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Obert P, Nottin S, Philouze C, Aboukhoudir F. Major impact of vitamin D 3 deficiency and supplementation on left ventricular torsional mechanics during dobutamine stress in uncomplicated type 2 diabetes. Nutr Metab Cardiovasc Dis 2023; 33:2269-2279. [PMID: 37543521 DOI: 10.1016/j.numecd.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AND AIMS Hypovitaminosis D is associated with the risk of diabetic complications. Its role in diabetic-related cardiac abnormalities remain poorly understood. We aimed therefore to evaluate the effect of vitamin D deficiency and supplementation on early left ventricular (LV) dysfunction in vitamin D deficient patients with uncomplicated T2D. METHODS AND RESULTS Sixty-three consecutive T2D patients who had a diagnosis of vitamin D3 were prospectively recruited and allocated into 2 groups (25(OH)D < 20 ng/mL: VDD, >20 ng/mL VDND). Twenty-eight of them with 25(OH)D < 20 ng/mL benefited from a 3-month supplementation. At baseline and follow-up, after conventional echocardiography including evaluation of epicardial adipose tissue (EAT), both LV longitudinal (LS) and circumferential (CS) strains and rotation/twist mechanics were evaluated at rest and during dobutamine (DOB) stress. After treatment, T2D patients successfully normalized their 25(OH)D levels. The strongest associations between vitamin D deficiency and supplementation with LV myocardial function were noticed for torsional mechanics indexes under DOB. EAT correlated significantly (p < 0.01) with baseline 25(OH)D and was reduced after supplementation. Significant correlations were obtained between these 2 parameters with twist or apical rotation at baseline (p < 0.01) and between their delta changes at follow-up (p < 0.01) under DOB. Significant improvements in LS and CS (p < 0.05) under DOB were also underlined at follow-up, with major enhancements noticed in the apical region (p < 0.01) of the LV. CONCLUSIONS This study provides the first evidences of the potential of vitamin D supplementation as an efficient prophylactic strategy to alleviate the progression of myocardial dysfunction in asymptomatic patients with uncomplicated T2D. CLINICALTRIALS NCT03437421.
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Affiliation(s)
- Philippe Obert
- UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France.
| | - Stéphane Nottin
- UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France
| | - Clothilde Philouze
- UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France
| | - Falah Aboukhoudir
- UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France; Cardiology department, Duffaut Hospital Center, Avignon, France.
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Zhao G, Yu X, Wang L, Jin Y, Yang A, Sun F, Wang X, Jing X, Gao B. Serum 25-hydroxyvitamin D level is associated with short-term glycemic variability metrics derived from continuous glucose monitoring in T2DM. Sci Rep 2023; 13:18463. [PMID: 37891255 PMCID: PMC10611772 DOI: 10.1038/s41598-023-45846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to investigate the association between 25-hydroxyvitamin D (25OHD) and continuous glucose monitoring-assessed short-term glycemic variability (GV) and HbA1c among patients with type 2 diabetes mellitus (T2DM). We conducted a cross-sectional study recruiting 325 patients. The association between 25OHD and GV metrics (mean amplitude of glycemic excursions [MAGE], coefficient of variation [CV], standard deviation of sensor glucose [SD], and TIR) and HbA1c were analyzed using multivariable linear and logistic regression analyses. The 25OHD level and GV metrics showed significant differences among HbA1c groups (P < 0.01). CV, MAGE, SD and HbA1c decreased, and TIR increased with ascending 25OHD tertiles (P < 0.05). Serum 25OHD was inversely associated with CV (β = - 0.211 [- 0.350 to - 0.071], P < 0.01) and HbA1c (β = - 0.061 [- 0.114 to - 0.031], P < 0.01), and further multivariable analyses confirmed these results (P < 0.05). However, no association of HbA1c and 25OHD was found with the highest tertile of CV. These findings revealed that increased GV and HbA1c were both associated with lower 25OHD, and the relationship between HbA1c and 25OHD was attenuated with higher glucose CV in T2DM. Taken together, the analyses suggest that increasing vitamin D status has effects on improvements in long-term glycemic control and low glycemic variability.
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Affiliation(s)
- Guohong Zhao
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Xinwen Yu
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Lin Wang
- College of Medicine, Xi'an International University, Xi'an, 710077, Shaanxi Province, People's Republic of China
- Engineering Research Center of Personalized Anti-Aging Health Product Development and Transformation, Universities of Shaanxi Province, Xi'an, 710077, Shaanxi Province, People's Republic of China
| | - Yuxin Jin
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Aili Yang
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Fei Sun
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Xin Wang
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Xiaorui Jing
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, Shaanxi Province, People's Republic of China.
