Sadeghi H. Vitamin D supplementation improves SIRT1, Irisin, and glucose indices in overweight or obese type 2 diabetic patients: a double-blind randomized placebo-controlled clinical trial. BMC FAMILY PRACTICE 2020; 21:26. [PMID: 32033527 PMCID: PMC7007689 DOI: 10.1186/s12875-020-1096-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/23/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D (VD) may increase sirtuin 1 (SIRT1) and subsequently PPAR-γ coactivator 1α (PGC-1α) and irisin levels and these improvements may reduce insulin resistance (IR). The aim was to assess the effects of vitamin D supplementation on SIRT1, irisin, and IR in overweight/obese type 2 diabetes (T2D) patients. METHODS Ninety T2D males and females were recruited as a clinical trial study (mean of age and body mass index (BMI) of intervention and placebo groups were 50.05 ± 10.17 and 50.36 ± 10.2 yrs. and 31.37 ± 3.4 and 30.43 ± 3.2 kg/m2, respectively). The inclusion criteria were T2D, VD deficient, BMI > 25 kg/m2, and serum HbA1c < 8.5%. The exclusion criteria were using vitamin and mineral supplements, having any acute disease, recent modifying dose or type of drugs. The supplementation was 50,000 IU/week VD or placebo for 8 weeks. The demographic characteristics, anthropometrics, dietary intakes and physical activity status, sun exposure status, fasting blood sugar (FBS) and insulin, glycosylated hemoglobin (HbA1c), irisin, SIRT1, 25-hydroxy D3 (25(OH)VD), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were determined. The significant P-value was ≤0.05. RESULTS The increase of serum VD, SIRT1, and irisin in the intervention group was significant (p < 0.001). HbA1c was decreased significantly by 1%. The changes in the other glucose indices (FBS, insulin, and IR) were non-significant. CONCLUSIONS VD supplementation may improve T2D by decreasing HbA1c and increasing SIRT1 and irisin in VD deficient T2D patients. Further trials are suggested. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT201604202365N11. Registered 21/08/2016, http://en.irct.ir/trial/2019.
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Affiliation(s)
- Peivasteh Safarpour
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Daneshi-Maskooni
- Department of Nutrition, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Mitra Nourbakhsh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Maddah
- Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
| | - Fatemeh-Sadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Mohammadi
- Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
| | - Homa Sadeghi
- Department of Epidemiology, University of Massachusetts Lowell, Lowell, MA, USA
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Gharekhani A, Najafipour F, Baradaran H, Tagharrobi P, Rezaee H. The Effect of Treating Vitamin D Deficiency or Insufficiency on Serum Adiponectin, Leptin and Insulin Resistance of Type 2 Diabetes Mellitus Patients: A Pilot Study. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2020; 19:86-94. [PMID: 33680012 PMCID: PMC7757991 DOI: 10.22037/ijpr.2020.112067.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Vitamin D deficiency is considered as one of the most prevalent healthcare problems in the world. Vitamin D contributes to insulin synthesis and secretion. Deficiency of vitamin D leads to insulin resistance which is the major cause of type 2 diabetes mellitus. We aim to evaluate the effect of treating vitamin D deficiency or insufficiency on serum adiponectin, leptin, and leptin to adiponectin ratio (LAR) of type 2 diabetes mellitus patients. Forty patients with type 2 diabetes mellitus were included according to the inclusion criteria of the study. Fasting venous blood samples were obtained and evaluated before and after the treatment of vitamin D deficiency or insufficiency. Then, blood levels of leptin, adiponectin, and LAR (an indicator of insulin resistance) were measured. The results of study indicate a significant decline in circulating leptin and adiponectin after vitamin D treatment, but it doesn't cause a noteworthy change in LAR. Furthermore, the study demonstrates that female gender, higher body mass index, and triglyceride levels increase LAR significantly. It was concluded that the treatment of vitamin D deficiency or insufficiency doesn't change insulin resistance in diabetic patients. Moreover, we concluded that LAR is not a reliable method to compare insulin resistance between men and women due to sex-related differences in adipose tissue.
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Affiliation(s)
- Afshin Gharekhani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hananeh Baradaran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Parisa Tagharrobi
- Student’s Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Haleh Rezaee
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
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Alaei-Shahmiri F, Khamseh ME, Manhoei K, Yadegari H, Kazemi H, Meshkini M. The optimal vitamin D cut-off value associated with hyperglycemia in an Iranian population. J Diabetes Metab Disord 2019; 19:5-12. [PMID: 32550151 DOI: 10.1007/s40200-019-00433-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/14/2019] [Indexed: 12/19/2022]
Abstract
Background Vitamin D deficiency may accelerate the risk of type 2 diabetes mellitus. The association of vitamin D with hyperglycemia may be influenced by lifestyle. Objective To evaluate the relationship between vitamin D status and hyperglycemia among the workers' population. Methods This was a medical records review of 7054 Iranian factory workers participating in an annual health check-up for employees. Of those, potential participants were included in this analysis if data for serum 25-hydroxyvitamin D [25(OH) D] levels were also available. Results Data of 429 male participants were used for this analysis. Of those, 61.07% had serum 25(OH)D concentrations lower than the sufficient level [≥20 ng/ml]. Hyperglycemic participants had significantly lower 25(OH)D than those with normal fasting blood glucose (FBG). Regression analyses highlighted serum 25(OH)D as a significant determinant of hyperglycemia [OR: 0.943(0.901, 988); p = 0.01]. The association between 25(OH)D and FBG remained significant after adjustment for potential confounders (p = 0.008). Using the ROC analysis, the serum 25(OH)D value of 14.7 ng/ml was the optimal cut-off point to predict hyperglycemia in this population (sensitivity: 63.6%, specificity: 62.3%, p = 0.01). Conclusion Our results revealed a considerable proportion of participants with serum 25(OH)D below the optimal level as well as a significant inverse association between vitamin D status and hyperglycemia among the factory workers. These findings highlight the importance of including the evaluation of vitamin D status as a part of annual health examinations for employees, and may help health policy- makers prevent or delay type 2 diabetes mellitus among the workers' population.
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Affiliation(s)
- Fariba Alaei-Shahmiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), No. 10, Firouzeh St, Vali-asr St, Vali-asr Sq, Tehran, Iran
| | - Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), No. 10, Firouzeh St, Vali-asr St, Vali-asr Sq, Tehran, Iran
| | | | | | | | - Majid Meshkini
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Analysis of Association between Vitamin D Deficiency and Insulin Resistance. Nutrients 2019; 11:nu11040794. [PMID: 30959886 PMCID: PMC6520736 DOI: 10.3390/nu11040794] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
Recent evidence revealed extra skeleton activity of vitamin D, including prevention from cardiometabolic diseases and cancer development as well as anti-inflammatory properties. It is worth noting that vitamin D deficiency is very common and may be associated with the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes. This review aims to provide molecular mechanisms showing how vitamin D deficiency may be involved in the insulin resistance formation. The PUBMED database and published reference lists were searched to find studies published between 1980 and 2019. It was identified that molecular action of vitamin D is involved in maintaining the normal resting levels of ROS and Ca2+, not only in pancreatic β-cells, but also in insulin responsive tissues. Both genomic and non-genomic action of vitamin D is directed towards insulin signaling. Thereby, vitamin D reduces the extent of pathologies associated with insulin resistance such as oxidative stress and inflammation. More recently, it was also shown that vitamin D prevents epigenetic alterations associated with insulin resistance and diabetes. In conclusion, vitamin D deficiency is one of the factors accelerating insulin resistance formation. The results of basic and clinical research support beneficial action of vitamin D in the reduction of insulin resistance and related pathologies.
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Hu Z, Chen J, Sun X, Wang L, Wang A. Efficacy of vitamin D supplementation on glycemic control in type 2 diabetes patients: A meta-analysis of interventional studies. Medicine (Baltimore) 2019; 98:e14970. [PMID: 30946322 PMCID: PMC6456062 DOI: 10.1097/md.0000000000014970] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Conflicting evidence exists on the effect of vitamin D supplementation on glucose metabolism in subjects with type 2 diabetes (T2D). Therefore, this meta-analysis focuses on the relationship between vitamin D intervention and glycaemic control in subjects with T2D. METHODS We reviewed available randomized controlled trials (RCTs) studies from the establishment time of each database to March 31, 2018. Stata 13.0 software was used to evaluate the included literature. RESULTS Finally, a total of 19 RCT studies involving 747 intervention subjects and 627 placebo controls were included in this meta-analysis. Meta-analysis results showed that compared with the control group, the short-term vitamin D supplementation group had a decline in hemoglobin A1c (HbA1c), insulin resistance, and insulin. The Standard Mean Difference (SMD) (95% CI [95% confidence interval]) of HbA1c, insulin resistance, and insulin were -0.17 (-0.29, -0.05), -0.75 (-0.97, -0.53), -0.57 (-0.78, -0.35), respectively with all P value <.05. But there were no significant differences in long-term follow-up vitamin D intervention. CONCLUSION Vitamin D supplementation in T2D patients can improve HbA1c, insulin resistance, and insulin in short-term intervention, suggesting that vitamin D can be considered as a therapeutic agent along with the other treatments for T2D.