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Lei F, Ni J, Hu JL, Guo DN, Fan J. Different doses of vitamin D supplementation to nonsurgical treatment for vitamin-D-insufficient patients with diabetic periodontitis and the effect on gingival BMP-2 levels. Kaohsiung J Med Sci 2023; 39:1030-1037. [PMID: 37395326 DOI: 10.1002/kjm2.12726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/03/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Abstract
Epidemiological data show people with diabetes mellitus (DM) have three-fold increase in risk of periodontitis. A vitamin D insufficiency can affect the progression of DM and periodontitis. This study evaluated the effects of different-dose vitamin D supplementation to nonsurgical periodontal therapy for vitamin-D-insufficient diabetic patients coexisting with periodontitis and changes of gingival bone morphogenetic protein-2 (BMP-2) levels. The study included 30 vitamin-D-insufficient patients receiving nonsurgical treatment followed by administration of 25,000 international units (IU) vitamin D3 per week (the low-VD group) and 30 patients receiving 50,000 UI vitamin D per week (the high-VD group). The decreases of probing pocket depth, clinical attachment loss, bleeding index, and periodontal plaque index values of patients after the six-month supplementation of 50,000 UI vitamin D3 per week to nonsurgical treatment were more significant than those after the six-month supplementation of 25,000 UI vitamin D3 per week to nonsurgical treatment. It was found that 50,000 IU per week vitamin D supplementation for 6 months could lead to a better glycemic control for vitamin-D-insufficient diabetic patients coexisting with periodontitis after nonsurgical periodontal therapy. Increased levels of serum 25(OH) vitamin D3 and gingival BMP-2 were found in both low- and high-dose VD groups, and the high-dose VD group exhibited higher levels than the low-dose VD group. Vitamin D supplementation in large doses for 6 months tended to improve the treatment of periodontitis and increase gingival BMP-2 levels in diabetic patients coexisting with periodontitis who were vitamin D deficient.
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Affiliation(s)
- Fei Lei
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jing Ni
- Clinical Medicine, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jin-Long Hu
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Dan-Ni Guo
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jing Fan
- Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
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Lei X, Zhou Q, Wang Y, Fu S, Li Z, Chen Q. Serum and supplemental vitamin D levels and insulin resistance in T2DM populations: a meta-analysis and systematic review. Sci Rep 2023; 13:12343. [PMID: 37524765 PMCID: PMC10390579 DOI: 10.1038/s41598-023-39469-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023] Open
Abstract
Observational studies have shown a negative correlation between Vitamin D level and the likelihood of developing insulin resistance (IR) and/or diabetes over time, yet evidence remains inconsistent. In this meta-analysis and systematic review, we strive to define the potential association between serum or supplemental Vitamin D Levels and insulin resistance respectively, as well as the contribution of Vitamin D to type 2 diabetes, and to summarize the biologic plausibility of Vitamin D. Four databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched for this Systematic Literature Review (SLR) to find appropriate observational studies and clinical trials published in English through to July 2022. EndNote (version X9) is used to manage the literature search results. We calculated Standard Mean Differences (SMDs) and Risk Ratios (RRs) with their 95% Confidence Intervals (CIs), separately, for continuous and dichotomous outcomes. The correlation coefficients were normalized to z values through Fisher's z-transformation to calculate the relevant statistics. Meta-analyses were carried out for all comparisons, based on a random-effects pooling model. Data analysis was performed using RevMan (version 5.3) and STATA (version 15.1). All statistical tests were two-sided, with P < 0.05 were regarded as significant. In our current meta-analysis, there are 18 RCTs and 20 observational studies including 1243 and 11,063 participants respectively. In the overall analysis, the diabetic with Vitamin D supplement treatment group showed significantly improve serum insulin (SMD = - 0.265, 95% CI - 0.394 to - 0.136, P < 0.05), glucose (SMD = - 0.17, 95% CI - 0.301to - 0.039, P < 0.05) and HOMA-IR (SMD = - 0.441, 95% CI - 0.582 to - 0.3, P < 0.05) compared with the routine treatment group. Correlation analysis results showed that all three outcomes were significantly correlated in a negative manner with raised Vitamin D (insulin: r = - 0.08 95% = - 0.12 to - 0.04; glucose: r = - 0.06 95% = - 0.11 to - 0.01; HOMA-IR: r = - 0.08 95% = - 0.09 to - 0.06). Results of overall analysis proved that vitamin D has shown significant effect on regulates insulin resistance, and there is a significant inverse association between serum Vitamin D level and IR. Vitamin D supplementation is expected to be integrated into conventional medical approaches to prevent type 2 diabetes and to mitigate the burden of diabetes for individuals and society.PROSPERO registration number: CRD42022348295.
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Affiliation(s)
- Xingxing Lei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Qian Zhou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yanmei Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Shunlian Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Zinan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Province, No. 39, Shi-er-Qiao Road, Chengdu, 610072, People's Republic of China.
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Musazadeh V, Kavyani Z, Mirhosseini N, Dehghan P, Vajdi M. Effect of vitamin D supplementation on type 2 diabetes biomarkers: an umbrella of interventional meta-analyses. Diabetol Metab Syndr 2023; 15:76. [PMID: 37072813 PMCID: PMC10114333 DOI: 10.1186/s13098-023-01010-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 02/26/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Vitamin D supplementation exerts several supporting effects on improving glycemic status, however, results are inconclusive. Thus, in the present study, we aimed to conduct an umbrella of meta-analysis regarding the impact of vitamin D on type 2 diabetes (T2DM) biomarkers. METHODS The Scopus, PubMed, Web of Science, Embase, and Google Scholar online databases were searched up to March 2022. All meta-analyses evaluating the impact of vitamin D supplementation on T2DM biomarkers were considered eligible. Overall, 37 meta-analyses were included in this umbrella meta-analysis. RESULTS Our findings indicated that vitamin D supplementation significantly decreased fasting blood sugar (FBS) (WMD = - 3.08; 95% CI: - 3.97, - 2.19, p < 0.001, and SMD = - 0.26; 95% CI: - 0.38, - 0.14, p < 0.001), hemoglobin A1c (HbA1c) (WMD = - 0.05; 95% CI: - 0.10, - 0.01, p = 0.016, and SMD = - 0.16; 95% CI: - 0.27, - 0.05, p = 0.004), insulin concentrations (WMD = - 2.62; 95% CI: - 4.11, - 1.13; p < 0.001, and SMD = - 0.33; 95% CI: - 0.56, - 0.11, p = 0.004), and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = - 0.67; 95% CI: - 1.01, - 0.32, p < 0.001, and SMD = - 0.31; 95% CI: - 0.46, - 0.16, p < 0.001). CONCLUSION This umbrella meta-analysis proposed that vitamin D supplementation may improve T2DM biomarkers.
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Affiliation(s)
- Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeynab Kavyani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parvin Dehghan
- Associate of Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Dall RD, Cheung MM, Shewokis PA, Altasan A, Volpe SL, Amori R, Singh H, Sukumar D. Combined vitamin D and magnesium supplementation does not influence markers of bone turnover or glycemic control: A randomized controlled clinical trial. Nutr Res 2023; 110:33-43. [PMID: 36640582 DOI: 10.1016/j.nutres.2022.12.005] [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: 05/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
High-dose vitamin D supplementation can increase total osteocalcin concentrations that may reduce insulin resistance in individuals at risk for prediabetes or diabetes mellitus. Magnesium is a cofactor in vitamin D metabolism and activation. The purpose of this study was to determine the combined effect of vitamin D and magnesium supplementation on total osteocalcin concentrations, glycemic indices, and other bone turnover markers after a 12-week intervention in individuals who were overweight and obese, but otherwise healthy. We hypothesized that combined supplementation would improve serum total osteocalcin concentrations and glycemic indices more than vitamin D supplementation alone or a placebo. A total of 78 women and men completed this intervention in 3 groups: a vitamin D and magnesium group (1000 IU vitamin D3 and 360 mg magnesium glycinate), a vitamin D group (1000 IU vitamin D3), and a placebo group. Despite a significant increase in serum 25-hydroxyvitamin D concentrations in the vitamin D and magnesium group compared with the placebo group (difference = 5.63; CI, -10.0 to -1.21; P = .001) post-intervention, there were no differences in serum concentrations of total osteocalcin, glucose, insulin, and adiponectin or the homeostatic model assessment of insulin resistance (HOMA-IR) among groups (P > .05 for all). Additionally, total osteocalcin (β = -0.310, P = .081), bone-specific alkaline phosphatase (β = 0.004, P = .986), and C-terminal cross-linked telopeptide (β = 0.426, P = .057), were not significant predictors of HOMA-IR after the intervention. Combined supplementation was not associated with short-term improvements in glycemic indices or bone turnover markers in participants who were overweight and obese in our study. This trial was registered at clinicaltrials.gov (NCT03134417).