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Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: A randomized controlled trial. Clin Nutr 2019; 39:718-726. [PMID: 30940404 DOI: 10.1016/j.clnu.2019.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/21/2019] [Accepted: 03/10/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND & AIMS Vitamin D supplementation may affect glycemic as well as hormonal regulation. Thus, the aim of the current study was to investigate whether vitamin D supplementation has any significant effects on metabolic and endocrine parameters in healthy premenopausal women. Primary outcome measure was the plasma glucose area under the curve (AUCgluc). METHODS The current study was a single-center, double-blind, randomized placebo-controlled trial that was conducted at the Medical University of Graz, Austria, between March 2013 and October 2017. One-hundred and fifty healthy premenopausal women with 25-hydroxyvitamin D [25(OH)D] concentrations <75 nmol/L once weekly received either 20,000 IU of cholecalciferol or placebo (2:1 ratio) over a total of 24 weeks. RESULTS In total, 127 women [age 36.2 ± 8.7 years; BMI 25.3 ± 5.6 kg/m2; baseline 25(OH)D 55.8 ± 19.7 nmol/L] completed the study. Vitamin D supplementation had no significant effect on AUCgluc (mean treatment effect 11.70; p = 0.069), while it had a significant treatment effect on homeostatic model assessment-insulin resistance (HOMA-IR; mean treatment effect 0.31; p = 0.019) and quantitative insulin-sensitivity check index (QUICKI; mean treatment effect -0.019; p = 0.013). There was no significant effect on the remaining secondary outcome parameters. CONCLUSIONS In this randomized-controlled trial in healthy premenopausal women, there was a significant treatment effect of vitamin D supplementation on HOMA-IR and QUICKI, while there was no significant treatment effect on AUCgluc.
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The effects of vitamin D supplementation on indices of glycemic control in Iranian diabetics: A systematic review and meta-analysis. Complement Ther Clin Pract 2019; 34:294-304. [DOI: 10.1016/j.ctcp.2018.12.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 12/15/2018] [Accepted: 12/16/2018] [Indexed: 12/17/2022]
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Antwi J, Huffman F, Sullivan S. Relationship of serum Vitamin D concentrations with Adipokines and Cardiometabolic risk among non-Hispanic black type 2 diabetic and non-diabetic subjects: a cross-sectional study. BMC Nutr 2018; 4:50. [PMID: 32153911 PMCID: PMC7050721 DOI: 10.1186/s40795-018-0259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report the association of serum 25-hydroxyvitamin D [25(OH)D] and its association with adipokines and cardiometabolic risk factors in Haitian Americans (HA) and African Americans (AA) by ethnicity and type 2 diabetes (T2D) status. METHODS A cross-sectional study in 197 HA (92 with T2D and 102 without T2D) and 200 AA (97 with T2D and 103 without T2D) recruited in South Florida. Serum 25(OH)D concentrations and adipokines were analyzed by ELISA and cardiometabolic risk factors were indexed by obesity, glycemic control, insulin sensitivity, lipid profile, and blood pressure. RESULTS Controlling for age, BMI, energy intake, smoking status and HOMA2-IR in multivariate linear regression analyses, serum 25(OH)D concentrations were significantly associated with WC (R2 = 0.760, B = - 0.092, P = 0.027), HbA1C (R2 = 0.142, B = - 0.012, P = 0.010), and TG (R2 = 0.159, B = - 1.192, P = 0.003) in only HA without T2D. While serum 25(OH)D concentrations were significantly associated with TC (R2 = 0.168, B = - 0.329, P = 0.040), log leptin (R2 = 0.544, B = - 0.007, P = 0.021), and adiponectin (R2 = 0.144, B = 0.111, P = 0.033), but slightly associated with LDL-c (R2 = 0.133, B = - 0.278, P = 0.064) in only AA without T2D. Among individuals with T2D, serum 25(OH)D concentrations were marginally associated with IL-6 (R2 = 0.109, B = 0.076, P = 0.085) in HA with T2D, and there was a trend toward significance with log leptin (R2 = 0.393, B = - 0.006, P = 0.075) in AA with T2D in regression analysis. CONCLUSIONS The findings that the associations of serum 25(OH)D concentrations with adipokines and cardiometabolic factors differ between HA and AA has clinical and public implications to guide design of T2D preventive strategies that are culturally specific even within the same ethnicity.
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Affiliation(s)
- Janet Antwi
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
| | - Fatma Huffman
- 0000 0001 2110 1845grid.65456.34Department of Dietetics and Nutrition, Robert Stempel College of Public Health, Florida International University, Miami, USA
| | - Stacey Sullivan
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
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Tabatabaei-Malazy O, Norani M, Heshmat R, Qorbani M, Vosoogh A, Afrashteh B, Kahkeshan F, Ajami A, Larijani B. Efficacy and Safety of the Biosimilar Recombinant Human Parathyroid Hormone Cinnopar ® in Postmenopausal Osteoporotic Women: A Randomized Double-blind Clinical Trial. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1336-1344. [PMID: 30320008 PMCID: PMC6174042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Due to high cost and burden of osteoporosis, it is reasonable to focus on the reduction of fractures as the main goal of treatment. We compared the efficacy and safety of a new biosimilar recombinant human parathyroid hormone (CinnoPar®, CinnaGen, Iran) to the reference product (Forteo®, Eli Lilly, USA) in a randomized double-blind clinical trial (RCT). Methods: Overall, 104 osteoporotic postmenopausal women aged 45–75 yr were randomized to receive 20 μg daily subcutaneous injections of either Forteo® or CinnoPar® for 6-months from 2011–2012. Bone biomarkers were measured at baseline, and during first, third, and sixth month’s follow-up along with lumbar spine, total hip, and femoral neck bone mineral density (BMD) assessment at the baseline and six months after that. The study was registered in Iranian registry of clinical trials under the registration number of IRCT138810121414N5. The endpoints were to compare bone biomarkers, BMD and drug safety between groups. Data analysis was performed using SPSS 11. Results: Age range of ninety-four patients who completed the study was 42–81 yr. Participants were divided into Forteo (45 subjects) and CinnoPar (49 subjects) groups. No significant difference in terms of bone biomarkers or BMD scores was shown between groups (P≥0.05). The most prevalent side effects were hypercalcemia and hypercalciuria without any significant statistical differences between groups. Conclusion: CinnoPar® can be considered as a good alternative therapy for Forteo® in postmenopausal osteoporotic women due to its comparable efficacy and safety properties.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masumeh Norani
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Afsaneh Vosoogh
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Afrashteh
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Kahkeshan
- Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Arman Ajami
- Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Razi F, Meshkani MA, Zarrabi F, Sadr M, Asgarbeik S, Bandarian F, Forouzanfar K, Amoli MM. Haplotypes in vitamin D receptor gene encode risk in diabetic nephropathy. Gene 2018; 683:149-152. [PMID: 30315926 DOI: 10.1016/j.gene.2018.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/30/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Diabetic Nephropathy (DN) is one of the microvascular complications of diabetes and its early diagnosis can improve patient's quality of life. Genetic factors may increase the risk of DN development. This study aimed to evaluate the association of vitamin D receptor (VDR) gene polymorphisms and DN. METHOD A total of 313 Iranian participants including 104 diabetic patients with nephropathy (DN), 100 diabetic patients without nephropathy (D) and 109 healthy people (HC) were studied. The frequencies of rs7975232, rs731236 and rs4516035 variants of VDR gene were determined and compared between three groups. Estimated haplotype frequencies between polymorphisms in the cases and controls were also calculated. RESULTS No significant differences were identified for allele /genotype frequencies in HC, D and DN groups. However haplotype analysis showed that haplotype encompassing CCC alleles for rs7975232, rs731236 and rs4516035 variants, respectively was more frequent in DN subjects compared to HC (p-value = 0.01) and also, haplotype comprising TCC alleles was more frequent in DN group compared to both HC and D groups (p-value = 0.004 and 0.007, respectively). CONCLUSION Our study identified that CCC and TCC VDR haplotypes are risk factors for DN in patients with diabetes type 2.