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Affiliation(s)
- Rosemary D Dall
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA
| | - May M Cheung
- City University of New York - Brooklyn College, Brooklyn, New York, USA
| | | | - Asma Altasan
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA
| | - Stella L Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Renee Amori
- St. Luke's University Health Network, Bethlehem, PA, USA
| | | | - Deeptha Sukumar
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA.
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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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Huang H, Lu L, Chen Y, Zeng Y, Xu C. The efficacy of vitamin D supplementation for irritable bowel syndrome: a systematic review with meta-analysis. Nutr J 2022; 21:24. [PMID: 35509010 PMCID: PMC9069731 DOI: 10.1186/s12937-022-00777-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS. METHODS We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention. RESULTS We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I2 = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I2 = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I2 = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I2 = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I2 = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I2 = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS. CONCLUSIONS This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment.
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Affiliation(s)
- Hangkai Huang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Linjie Lu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China.,Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, 314499, Haining, China
| | - Yishu Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Yan Zeng
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China
| | - Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China. .,Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, 314499, Haining, China.
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Abdou M, Hassan MM, ElAtti SA, Aiad DN, Ibrahim A. Effect of Vitamin D Supplementation on Insulin Resistance Status in Pubertal Girls with Congenital Adrenal Hyperplasia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Congenital adrenal hyperplasia (CAH) patients especially females are at increased risk for developing obesity and resistance to insulin (IR). Rising evidence indicate that insufficient vitamin D levels are associated with impaired function of β-cells of islets of Langerhans and IR, however, this finding hasn’t been investigated in patients with CAH. The aim was to identify the vitamin D levels and insulin resistance status in pubertal females with CAH, following up at Diabetes Endocrine and Metabolism Pediatric Unit, Abou ElRish Children’s Hospital, Cairo University. We also examined the association between vitamin D level & insulin resistance and the impact of cholecalciferol administration on metabolic abnormalities.
Subjects and Methods: Sixteen pubertal CAH females with deficient or insufficient Vitamin D levels were recruited. Follow up was done after a period of 6 months during which oral Vitamin D replacement therapy was prescribed.
Results: The serum levels of 25-hydroxyvitamin D (25(OH)D3) were significantly raised following replacement therapy. Significant correlation was detected between HOMA-IR and serum levels of insulin, other IR indices both prior to and following vitamin D supplementation. However, HOMA-IR didn’t correlate with any of the following: 25(OH)D3 levels, 17 hydroxyprogesterone (17-OHP), or steroid dose either prior to or following replacement therapy.
Conclusion: Vitamin D replacement therapy didn’t have favorable effects on IR in females with CAH. Future research using randomized controlled trials is required to examine the impact of Vitamin D on IR. This might influence the production of adrenal androgen, resulting in reduction of the therapeutic effect of glucocorticoids and evolution of metabolic derangements.
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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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12
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Ganmaa D, Enkhmaa D, Nasantogtokh E, Sukhbaatar S, Tumur-Ochir KE, Manson JE. Vitamin D, respiratory infections, and chronic disease: Review of meta-analyses and randomized clinical trials. J Intern Med 2022; 291:141-164. [PMID: 34537990 DOI: 10.1111/joim.13399] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Observational studies have suggested associations of vitamin D deficiency (VDD) with respiratory tract infections, impaired bone health, and myriad chronic diseases. OBJECTIVE To assess potential causal relationships between vitamin D supplementation and a reduced risk of these conditions, a review of the evidence across available meta-analyses of randomized control trials (RCTs) and RCTs was performed. METHOD PubMed, Embase, Cochrane Library, and Web of Science were searched from their inception to March 2021. We included only RCTs and meta-analyses of RCTs focusing on the association between vitamin D and respiratory disease, bone health, cardiovascular disease (CVD), diabetes mellitus, and cancer. RESULTS A total of 107 RCTs and 62 meta-analysis of RCTs were included. Although most RCTs did not support benefits of vitamin D supplementation, suggestive evidence for benefit was found in populations at greater risk of VDD and for acute respiratory infections, fractures in institutionalized older adults, type 2 diabetes among patients with prediabetes, and cancer mortality. In contrast, no compelling evidence for benefit was found for other respiratory conditions, fractures in community-dwelling adults, falls, cancer incidence, or CVD. CONCLUSIONS Current evidence from RCTs and meta-analyses of RCTs is inconsistent regarding the effects of vitamin D supplementation on respiratory infections and chronic diseases. Individuals most likely to benefit are those with baseline VDD or with selected high-risk conditions. Public health initiatives are needed to eliminate VDD globally, and future research will be enhanced by a 'precision prevention' approach to identify those most likely to benefit from vitamin D supplementation.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | | | | | | | - J E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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13
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Yu S, Feng Y, Qu C, Yu F, Mao Z, Wang C, Li W, Li X. Vitamin D receptor methylation attenuates the association between physical activity and type 2 diabetes mellitus: A case-control study. J Diabetes 2022; 14:97-103. [PMID: 34751501 PMCID: PMC9060074 DOI: 10.1111/1753-0407.13239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/12/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Physical activity and vitamin D receptor (VDR) have been associated with type 2 diabetes mellitus (T2DM). However, the associations of VDR methylation with T2DM and physical activity remained unknown. We aimed to investigate whether VDR methylation was a link between physical activity and T2DM. METHODS A 1:1 matching case-control study was designed based on the Henan Rural Cohort Study, including 272 pairs of T2DM patients and nonpatients. Physical activity level was assessed using the International Physical Activity Questionnaire. The high-resolution melt method was applied to determine the methylation level of the promoter region of VDR. The association between physical activity and T2DM was analyzed with a conditional logistic regression model. The effect modification of VDR methylation levels on the association between physical activity and T2DM was conducted. A multivariate correlation analysis model was applied to investigate correlations of VDR methylation with insulin sensitivity. RESULTS Physical activity level was associated with T2DM risk (crude model: odds ratio [OR] 0.611; 95% CI, 0.416-0.897; adjusted model: OR 0.619; 95% CI, 0.418-0.917). In effect modification analysis, the effects of physical activity on T2DM were stronger for low VDR methylation levels than for high (P = .025). Moreover, VDR methylation levels were associated with insulin (r = -0.089, P = .039) as well as homeostatic model assessment of insulin resistance (r = -0.098, P = .022). CONCLUSIONS The methylation status of the VDR promoter is associated with the secretion and sensitivity of insulin. VDR methylation attenuates the association between physical activity and T2DM, indicating that proactively physical activity may reduce the risk of T2DM, especially in people with low VDR methylation level.
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Affiliation(s)
- Songcheng Yu
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Yinhua Feng
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Chenling Qu
- College of Grain Oil and Food ScienceHenan University of TechnologyZhengzhouChina
| | - Fei Yu
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Zhenxing Mao
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Chongjian Wang
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Wenjie Li
- College of Public HealthZhengzhou UniversityZhengzhouChina
| | - Xing Li
- College of Public HealthZhengzhou UniversityZhengzhouChina
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14
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Nasr MH, Hassan BAR, Othman N, Karuppannan M, Abdulaziz NB, Mohammed AH, Alsarani MA, Eskembaji MH, Aman AM, Othman G. Prevalence of Vitamin D Deficiency Between Type 2 Diabetes Mellitus Patients and Non-Diabetics in the Arab Gulf. Diabetes Metab Syndr Obes 2022; 15:647-657. [PMID: 35250286 PMCID: PMC8896538 DOI: 10.2147/dmso.s350626] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/15/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The link between the risk of type 2 diabetes mellitus (T2DM) and vitamin D deficiency has perplexed the medical society due to the controversy in the data available. Saudi Arabia (SA) is a sunny region; however, ample amount of data reported the increased prevalence of vitamin D deficiency along with T2DM. Thus, this study aimed to compare vitamin D deficiency between healthy and T2DM patients in SA, alongside with the risk factors associated with that. METHODS A cross-sectional study was conducted in the Medical Unit, Taibah University in Al-Madinah Al-Munawarah, SA, from November 2017 to May 2018. The involved participants were non-diabetics and T2DM men. Measuring vitamin D for T2DM and non-diabetics group was done by trained technicians. Data analysis was done via SPSS. RESULTS Sixty-four participants (T2DM group = 32; non-diabetics group = 32) were recruited, and the mean age of T2DM patients was 48.6 ± 10.4, while that of the non-diabetics was 42.4 ± 6.5. The mean of vitamin D level was found higher in the non-diabetic participants than in diabetic patients. There was statistically significant association between vitamin D deficiency and T2DM (P = 0.001). Besides, duration of diabetes was the only factor, found to be positively correlated with vitamin D deficiency in T2DM patients. CONCLUSION Early screening for vitamin D serum-level is recommended for T2DM patients in Saudi Arabia. Therefore, early correction of vitamin D levels should be considered, and medical and scientific societies, along with other sectors such as the media, should highlight and increase the awareness of the importance of vitamin D and the seriousness of its deficiency.