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Affiliation(s)
- Farideh Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Arshadi Meshkani
- Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fariba Zarrabi
- Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sadr
- Molecular Immunology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Asgarbeik
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Fatemeh Bandarian
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Katayoon Forouzanfar
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mohammad Amoli
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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The Effect of a Single Intramuscular Injection of Cholecalciferol on the Serum Levels of Vitamin D, Adiponectin, Insulin Resistance, and Liver Function in Women with Non-Alcoholic Fatty Liver Disease (NAFLD): A Randomized, Controlled Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.60746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Safarpour P, Vafa MR, Amiri F, Janani L, Noorbakhsh M, Rajabpour Nikoo E, Sadeghi H. A double blind randomized clinical trial to investigate the effect of vitamin D supplementation on metabolic and hepato-renal markers in type 2 diabetes and obesity. Med J Islam Repub Iran 2018; 32:34. [PMID: 30159285 PMCID: PMC6108264 DOI: 10.14196/mjiri.32.34] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Indexed: 02/06/2023] Open
Abstract
Background: According to the recent studies, vitamin D deficiency has been correlated with progress in type 2 Diabetes and Metabolic Syndrome. The aim of this study was to assess the effect of vitamin D supplementation on glucose and lipid profiles, blood pressure, and biomarkers of liver and kidney in type 2 diabetic patients. Methods: In this Double blinded randomized clinical trial, 90 patients with type 2 diabetes and serum 25-Hydroxy vitamin D levels of less than 30 ng/ml recruited from "Besat Diabetes Clinic" in Rasht, North of Iran. The subjects took 50000 IU vitamin D supplements or placebo for 8 weeks. We assessed the levels of serum 25 (OH) vitamin D, glucose and lipid profiles, oxidative and inflammatory indices, liver and kidney biomarkers, blood pressure, and sun exposure time, physical activity before and after intervention, and compared them between cases and controls. Results: Vitamin D supplementation significantly increased serum vitamin D level, Superoxide Dismutase (SOD) activity, and significantly decreased serum HbA1C (Glycosylated Hemoglobin) level (p<0.001). High Density Lipoprotein (HDL) Cholesterol increased significantly (p=0.016), and Erythrocyte Sedimentation Rate (ESR) significantly decreased (p=0.039) after the intervention. Conclusion: Our results represented that weekly supplementation with 50000 IU vitamin D for 8 weeks may be effective by improving HbA1C and lipid profile in type 2 diabetes mellitus.
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Affiliation(s)
- Peivasteh Safarpour
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Noorbakhsh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ensieh Rajabpour Nikoo
- Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
| | - Homa Sadeghi
- Department of Epidemiology, School of Massachusetts Lowell, Massachusetts, USA
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23
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Evaluating Vitamin D Status in Pre- and Postmenopausal Type 2 Diabetics and Its Association with Glucose Homeostasis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9369282. [PMID: 29808168 PMCID: PMC5902073 DOI: 10.1155/2018/9369282] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/24/2018] [Accepted: 02/20/2018] [Indexed: 12/21/2022]
Abstract
Background Type 2 Diabetes Mellitus (T2DM) and menopause are associated with vitamin D status. Oestrogen decline during menopausal stages promotes hypovitaminosis D. However, the interplay between vitamin D, menopause, lifestyle, and T2DM cannot be overlooked. This study assessed vitamin D status among pre- and postmenopausal T2DM women and determined its association with glycemic control and influence of lifestyle habits on hypovitaminosis D. Methods This cross-sectional study was conducted at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Structured questionnaires were administered to 192 T2DM women; blood samples were collected for estimation of 25(OH) D and insulin using ELISA. Fasting blood glucose (FBG), lipid profile, glycated haemoglobin (HbA1c), and calcium were measured. Statistical analyses were performed using Graphpad Prism 6. Results The prevalence of vitamin D inadequacy was 92.2%. Hypovitaminosis D was more prevalent among the postmenopausal T2DM women (63.8% versus 58.2%). Hypovitaminosis D significantly associated with insulin [R2 = 0.01760, p = 0.0008], HbA1c [R2 = 0.3709, p = <0.0001], and FBG [R2 = 0.3465, p = 0.0001] in only the postmenopausal women. Conclusion Vitamin D deficiency is prevalent in pre- and postmenopausal T2DM but higher among postmenopausal women. Adequate vitamin D levels in both groups were associated with improved glucose control while hypovitaminosis D in the postmenopausal women was related to poorer glucose control. Vitamin D screening should be incorporated into management plan for T2DM to serve as an early tool for prevention of vitamin D deficiency.
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Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee SY. Vitamin D and Hypertension. Electrolyte Blood Press 2017; 15:1-11. [PMID: 29042901 PMCID: PMC5641496 DOI: 10.5049/ebp.2017.15.1.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/11/2017] [Indexed: 12/11/2022] Open
Abstract
Vitamin D has the pleiotropic effects in multiple organ systems, and vitamin D deficiency was suggested to be associated with high blood pressure according to previous reports. Several interventional studies have examined the effect of vitamin D supplementation on high blood pressure patients, but the results have been inconsistent. In this article, we examined the literature that have proposed a mechanism involving vitamin D in the regulation of blood pressure and review previous observational and interventional studies that have shown the relationship between vitamin D and hypertension among various populations.
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Affiliation(s)
- Hye Yun Jeong
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kyung Mi Park
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Mi Jung Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong Ho Yang
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hoon Kim
- Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - So-Young Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Wu C, Qiu S, Zhu X, Li L. Vitamin D supplementation and glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Metabolism 2017; 73:67-76. [PMID: 28732572 DOI: 10.1016/j.metabol.2017.05.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 05/01/2017] [Accepted: 05/02/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Low vitamin D status has been found to be associated with impaired glycemic control in patients who suffer from type 2 diabetes; however, whether vitamin D supplementation is associated with improved glycemic status remains controversial. The aim of this study was to summarize evidence from randomized controlled trials (RCTs) to assess the efficacy of vitamin D supplementation in reducing glycosylated haemoglobinA1c (HbA1c) and fasting blood glucose (FBG) levels. MATERIALS/METHODS We searched PubMed, Web of Science and the Cochrane Library for reports published up to March 2017. We selected parallel RCTs investigating the effect of vitamin D or vitamin D analogues on HbA1c or FBG levels in type 2 diabetes patients. Cohen's d was calculated to represent the standardized mean difference (SMD) for each study, and the SMDs with 95%confidence intervals (CIs) were pooled using a random effects model. RESULTS Twenty-four studies were included that evaluated HbA1c levels and 18 studies were included that evaluated FBG levels. Meta-analyses showed that vitamin D supplementation was associated with reduced HbA1c levels (standardized mean difference (SMD) -0.25 [-0.45 to -0.05]) but had no influence on FBG levels (SMD -0.14 [-0.31 to 0.03]). However, the subgroup analyses suggested that vitamin D supplementation was associated with reduced HbA1c levels (SMD -0.39 [-0.67 to -0.10]) and FBG (SMD -0.27 [-0.46 to -0.07]) among patients with 25-hydroxyvitamin D (25(OH) D) deficiency at baseline. Significantly reduced HbA1c levels were also observed in association with vitamin D supplementation in the subgroup including type 2 diabetes patients with a body mass index (BMI) <30kg m-2 (SMD -0.30 [-0.54 to -0.07]). CONCLUSIONS Vitamin D supplementation could be effective at improving glycemic control in vitamin D deficient or non-obese type 2 diabetes patients.
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Affiliation(s)
- Chunhua Wu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, China
| | - Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, China
| | - Xiangyun Zhu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, China
| | - Ling Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, China.
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Garbossa SG, Folli F. Vitamin D, sub-inflammation and insulin resistance. A window on a potential role for the interaction between bone and glucose metabolism. Rev Endocr Metab Disord 2017; 18:243-258. [PMID: 28409320 DOI: 10.1007/s11154-017-9423-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vitamin D is a key hormone involved in the regulation of calcium/phosphorous balance and recently it has been implicated in the pathogenesis of sub-inflammation, insulin resistance and obesity. The two main forms of vitamin D are cholecalciferol (Vitamin D3) and ergocalciferol (Vitamin D2): the active form (1,25-dihydroxyvitamin D) is the result of two hydroxylations that take place in liver, kidney, pancreas and immune cells. Vitamin D increases the production of some anti-inflammatory cytokines and reduces the release of some pro-inflammatory cytokines. Low levels of Vitamin D are also associated with an up-regulation of TLRs expression and a pro-inflammatory state. Regardless of the effect on inflammation, Vitamin D seems to directly increase insulin sensitivity and secretion, through different mechanisms. Considering the importance of low grade chronic inflammation in metabolic syndrome, obesity and diabetes, many authors hypothesized the involvement of this nutrient/hormone in the pathogenesis of these diseases. Vitamin D status could alter the balance between pro and anti-inflammatory cytokines and thus affect insulin action, lipid metabolism and adipose tissue function and structure. Numerous studies have shown that Vitamin D concentrations are inversely associated with pro-inflammatory markers, insulin resistance, glucose intolerance and obesity. Interestingly, some longitudinal trials suggested also an inverse association between vitamin D status and incident type 2 diabetes mellitus. However, vitamin D supplementation in humans showed controversial effects: with some studies demonstrating improvements in insulin sensitivity, glucose and lipid metabolism while others showing no beneficial effect on glycemic control and on inflammation. In conclusion, although the evidences of a significant role of Vitamin D on inflammation, insulin resistance and insulin secretion in the pathogenesis of obesity, metabolic syndrome and type 2 diabetes, its potential function in treatment and prevention of type 2 diabetes mellitus is unclear. Encouraging results have emerged from Vitamin D supplementation trials on patients at risk of developing diabetes and further studies are needed to fully explore and understand its clinical applications.