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Affiliation(s)
- Muhammed Hassan Nasr
- Clinical Pharmacy Department, Faculty of Health Sciences and Nursing, Al-Rayan Colleges, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Noordin Othman
- Quality Use of Medicines in Umrah and Hajj Pilgrimage Research Group, Department of Clinical and Hospital Pharmacy, Faculty of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, 42300, Selangor, Malaysia
| | - Noorizan binti Abdulaziz
- Clinical Pharmacy Department, Faculty of Pharmacy, Management and Science University, Shah Alam, Malaysia
| | - Ali Haider Mohammed
- Department of Pharmacy, Al Rafidain University College, Baghdad, 10001, Iraq
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500, Selangor, Malaysia
| | - Mohammed Ahmed Alsarani
- Laboratory Department, Medical Care Unit, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Abdelmannan Mohamed Aman
- Family Medicine Department, Medical Care Unit, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Gamil Othman
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, Yemen
- Correspondence: Gamil Othman, Email
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15
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Xiang M, Sun X, Wei J, Cao ZB. Combined effects of vitamin D supplementation and endurance exercise training on insulin resistance in newly diagnosed type 2 diabetes mellitus patients with vitamin D deficiency: study protocol for a randomized controlled trial. Trials 2021; 22:888. [PMID: 34872610 PMCID: PMC8647429 DOI: 10.1186/s13063-021-05861-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although approximately 50% of Chinese with type 2 diabetes mellitus (T2DM) patients have vitamin D deficiency, studies regarding vitamin D supplementation on insulin resistance (IR) have mainly focused on non-Asians. Endurance exercise training (ET) enhances insulin-mediated glucose metabolism, which plays a critical role in T2DM prevention and control. However, the combined effects of vitamin D supplementation and ET on IR in T2DM patients are unclear. The objectives of this study is to investigate the synergistic effect of vitamin D supplementation combined with exercise training intervention on IR in T2DM patients. METHODS AND ANALYSIS We propose a 3-month randomized controlled trial among 60 T2DM patients aged 40-65, newly diagnosed with T2DM ≤ 1 year, and with stable HbA1c level (≤ 8.0%) in the past 3 months. The participants will be randomly allocated to the vitamin D group, vitamin D combined with exercise training group, exercise training group, and control group (CG) using a computer-generated random number sequence. At baseline, participants will undergo a medical review, anthropometric measurements, dual X-ray absorptiometry, a 75-g oral glucose tolerance test (OGTT), ankle-brachial index measurements, and physical fitness measurements and will complete related lifestyle questionnaires. Fasting blood lipid and glucose levels were also measured. In a 3-month intervention period, vitamin D intervention group will receive a dose of 1000 IU daily; exercise group will perform a 1-h endurance exercise 3 times per week (maximal heart rate, 60-80%), and the control group will receive apparently identical tablets. Additionally, all participants will be advised to maintain their normal diet and physical activities during the intervention. All measurements will be repeated at 3-month follow-up after the intervention with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion. Secondary outcome measures will compare the changes in anthropometry, ankle-brachial index, and physical fitness factors (e.g., peak oxygen uptake, hand grip strength). Data will be managed and analyzed using the Statistical Package for the Social Sciences. DISCUSSION This is the first study to conduct a randomized trial to clearly determine the independent and combined effects of vitamin D supplementation and endurance exercise trial on IR in Chinese T2DM patients as measured by OGTT. The findings from the proposed study will not only provide new evidences that vitamin D supplementation plays an important role in IR management but also develop a simple and efficient method to improve IR-associated metabolic diseases for T2DM patients. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800015383 , Registered on 28 March 2018.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, Shaanxi, 710061, China.
| | - Junxiang Wei
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, Shaanxi, 710061, China
| | - Zhen-Bo Cao
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, China.