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Affiliation(s)
- Stefania Giuliana Garbossa
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Ospedale San Paolo, Via A. Di Rudini 8, Milan, 20142, Italy
- Program in Nutritional Science, Universitá degli Studi di Milano, Milan, Italy
| | - Franco Folli
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Ospedale San Paolo, Via A. Di Rudini 8, Milan, 20142, Italy.
- Endocrinology and Metabolism, Department of Health Science, Universitá degli Studi di Milano, San Paolo Hospital, Room #737, Via A. Di Rudiní 8, 20142, Milan, Italy.
- Department of Medicine, Diabetes Division, University of Texas Health System, 7703 Floyd Curl Drive, San Antonio, 78229, TX, USA.
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Tabatabaei-Malazy O, Salari P, Khashayar P, Larijani B. New horizons in treatment of osteoporosis. Daru 2017; 25:2. [PMID: 28173850 PMCID: PMC5297185 DOI: 10.1186/s40199-017-0167-z] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/31/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. MAIN BODY This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines. As well, the effect of combination therapy and recommendations for future research will be further discussed. SHORT CONCLUSION The use of current antiresorptive and anabolic agents alone or in combinations for the treatment of osteoporosis entails several limitations. Mainly, their efficacy on non-vertebral fracture reduction is lower than that observed on vertebral fracture. In addition, they have potential adverse events on long time usage. Development of newer agents such as cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis, but also have opened doors of opportunity to improvements in the effective treatment. However, the high cost of new agents have restricted their usage in selective patients who are at high risk of fracture or whom failed response to first line treatment options. Thus, personalized medicine should be considered for future evaluation of genetic risk score and also for environmental exposure assessment. In addition to permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there seems a need to more well-designed clinical trials with larger sample sizes and longer duration on current as well as on newer agents. Also, continuous research on plant-derived components as the source of discovering new agents, and conducting more clinical trials with combination of two or more synthetic drugs, plants, or drug-plant for the treatment of osteoporosis are recommended. Summary of treatment modalities for osteoporosis.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Fifth floor, Dr.Shariati Hospital, North Kargar Ave, Tehran, 14114 Iran
| | - Pooneh Salari
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Patricia Khashayar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Center for Microsystems Technology, Imec and Ghent University, Gent-Zwijnaarde, Belgium
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Fifth floor, Dr.Shariati Hospital, North Kargar Ave, Tehran, 14114 Iran
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Krul-Poel YHM, Ter Wee MM, Lips P, Simsek S. MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Eur J Endocrinol 2017; 176:R1-R14. [PMID: 27484453 DOI: 10.1530/eje-16-0391] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/08/2016] [Accepted: 08/01/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Epidemiologic studies suggest that vitamin D status plays a role in glycaemic control in patients with type 2 diabetes. However, intervention studies yielded inconsistent results. The aim of this study is to systematically review the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. METHODS Systematic review and meta-analysis. We searched Medline, Embase and the Cochrane Library for RCTs examining the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. A random-effects model meta-analysis was performed to obtain a summarized outcome of vitamin D supplementation on HbA1c, fasting glucose and homeostasis model assessment - insulin resistance (HOMA-IR). RESULTS Twenty-three RCTs were included in this systematic review representing a total of 1797 patients with type 2 diabetes. Mean (± s.d.) change in serum 25-hydroxyvitamin D varied from 1.8 ± 10.2 nmol/L to 80.1 ± 54.0 nmol/L. Nineteen studies included HbA1c as outcome variable. Combining these studies no significant effect in change of HbA1c was seen after vitamin D intervention compared with placebo. A significant effect of vitamin D supplementation was seen on fasting glucose in a subgroup of studies (n = 4) with a mean baseline HbA1c ≥ 8% (64 mmol/mol) (standardized difference in means: 0.36; 95% CI: 0.12-0.61, P = 0.003). CONCLUSIONS Current evidence of RCTs does not support short-term vitamin D supplementation in a heterogeneous population with type 2 diabetes. However, in patients with poorly controlled diabetes, a favourable effect of vitamin D is seen on fasting glucose.
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Affiliation(s)
| | - Marieke M Ter Wee
- Department of Epidemiology and BiostatisticsVU University Medical Centre, Amsterdam, The Netherlands
| | - Paul Lips
- Department of Epidemiology and BiostatisticsVU University Medical Centre, Amsterdam, The Netherlands
| | - Suat Simsek
- Department of Internal MedicineMedical Centre Alkmaar, Alkmaar, The Netherlands
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Salekzamani S, Mehralizadeh H, Ghezel A, Salekzamani Y, Jafarabadi MA, Bavil AS, Gargari BP. Effect of high-dose vitamin D supplementation on cardiometabolic risk factors in subjects with metabolic syndrome: a randomized controlled double-blind clinical trial. J Endocrinol Invest 2016; 39:1303-1313. [PMID: 27400997 DOI: 10.1007/s40618-016-0507-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/23/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE The evidence in support of the effect of vitamin D deficiency on cardiovascular diseases is inconsistent. The objective of this randomized, controlled, double-blind study was to assess the effect of high-dose vitamin D supplementation on cardiometabolic risk factors in subjects with metabolic syndrome. METHODS Eighty subjects were randomized to receive 50,000 IU vitamin D or matching placebo weekly for 16 weeks. Fasting blood sugar, homeostasis model assessment of insulin resistance, insulin sensitivity (Quicki), serum lipid profiles (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride (TG) and total cholesterol), anthropometric factors and blood pressure were assessed before and after intervention. Dietary intake and sun exposure were also determined. The trial was registered at http://www.irct.ir (code: IRCT201409033140N14). RESULTS Participants were 40.49 ± 5.04 years and 49 % male. All of the intervention group and 97 % of placebo group were vitamin D deficient or insufficient (25-hydroxyvitamin D <75 nmol/L). After intervention, serum 25(OH)D concentration was increased by 61.93 nmol/L in intervention group, while it was decreased in placebo group (p < 0.001). There was a significant change in TG concentration after 4 months (p < 0.001). Other metabolic or anthropometric factors did not change significantly (p = 0.05). CONCLUSION Supplementation with high-dose vitamin D for 4 months improved vitamin D status and decreased TG levels in subjects with metabolic syndrome. However, it did not have any beneficial effects on other cardiometabolic risk factors; this might be due to the inadequate vitamin D status attained in this study which was conducted in a severely deficient region.
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Affiliation(s)
- S Salekzamani
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - H Mehralizadeh
- Student Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Ghezel
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Y Salekzamani
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M A Jafarabadi
- Road Traffic Injury Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A S Bavil
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - B P Gargari
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Golgasht St., Attar Neyshapouri Av., 5166614, Tabriz, Iran.
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Grübler MR, Gaksch M, Kienreich K, Verheyen N, Schmid J, Ó Hartaigh B, Richtig G, Scharnagl H, Meinitzer A, Fahrleitner-Pammer A, März W, Tomaschitz A, Pilz S. Effects of vitamin D supplementation on glycated haemoglobin and fasting glucose levels in hypertensive patients: a randomized controlled trial. Diabetes Obes Metab 2016; 18:1006-12. [PMID: 27334070 DOI: 10.1111/dom.12709] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/08/2016] [Accepted: 06/12/2016] [Indexed: 12/26/2022]
Abstract
AIM To investigate the efficacy of vitamin D supplementation on glycaemic control. METHODS The Styrian Vitamin D Hypertension Trial was a single-centre, double-blind, placebo-controlled study conducted between 2011 and 2014 at the Medical University of Graz, Austria. We enrolled 200 people with arterial hypertension and 25-hydroxyvitamin D [25(OH)D] concentrations <30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D or placebo per day for 8 weeks. The present study was a post hoc analysis that incorporated an analysis of covariance (ancova) approach, while adjusting for baseline differences. RESULTS A total of 185 participants [mean ± standard deviation age, 60.1 ± 11.3 years; 47% women; mean 25(OH)D 21.2 ± 5.6 ng/mL, mean glycated haemoglobin (HbA1c) 44.8 ± 11.8 mmol/mol and mean body mass index 30.4 ± 5.4 kg/m(2) ] completed the trial. ancova showed a mean treatment effect [95% confidence interval (CI)] on HbA1c of -3.52 (-6.7 to -0.34) mmol/mol (p = .045). There was no difference in fasting glucose -4.7 mg/dL (95% CI -16.3 to 6.9; p = .426). CONCLUSIONS Vitamin D supplementation in obese hypertensive patients with low 25(OH)D reduces HbA1c levels. This finding warrants further investigation into potential vitamin D effects on glucose homeostasis.
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Affiliation(s)
- M R Grübler
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland.
| | - M Gaksch
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - K Kienreich
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - N Verheyen
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - J Schmid
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - B Ó Hartaigh
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York
| | - G Richtig
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - H Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - A Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - A Fahrleitner-Pammer
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - W März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinolgy, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - A Tomaschitz
- Department of Cardiology, Medical University of Graz, Graz, Austria
- Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria
| | - S Pilz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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The Potential Protective Action of Vitamin D in Hepatic Insulin Resistance and Pancreatic Islet Dysfunction in Type 2 Diabetes Mellitus. Nutrients 2016; 8:147. [PMID: 26959059 PMCID: PMC4808876 DOI: 10.3390/nu8030147] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency (i.e., hypovitaminosis D) is associated with increased insulin resistance, impaired insulin secretion, and poorly controlled glucose homeostasis, and thus is correlated with the risk of metabolic diseases, including type 2 diabetes mellitus (T2DM). The liver plays key roles in glucose and lipid metabolism, and its dysregulation leads to abnormalities in hepatic glucose output and triglyceride accumulation. Meanwhile, the pancreatic islets are constituted in large part by insulin-secreting β cells. Consequently, islet dysfunction, such as occurs in T2DM, produces hyperglycemia. In this review, we provide a critical appraisal of the modulatory actions of vitamin D in hepatic insulin sensitivity and islet insulin secretion, and we discuss the potential roles of a local vitamin D signaling in regulating hepatic and pancreatic islet functions. This information provides a scientific basis for establishing the benefits of the maintenance, or dietary manipulation, of adequate vitamin D status in the prevention and management of obesity-induced T2DM and non-alcoholic fatty liver disease.
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The Role of Vitamin D in Diabetes and Cardiovascular Disease: An Updated Review of the Literature. DISEASE MARKERS 2015; 2015:580474. [PMID: 26576069 PMCID: PMC4630385 DOI: 10.1155/2015/580474] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023]
Abstract
The dietary reference values for Vitamin D were set primarily considering its role in bone health, but with the discovery of Vitamin D receptors throughout body tissues, new links with other health conditions are now studied, such as for diabetes and cardiovascular diseases (CVD). This paper shall analyze and examine all new research studies carried out, especially in 2013–2015 regarding diabetes mellitus (DM) and cardiovascular diseases (CVD). Vast research has been carried out to establish strong relationship between Vitamin D serum levels, supplementation, diabetes, and CVD. However, the results from researches identified in this paper are disputable. Benefits of Vitamin D adequate levels were recognized from gestational period until later in disease development such as diabetes and/or CVD, but since not all studies are in agreement further investigation is suggested. Researches conducting large randomized controlled trials, exploring range of supplement doses, with variable baseline serum Vitamin D levels, and inclusion of array of associated parameters, are still required to conduct large-scale analysis and draw conclusion as a risk factor. Until then it is possible to conclude that maintenance of serum Vitamin D levels holds advantageous aspects in diabetic and cardiovascular conditions, and people should strive to attain them.
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Mohamad MI, El-Sherbeny EE, Bekhet MM. The Effect of Vitamin D Supplementation on Glycemic Control and Lipid Profile in Patients with Type 2 Diabetes Mellitus. J Am Coll Nutr 2015; 35:399-404. [PMID: 26391639 DOI: 10.1080/07315724.2015.1026427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM The aim of this study was to evaluate the effect of vitamin D supplementation in patients with type 2 diabetes mellitus (T2DM) with regard to their glycemic control and lipid profile. METHODS One hundred subjects with T2DM were recruited and given 4500 IU/day of vitamin D for 2 months. 25-Hydroxyvitamin D [25(OH)D], fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), and lipid profile were measured pre- and postsupplementation. RESULTS There was a significant increase in the mean value of 25(OH)D level after supplementation (baseline level 16 ± 5.3 ng/ml vs. after supplement level 49.2 ± 17.7 ng/ml, p < 0.05). Both FBG and HbA1c but not lipid profile were significantly decreased after supplementation. However, the univariate general linear model between 25(OH)D percentiles and lipid profile levels showed that diabetic subjects with high 25(OH)D levels (>61 ng/ml) had significantly lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) in comparison to those in the low or middle percentiles. Furthermore, participants in a higher percentile had a significantly higher level of high-density lipoprotein cholesterol (HDL-C) than those in the middle percentile. Lipid profile levels were not affected by the supplement except for triglycerides (TG) levels in females, which were significantly decreased. CONCLUSIONS Vitamin D supplementation may be beneficial to diabetic subjects because it improved glycemic control. Diabetic subjects with high 25(OH)D levels (>61 ng/ml) had better lipid profiles.
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Affiliation(s)
| | - Enas E El-Sherbeny
- c Faculty of Medicine, Ain Shams University, Cairo, EGYPT; Public Health & Community Medicine Department , Faculty of Medicine, Mansoura University, Mansoura, EGYPT
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Krul-Poel YHM, Westra S, ten Boekel E, ter Wee MM, van Schoor NM, van Wijland H, Stam F, Lips PTAM, Simsek S. Effect of Vitamin D Supplementation on Glycemic Control in Patients With Type 2 Diabetes (SUNNY Trial): A Randomized Placebo-Controlled Trial. Diabetes Care 2015; 38:1420-6. [PMID: 25972575 DOI: 10.2337/dc15-0323] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/22/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Low vitamin D status has been associated with impaired glycemic control in patients with type 2 diabetes. The purpose of our study was to evaluate the effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This randomized, double-blind, placebo-controlled trial was conducted in 275 adult patients with type 2 diabetes without insulin treatment. Patients were randomly assigned to receive either vitamin D3 (50,000 IU/month) or placebo for 6 months. To assess the primary outcome of the study, change in HbA(1c), we performed a linear regression analysis. RESULTS Mean baseline serum 25-hydroxyvitamin D [25(OH)D] increased from 60.6 ± 23.3 to 101.4 ± 27.6 nmol/L and 59.1 ± 23.2 to 59.8 ± 23.2 nmol/L in the vitamin D and placebo group, respectively. Mean baseline HbA(1c) was 6.8 ± 0.5% (51 ± 6 mmol/mol) in both groups. After 6 months, no effect was seen on HbA(1c) (mean difference: β = 0.4 [95% CI -0.6 to 1.5]; P = 0.42) and other indicators of glycemic control (HOMA of insulin resistance, fasting insulin, and glucose) in the entire study population. Subgroup analysis in patients with a serum 25(OH)D <50 nmol/L or an HbA(1c) level >7% (53 mmol/mol) did not differ the results. CONCLUSIONS In a well-controlled group of patients with type 2 diabetes, intermittent high-dose vitamin D supplementation did not improve glycemic control.