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16
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Zou Y, Guo B, Yu S, Wang D, Qiu L, Jiang Y. Effect of vitamin D supplementation on glycose homeostasis and islet function in vitamin D deficient or insufficient diabetes and prediabetes: a systematic review and meta-analysis. J Clin Biochem Nutr 2021; 69:229-237. [PMID: 34857984 PMCID: PMC8611361 DOI: 10.3164/jcbn.20-165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/25/2020] [Indexed: 11/25/2022] Open
Abstract
Objective of the present study was to evaluate the effect of vitamin D supplementation on glycose homeostasis, islet function, and diabetes progress. Literatures were searched via electronic databases, websites, and previous reviews from the earliest available time to the end of May 2020. Randomized controlled trials initially designed for diabetes and prediabetes with 25-dihydroxyvitamin D [25(OH)D]<30 ng/ml were included. All data were analyzed and presented based on the Cochrane guidelines and PRISMA guidelines. In total, 27 articles (n = 1,932) were enrolled in this study. Vitamin D supplementation significantly improved fasting blood glucose, postprandial blood glucose, and quantitative insulin sensitivity check index in diabetes and prediabetes with baseline 25(OH)D<30 ng/ml. Higher percentages regressing from prediabetes to normal glucose status [1.60 (1.19, 2.17), p = 0.002, n = 564] and lower percentage progressing from prediabetes to diabetes [0.68 (0.36, 1.27), p = 0.23, n = 569] were found in the supplementation group. The positive effects of vitamin D supplementation on body mass index, waist, HDL-C, LDL-C, and CRP were also demonstrated. In conclusion, modest improvements in vitamin D supplementation on short-term glycose homeostasis, insulin sensitivity, and disease development in diabetes and prediabetes with 25(OH)D<30 ng/ml were demonstrated, but more research needs to be conducted in the future to support the clinical application. (Register ID: CRD42020186004)
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Affiliation(s)
- Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Bo Guo
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Danchen Wang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing 100730, China
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17
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Cojic M, Kocic R, Klisic A, Kocic G. The Effects of Vitamin D Supplementation on Metabolic and Oxidative Stress Markers in Patients With Type 2 Diabetes: A 6-Month Follow Up Randomized Controlled Study. Front Endocrinol (Lausanne) 2021; 12:610893. [PMID: 34489860 PMCID: PMC8417320 DOI: 10.3389/fendo.2021.610893] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency could play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) as it may alter several crucial processes in the development of diabetes and its complications, such as pancreatic insulin secretion, peripheral insulin resistance, persistence of systemic "sterile" inflammation and immune activation. Vitamin D may also have an antioxidant effect through the inhibition of free radicals generation. The reported study was designed with eligible consecutively recruited patients with T2DM on standard metformin therapy (n=130), randomized in 1:1 ratio, considered to have undergone Vitamin D supplementation according to the guidelines proposed by the Endocrine Society, or to have continued with metformin only. The potential benefit was monitored through the influence on glycemia level, glycated haemoglobin (HbA1c), insulin resistance index (calculated as homeostatic model assessment; HOMA-IR), Castelli Risk Index I and Tryglicerides/Thiobarbituric acid-reactive substances (TG/TBARS) Index in a 6-month follow up period. Our study indicates that oral daily doses of vitamin D improve HbA1c levels over the 3-month and 6-month period, followed by a significant decrease in advanced oxidation protein products levels over the 3-month period when higher vitamin D doses are given. The effect of vitamin D on HOMA-IR index, malondialdehyde levels and TG/TBARS index was not statistically significant. Further investigation should consider defining the doses of vitamin D in patients with T2DM which may attenuate the oxidative stress risk, the risk of metabolic syndrome and the risk of related cardiovascular events.