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Affiliation(s)
- Yvonne H M Krul-Poel
- Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands
| | - Sanne Westra
- Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands
| | - Edwin ten Boekel
- Department of Clinical Chemistry, Medical Center Alkmaar, Alkmaar, the Netherlands
| | - Marieke M ter Wee
- Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Hans van Wijland
- Department of General Practice, DIAZON, Alkmaar, the Netherlands
| | - Frank Stam
- Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands
| | - Paul T A M Lips
- Department of Internal Medicine/Endocrinology, VU University Medical Center, Amsterdam, the Netherlands
| | - Suat Simsek
- Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands Department of Internal Medicine/Endocrinology, VU University Medical Center, Amsterdam, the Netherlands
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Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, Alvarez JA, Boxer RS, Dalbeni A, Gepner AD, Isbel NM, Larsen T, Nagpal J, Petchey WG, Stricker H, Strobel F, Tangpricha V, Toxqui L, Vaquero MP, Wamberg L, Zittermann A, Witham MD. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data. JAMA Intern Med 2015; 175:745-54. [PMID: 25775274 PMCID: PMC5966296 DOI: 10.1001/jamainternmed.2015.0237] [Citation(s) in RCA: 208] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear. OBJECTIVE To systematically review whether supplementation with vitamin D or its analogues reduce BP. DATA SOURCES We searched MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.com augmented by a hand search of references from the included articles and previous reviews. Google was searched for gray literature (ie, material not published in recognized scientific journals). No language restrictions were applied. The search period spanned January 1, 1966, through March 31, 2014. STUDY SELECTION We included randomized placebo-controlled clinical trials that used vitamin D supplementation for a minimum of 4 weeks for any indication and reported BP data. Studies were included if they used active or inactive forms of vitamin D or vitamin D analogues. Cointerventions were permitted if identical in all treatment arms. DATA EXTRACTION AND SYNTHESIS We extracted data on baseline demographics, 25-hydroxyvitamin D levels, systolic and diastolic BP (SBP and DBP), and change in BP from baseline to the final follow-up. Individual patient data on age, sex, medication use, diabetes mellitus, baseline and follow-up BP, and 25-hydroxyvitamin D levels were requested from the authors of the included studies. For trial-level data, between-group differences in BP change were combined in a random-effects model. For individual patient data, between-group differences in BP at the final follow up, adjusted for baseline BP, were calculated before combining in a random-effects model. MAIN OUTCOMES AND MEASURES Difference in SBP and DBP measured in an office setting. RESULTS We included 46 trials (4541 participants) in the trial-level meta-analysis. Individual patient data were obtained for 27 trials (3092 participants). At the trial level, no effect of vitamin D supplementation was seen on SBP (effect size, 0.0 [95% CI, -0.8 to 0.8] mm Hg; P=.97; I2=21%) or DBP (effect size, -0.1 [95% CI, -0.6 to 0.5] mm Hg; P=.84; I2=20%). Similar results were found analyzing individual patient data for SBP (effect size, -0.5 [95% CI, -1.3 to 0.4] mm Hg; P=.27; I2=0%) and DBP (effect size, 0.2 [95% CI, -0.3 to 0.7] mm Hg; P=.38; I2=0%). Subgroup analysis did not reveal any baseline factor predictive of a better response to therapy. CONCLUSIONS AND RELEVANCE Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.
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Affiliation(s)
- Louise A Beveridge
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Allan D Struthers
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Faisel Khan
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Institute of Clinical Medicine, UiT (Universitetet i Tromsø), The Arctic University of Norway, Tromsø, Norway
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Helen M Macdonald
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland
| | - Jessica A Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Rebecca S Boxer
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora
| | - Andrea Dalbeni
- Department of Medicine, University of Verona, Verona, Italy
| | - Adam D Gepner
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | - Nicole M Isbel
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Thomas Larsen
- Department of Medical Research, Holstebro Hospital, Holstebro, Denmark
| | - Jitender Nagpal
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - William G Petchey
- Department of Nephrology, Cambridge University Hospitals NHS (National Health Service) Foundation Trust, Cambridge, England
| | - Hans Stricker
- Angiology Unit, Ospedale La Carità, Locarno, Switzerland
| | - Franziska Strobel
- Department of Internal Medicine, Asklepios-Paulinenklinik, Wiesbaden, Germany
| | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Laura Toxqui
- Department of Metabolism and Nutrition, Institute of Food Science, Technology, and Nutrition, Spanish National Research Council, Madrid, Spain
| | - M Pilar Vaquero
- Department of Metabolism and Nutrition, Institute of Food Science, Technology, and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Louise Wamberg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Armin Zittermann
- Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bochum, Germany
| | - Miles D Witham
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
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Sadiya A, Ahmed SM, Carlsson M, Tesfa Y, George M, Ali SH, Siddieg HH, Abusnana S. Vitamin D3 supplementation and body composition in persons with obesity and type 2 diabetes in the UAE: A randomized controlled double-blinded clinical trial. Clin Nutr 2015; 35:77-82. [PMID: 25892603 DOI: 10.1016/j.clnu.2015.02.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 02/23/2015] [Accepted: 02/26/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND & AIM The co-existence of vitamin D deficiency with obesity and type 2 diabetes is highly prevalent in the United Arab Emirates. We do not have studies evaluating the vitamin D dose response and sufficiency, and if sufficient substitution dose during a longer period could decrease obesity or change fat distribution in obese type 2 diabetic vitamin D deficient Emiratis. METHODS A randomized double-blind clinical trial was conducted for 6 months followed by another 6 months of un-blinded follow up with 87 obese, type 2 diabetic participants. Serum 25-hydroxy vitamin D (S-25(OH)D), anthropometric data, and life-style factors such as diet and sunlight exposure were measured. The study was executed in 3 phases in two arms vitamin D arm (n = 45) and placebo arm (n = 42); in Phase 1 the vitamin D arm received 6000 IU vitamin D3/day (3 months) followed by Phase 2 with 3000 IU vitamin D3/day. During follow up (phase 3) both the arms were un-blinded and supplemented with 2200 IU vitamin D3/day for another 6 months. RESULTS At the baseline a significant (p < 0.01) positive association between body fat mass and body weight (r = 0.97) muscle mass (r = 0.47), water mass (r = 0.54), waist circumference (r = 0.82) and serum PTH (r = 0.28) was observed. On supplementation no significant changes in anthropometric dimensions was observed. S-25(OH) D peaked in phase 1 (77.2 ± 30.1 vs 28.5 ± 9.2, p = 0.003) followed by a decrease in phase 2 (62.3 ± 20.8, p = 0.006) paralleled by a decrease in parathyroid hormone in phase 2 (5.9 ± 2.4 vs 4.5 ± 1.8, p < 0.01) compared to baseline in vitamin D group. CONCLUSION This study shows no significant influence of vitamin D supplementation on weight, fat mass or waist circumference in type 2 diabetic obese vitamin D deficient participants of Arab ethnicity after one year. Despite a relatively high daily dose of vitamin D3 we did not achieve target levels of S-25(OH)D above 75 nmol/L in this population. However, supplementation was safe, improved s- 25 (OH)D also reducing the incidence of eucalcemic parathyroid hormone elevation. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT02101151.
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Affiliation(s)
- Amena Sadiya
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates.
| | - Solafa M Ahmed
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | | | - Yohannes Tesfa
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Mary George
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Samia H Ali
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Hisham H Siddieg
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Salah Abusnana
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
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Sheth JJ, Shah A, Sheth FJ, Trivedi S, Lele M, Shah N, Thakor P, Vaidya R. Does vitamin D play a significant role in type 2 diabetes? BMC Endocr Disord 2015; 15:5. [PMID: 25887335 PMCID: PMC4357062 DOI: 10.1186/s12902-015-0003-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/18/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vitamin D deficiency reportedly is associated with type 2 diabetes (T2DM). We aim to examine whether 25-hydroxyvitamin D (25OHD) has clinically significant influence on hemoglobin glycation (HbA1c) and insulin resistance (HOMA-IR) in T2DM subjects. METHODS Present study was carried out in 912 subjects (429 T2DM cases and 483 non-diabetic controls) from Western India. The enrolled study subjects were investigated for biochemical parameters like FBS, PPBS, HbA1c, FI, HOMA-IR and 25OHD levels in blood. RESULTS Vitamin D deficiency was seen in 91.4% and 93.0% of T2DM cases and control subjects respectively. There was no association of serum 25OHD deficiency on HbA1c or HOMA-IR in T2DM cases (p = 0.057 & p = 0.257 respectively) and in control subjects (p = 0.675 & p = 0.647 respectively). CONCLUSION Our findings suggests that though vitamin D deficiency is prevalent in T2DM and non-diabetic subjects, its role in hemoglobin glycation and insulin resistance could not be established.
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Affiliation(s)
- Jayesh J Sheth
- Department of Biochemistry and Molecular Genetics, FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, 380015, India.
| | - Ankna Shah
- Department of Biochemistry and Molecular Genetics, FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, 380015, India.
| | - Frenny J Sheth
- Department of Biochemistry and Molecular Genetics, FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, 380015, India.
| | - Sunil Trivedi
- Department of Biochemistry and Molecular Genetics, FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, 380015, India.
| | - Mamta Lele
- Unit of Endocrine and Metabolic Disorders, Kasturba Health Society, Medical Research Centre, Mumbai, 400056, India.
| | - Navneet Shah
- Department of Diabetes and Endocrinology, Sterling Hospital, Ahmedabad, 380052, India.
| | - Premal Thakor
- Gujarat Diabetic Association, Ahmedabad, 380007, India.
| | - Rama Vaidya
- Unit of Endocrine and Metabolic Disorders, Kasturba Health Society, Medical Research Centre, Mumbai, 400056, India.
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Nigil Haroon N, Anton A, John J, Mittal M. Effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes: a systematic review of interventional studies. J Diabetes Metab Disord 2015; 14:3. [PMID: 25722966 PMCID: PMC4340830 DOI: 10.1186/s40200-015-0130-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/25/2015] [Indexed: 01/23/2023]
Abstract
Background Diabetes and vitamin D deficiency are global epidemics. Researchers have long been exploring the role of potentially modifiable factors to manage type 2 diabetes. We conducted a systematic review of prospective studies and randomized controlled trials that involved vitamin D supplementation and specifically intended to study glycemic outcomes related to type 2 diabetes. Methods Two authors independently searched Medline and PubMed for longitudinal studies that had assessed the effect of vitamin D supplements on glycemic control, insulin resistance and beta-cell dysfunction in patients with diabetes. Results Seventeen randomized control trials and seven longitudinal studies with a minimum follow-up of one month were included. Results of the various short-term studies (follow up ≤ 3 months) suggested that vitamin D supplementation had a positive impact on glycemic control and metabolic parameters such as insulin resistance and beta cell dysfunction. However, the evidence was weak due to the low methodological quality of the studies. There was no significant effect on HbA1c, beta cell function and insulin resistance in the long-term studies (follow up > 3 months). There existed heterogeneity in the methodology of the studies, inclusion criteria, mode of supplementation of vitamin D and the duration of follow up. Conclusions Current evidence based on randomized controlled trials and longitudinal studies do not support the notion that vitamin D supplementation can improve hyperglycemia, beta cell secretion or insulin sensitivity in patients with type 2 diabetes. Large-scale trials with proper study design, optimal vitamin D supplementation and longer follow up need to be conducted.
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Affiliation(s)
- Nisha Nigil Haroon
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Ammepa Anton
- Toronto Western Hospital, University Health Network, Toronto, ON Canada
| | - Jisha John
- Department of Medicine, Wayne State University, Detroit, MI USA
| | - Madhukar Mittal
- Endocrinology Unit, Department of Medicine, King George Medical University, Lucknow, India
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Ozder A. Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: a cross-sectional study. Lipids Health Dis 2014; 13:183. [PMID: 25481115 PMCID: PMC4271485 DOI: 10.1186/1476-511x-13-183] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/29/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. We aimed to research association between serum lipid profile and blood glucose, hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorder and cerebrovascular accident in patients with type 2 diabetes mellitus. METHODS Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and glycated haemoglobin (HbA1c) levels were evaluated. A hepatic ultrasound was performed for every diabetic to evaluate hepatosteatosis. The study was done from January 2014 to June 2014 among 132 patients with T2DM who were admitted to outpatient clinic of Family Medicine department in a university hospital. The patients whose taking multi-vitamin supplementation or having hepatic, renal or metabolic bone disorders (including parathyroid related problems) were excluded from the study for the reason that those conditions might affect the carbohydrate and lipid metabolism in diabetes. Test of significance was calculated by unpaired student's t test between cases and controls. Correlation studies (Pearson's correlation) were performed between the variables of blood glucose and serum lipid profile. Significance was set at p<0.05. RESULTS Results of serum lipid profile showed that the mean values for TC, TG, HDL and LDL in female patients were 227.6 ± 57.7 mg/dl, 221.6 ± 101.1 mg/dl, 31.5 ± 6.7 mg/dl and 136.5 ± 43.7 mg/dl, respectively. The mean values for TC, TG, HDL and LDL in male patients were 219.1 ± 34.7 mg/dl, 250.0 ± 100.7 mg/dl, 30.2 ± 7.4 mg/dl and 125.7 ± 21.4 mg/dl, respectively. Significantly higher mean serum levels of TC, TG and LDL and significantly lower mean serum levels of HDL were noted in patients with diabetes (p<0.001). FBG showed significant positive correlation with TC (p<0.05) and TG (p<0.05). Significant correlations were observed between serum levels of TC, TG, LDL and hepatosteatosis and HbA1c (p<0.05). CONCLUSIONS The study showed widespread lipid abnormalities in the course of diabetes triggered dyslipidemia as hypercholesterolemia, hypertriglyceridemia, elevated LDL and decreased HDL. This study proposes the predominance of hyperlipidemia over increased prevalence of diabetic dyslipidemia.
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Affiliation(s)
- Aclan Ozder
- Medical Faculty, Department of Family Medicine, Bezmialem Vakif University, Adnan Menderes Boulevard, 34093 Fatih, Istanbul, Turkey.
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Seida JC, Mitri J, Colmers IN, Majumdar SR, Davidson MB, Edwards AL, Hanley DA, Pittas AG, Tjosvold L, Johnson JA. Clinical review: Effect of vitamin D3 supplementation on improving glucose homeostasis and preventing diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab 2014; 99:3551-60. [PMID: 25062463 PMCID: PMC4483466 DOI: 10.1210/jc.2014-2136] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONTEXT Observational studies report consistent associations between low vitamin D concentration and increased glycemia and risk of type 2 diabetes, but results of randomized controlled trials (RCTs) are mixed. OBJECTIVE The objective of the study was to systematically review RCTs that report on the effects of vitamin D supplementation on glucose homeostasis or diabetes prevention. DATA SOURCES Sources of data for the study were MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment, and Science Citation Index from inception to June 2013. STUDY SELECTION Study selection was trials that compared vitamin D3 supplementation with placebo or a non-vitamin D supplement in adults with normal glucose tolerance, prediabetes, or type 2 diabetes. DATA EXTRACTION AND SYNTHESIS Two reviewers collected data and assessed trial quality using the Cochrane Risk of Bias tool. Random-effects models were used to estimate mean differences (MDs) and odds ratios. The main outcomes of interest were homeostasis model assessment of insulin resistance, homeostasis model assessment of β-cell function, hemoglobin A1c levels, fasting blood glucose, incident diabetes, and adverse events. DATA SYNTHESIS Thirty-five trials (43 407 patients) with variable risk of bias were included. Vitamin D had no significant effects on insulin resistance [homeostasis model assessment of insulin resistance: MD -0.04; 95% confidence interval (CI) -0.30 to 0.22, I-squared statistic (I(2)) = 45%], insulin secretion (homeostasis model of β-cell function: MD 1.64; 95% CI -25.94 to 29.22, I(2) = 40%), or hemoglobin A1c (MD -0.05%; 95% CI -0.12 to 0.03, I(2) = 55%) compared with controls. Four RCTs reported on the progression to new diabetes and found no effect of vitamin D (odds ratio 1.02; 95% CI 0.94 to 1.10, I(2) = 0%). Adverse events were rare, and there was no evidence of publication bias. CONCLUSIONS Evidence from available trials shows no effect of vitamin D3 supplementation on glucose homeostasis or diabetes prevention. Definitive conclusions may be limited in the context of the moderate degree of heterogeneity, variable risk of bias, and short-term follow-up duration of the available evidence to date.
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Affiliation(s)
- Jennifer C Seida
- Alliance for Canadian Health Outcomes Research in Diabetes (J.C.S., I.N.C., S.R.M., L.T., J.A.J.) and Division of General Internal Medicine (S.R.M.), Department of Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2E1; Division of Endocrinology, Diabetes & Metabolism, Tufts Medical Center (J.M., A.G.P.), Boston, Massachusetts 02111; Department of Medicine, Charles R. Drew University (M.B.D.), Los Angeles, California 90059; and Division of Endocrinology and Metabolism, University of Calgary (A.L.E., D.A.H.), Calgary, Canada T2N 1N4
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Baziar N, Jafarian K, Shadman Z, Qorbani M, Khoshniat Nikoo M, Abd Mishani M. Effect of therapeutic dose of vitamin d on serum adiponectin and glycemia in vitamin d-insufficient or deficient type 2 diabetic patients. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e21458. [PMID: 25593737 PMCID: PMC4270651 DOI: 10.5812/ircmj.21458] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/16/2014] [Accepted: 08/30/2014] [Indexed: 12/17/2022]
Abstract
Background: Lower vitamin D status has been reported in diabetic patients. Serum 25-hydroxyvitamin D and adiponectin were inversely associated with type 2 diabetes and insulin resistance. Vitamin D may involve in regulation of the adiponectin levels, which is directly related to insulin sensitivity. Objectives: The aim of this study was to investigate the effect of therapeutic dose of vitamin D on serum adiponectin and insulin resistance in vitamin D-insufficient or deficient type 2 diabetic patients. Materials and Methods: This double-blind, randomized, clinical trial was conducted on 81 type 2 diabetic patients with vitamin D level of 10-30 ng/mL. Intervention was 50000 IU vitamin D or placebo once a week for 8 weeks. At the beginning and end of the study, blood samples were collected after 12 hours of fasting and serum glucose, insulin, 25-hydroxyvitamin D, and adiponectin were measured. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). Results: After 8-week intervention, serum 25-hydroxyvitamin D significantly increased and reached the normal levels in patients receiving vitamin D (P < 0.001) and the levels of fasting serum glucose, insulin, and HOMA-IR were significantly decreased (P = 0.04, 0.02 and 0.007, respectively). No significant changes were observed in these levels in the placebo group. Significant differences were observed in mean changes in the above-mentioned variables between the two groups (P = 0.01, 0.04 and 0.006, respectively). No significant changes were found in serum adiponectin in the vitamin D and placebo groups (P = 0.83). Conclusions: Therapeutic dose of vitamin D can improve vitamin D status and glycemic indicators. But it seems that an 8-week intervention period was not sufficient to reveal the possible effects of vitamin D on serum adiponectin levels.
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Affiliation(s)
- Nima Baziar
- Department of Clinical Nutrition and Dietetics Therapy, Faculty of Nutrition Sciences and Food Technology, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Kurosh Jafarian
- Department of Clinical Nutrition and Dietetics Therapy, Faculty of Nutrition Sciences and Food Technology, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Zhaleh Shadman
- Research Center of Endocrinology and Metabolism, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mostafa Qorbani
- Department of Community Medicine, Alborz University of Medical Sciences, Karaj, IR Iran
- Non Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Khoshniat Nikoo
- Research Center of Endocrinology and Metabolism, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mohsen Khoshniat Nikoo, Research Center of Endocrinology and Metabolism, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188220094; Ext: 5; Fax: +98-2188220052, E-mail:
| | - Mahshid Abd Mishani
- Research Center of Endocrinology and Metabolism, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
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Krul-Poel YHM, Wijland HV, Stam F, ten Boekel E, Lips P, Simsek S. Study protocol: a randomised placebo-controlled clinical trial to study the effect of vitamin D supplementation on glycaemic control in type 2 Diabetes Mellitus SUNNY trial. BMC Endocr Disord 2014; 14:59. [PMID: 25033925 PMCID: PMC4107614 DOI: 10.1186/1472-6823-14-59] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 07/14/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Besides the classical role of vitamin D on calcium and bone homeostasis, vitamin D deficiency has recently been identified as a contributing factor in the onset of insulin resistance in type 2 diabetes mellitus. However, it is uncertain whether vitamin D deficiency and poor glycaemic control are causally interrelated or that they constitute two independent features of type 2 diabetes mellitus. There are limited clinical trials carried out which measured the effect of vitamin D supplementation on glycaemic control.The objective of this study is to investigate the effect of vitamin D supplementation on glycaemic control and quality of life in patients with type 2 diabetes mellitus. METHODS/DESIGN In a randomised double-blind placebo-controlled trial conducted in five general practices in the Netherlands three hundred patients with type 2 diabetes mellitus treated with lifestyle advises or metformin or sulphonylurea-derivatives are randomised to receive either placebo or 50,000 IU Vitamin D3 at monthly intervals. The primary outcome measure is the change in glycated haemoglobin level between baseline and six months. Secondary outcome measures include blood pressure, anthropometric parameters, lipid profile, insulin resistance, quality of life, advanced glycation end products and safety profiles. Quality of life will be measured by The Short Form (SF-36) Health Survey questionnaire. Advanced glycation end products are measured by an AGE-reader. DISCUSSION This trial will be the first study exploring the effect of vitamin D supplementation on both glycaemic control and quality of life in patients with type 2 diabetes mellitus. Our findings will contribute to the knowledge of the relationship between vitamin D status and insulin resistance in patients with type 2 diabetes mellitus. TRIAL REGISTRATION The Netherlands trial register: NTR3154.
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Affiliation(s)
- Yvonne HM Krul-Poel
- From the Department of Internal Medicine, Medical Centre Alkmaar, PO Box 7057, 1815 JD, Wilhelminalaan 12, Alkmaar, The Netherlands
| | | | - Frank Stam
- From the Department of Internal Medicine, Medical Centre Alkmaar, PO Box 7057, 1815 JD, Wilhelminalaan 12, Alkmaar, The Netherlands
| | - Edwin ten Boekel
- Department of Clinical Chemistry, Haematology & Immunology, Medical Centre Alkmaar, Alkmaar, The Netherlands
| | - Paul Lips
- Department of Internal Medicine/Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Suat Simsek
- From the Department of Internal Medicine, Medical Centre Alkmaar, PO Box 7057, 1815 JD, Wilhelminalaan 12, Alkmaar, The Netherlands
- Department of Internal Medicine/Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands
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Nasri H, Rafieian-Kopaei M. Effect of vitamin D on insulin resistance and nephropathy in type 2 diabetes. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:581-2. [PMID: 25197306 PMCID: PMC4155719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hamid Nasri
- Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Rafieian-Kopaei
- Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,Address for correspondence: Prof. Mahmoud Rafieian-Kopaei, Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran. E-mail:
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Abstract
There has been increasing evidence that vitamin D may have a role in modifying risk of diabetes. Vitamin D has both direct and indirect effects on various mechanisms related to the pathophysiology of type 2 diabetes, including pancreatic beta cell dysfunction, impaired insulin action and systemic inflammation. This article describes the biologic plausibility behind the potential association between vitamin D and type 2 diabetes and summarizes the current evidence from human studies that suggests but does not prove a relation between vitamin D and type 2 diabetes, and briefly reports on the potential association between vitamin D and type 1 diabetes.
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Affiliation(s)
- Joanna Mitri
- Division of Endocrinology, Diabetes and Metabolism, Prima CARE Medical Center, 277 Pleasant Street, Fall River, MA 02721, USA.
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA
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Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Ther Adv Endocrinol Metab 2013; 4:122-8. [PMID: 23997931 PMCID: PMC3755528 DOI: 10.1177/2042018813501189] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The extraskeletal effects of vitamin D have attracted considerable interest. Vitamin D deficiency appears to be related to the development of diabetes mellitus type 2 and the metabolic syndrome. Vitamin D may affect glucose homeostasis, vitamin D levels having been found to be inversely related to glycosylated hemoglobin levels in gestational diabetes mellitus. In addition, vitamin D appears to protect from the development of gestational diabetes mellitus. The aim was to study levels of 25-hydroxy vitamin D3 [25(OH)D3] and the relationship between 25(OH)D3 levels and glycemic control in patients with diabetes mellitus type 2. METHODS Glycosylated hemoglobin (HbA1c) and 25(OH)D3 levels were measured in a group of 120 diabetes mellitus type 2 patients. The same measurements were performed in a group of 120 control subjects of the same age and sex. 25(OH)D3 was measured by radioimmunoassay and glycosylated hemoglobin (HbA1c) was measured by high-performance liquid chromatography. RESULTS 25(OH)D3 levels were lower in the diabetes mellitus type 2 patients than in the control group, being 19.26 ± 0.95 ng/ml and 25.49 ± 1.02 ng/ml, in the patient and control groups, respectively (p < 0.001, Student's t-test). 25(OH)D3 levels were found to be inversely associated with HbA1c levels in the diabetic patients (p = 0.008, r (2) = 0.058, linear regression). 25(OH)D3 levels were found to be inversely associated with HbA1c when the patient and control groups were analysed together (p < 0.001, r (2) = 0.086). CONCLUSIONS Vitamin D levels appeared to be lower in diabetes mellitus type 2 patients than in the control group, vitamin D levels being related to glycemic control in diabetes mellitus type 2. These findings may have therapeutic implications as cautious vitamin D supplementation may improve glycemic control in diabetes mellitus type 2.
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Nasri RH. Renoprotective effects of metformin. ACTA ACUST UNITED AC 2013; 21:36. [PMID: 23679951 PMCID: PMC3658943 DOI: 10.1186/2008-2231-21-36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 05/11/2013] [Indexed: 12/17/2022]
Abstract
Metformin as a biguanid drug entered to the market 50 years ago and now is generally recommended as the first-line treatment in type 2 diabetes, especially in overweight patients, however in recent years new indications for its use have emerged . It improves peripheral and liver sensitivity to insulin, reduces basal hepatic glucose production, increases insulin-stimulated uptake and utilization of glucose by peripheral tissues, decreases hunger and causes weight reduction.Recently, much attention has been made toward the possible kidney protective efficacy of metformin. Recent studies have proven that metformin, possesses antioxidant properties, too.
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Affiliation(s)
- Running Hamid Nasri
- Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran.
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Baradaran A. Commentary on: effect of vitamin D on insulin resistance and anthropometric parameters in type 2 diabetes; a randomized double-blind clinical trial. ACTA ACUST UNITED AC 2013; 21:19. [PMID: 23497703 PMCID: PMC3599674 DOI: 10.1186/2008-2231-21-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 03/03/2013] [Indexed: 12/04/2022]
Affiliation(s)
- Azar Baradaran
- Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran.
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