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Affiliation(s)
- Milena Cojic
- Primary Health Care Center, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Radivoj Kocic
- Clinic for Endocrinology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - Aleksandra Klisic
- Primary Health Care Center, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Gordana Kocic
- Institute of Biochemistry, Faculty of Medicine, University of Nis, Nis, Serbia
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18
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Su S, Tang X, Che H, Zhen J, Liu L, Zhao N, Liu J, Guan C, Fu S, Wang L, Li H, Zhang D, Wang Q, Zhen D. [Correlation of baseline serum 25-hydroxyvitamin D level with the risk of type 2 diabetes mellitus: a prospective cohort study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:811-819. [PMID: 34238732 DOI: 10.12122/j.issn.1673-4254.2021.06.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the correlation of baseline serum 25(OH) D level with the risk of type 2 diabetes mellitus (T2DM) and blood glucose control in diabetic patients among the middle-aged and elderly individuals in Chengguan District of Lanzhou, Gansu Province. OBJECTIVE Residents aged 40 to 75 years in Lanzhou were selected from the "REACTION" study conducted in 2011 and had been followed up since 2014. A total of 5044 subjects with complete data from the two surveys were analyzed. Participants were divided into Q1, Q2, Q3, and Q4 subgroups based on quartiles of serum 25(OH)D level for comparison of the incidence of T2DM and blood glucose control. OBJECTIVE Baseline 25(OH)D level was not found to correlate with FPG, 2h-PG or HbA1c levels among the residents (P>0.05). The participants were followed up for a mean of 3.4±0.6 years, and compared with those in Q1 group, the participants in Q2, Q3 and Q4 groups did not show significantly lowered risk of prediabetes or diabetes regardless of glucose tolerance status. Among the patients with T2DM, the compliance rate of glycemic control after the follow-up was significantly higher than that before the follow-up (63.4% vs 60.6%), and the levels of HbA1c, FPG, and 2h-PG decreased obviously after the follow-up. But compared with Q1 group, Q2, Q3 and Q4 groups showed no significant changes in glycemic control compliance rate or levels of HbA1c, FPG and 2h-PG after the follow-up (P>0.05). OBJECTIVE There is no evidence that baseline 25(OH)D levels are associated with the risk of diabetes and blood glucose control in patients with T2DM.
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Affiliation(s)
- S Su
- First Clinical Medical College First Hospital of Lanzhou University, Lanzhou 730000 China.,Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - X Tang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - H Che
- Department of Endocrinology, Gansu Provincial Third People's Hospital, Lanzhou 730000, China
| | - J Zhen
- Department of Gynecology, Gansu Provincial People's Hospital, Lanzhou 730000, China
| | - L Liu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - N Zhao
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - J Liu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - C Guan
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - S Fu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - L Wang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - H Li
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - D Zhang
- First Clinical Medical College First Hospital of Lanzhou University, Lanzhou 730000 China.,Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
| | - Q Wang
- First Clinical Medical College First Hospital of Lanzhou University, Lanzhou 730000 China.,Department of Endocrinology, Gansu Provincial Third People's Hospital, Lanzhou 730000, China
| | - D Zhen
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000 China
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19
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The role of vitamin D deficiency and thyroid dysfunction on blood glucose regulation in patients with type 2 diabetes mellitus: A retrospective cohort study. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.911291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Derosa G, D'Angelo A, Martinotti C, Valentino MC, Di Matteo S, Bruno GM, Maffioli P. Vitamin D3 supplementation improves glycemic control in type 2 diabetic patients: Results from an Italian clinical trial. INT J VITAM NUTR RES 2020; 92:91-100. [PMID: 32795167 DOI: 10.1024/0300-9831/a000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.,Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Angela D'Angelo
- Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Chiara Martinotti
- S.A.V.E. Studi Analisi Valutazioni Economiche Research Centre, Milan, Italy
| | | | - Sergio Di Matteo
- S.A.V.E. Studi Analisi Valutazioni Economiche Research Centre, Milan, Italy
| | - Giacomo M Bruno
- Department of Management information and production Engineering, University of Bergamo, Bergamo, Italy.,Drug Science Department, University of Pavia, Pavia, Italy
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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21
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Behrouz V, Dastkhosh A, Sohrab G. Overview of dietary supplements on patients with type 2 diabetes. Diabetes Metab Syndr 2020; 14:325-334. [PMID: 32298985 DOI: 10.1016/j.dsx.2020.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS The primary approach for managing type 2 diabetes mellitus (T2DM) involves lifestyle modification and diet therapy along with pharmacologic interventions. Many patients are interested to identify nutritional supplements that may provide benefit in prevention and management of diabetes. However, the efficacy and safety of nutritional supplements such as chromium, n-3 polyunsaturated fatty acids (PUFAs), vitamin D, zinc and magnesium in disease treatment is a worrying and controversial matter. In this narrative review, patients and health care providers are introduced to the effects of mentioned dietary supplements that may help in choosing or not choosing these supplements in treatment of diabetes. METHODS This review was carried out using comprehensive and systematic literature reports on the dietary supplements in the management of diabetes. Empirical searches were conducted using Google Scholar, Science Direct and PubMed databases. Searches were also undertaken using keywords, in English, such as "chromium" OR "vitamin D" OR "omega-3 fatty acids" OR "zinc" OR "magnesium" in combination with "type 2 diabetes". RESULTS The available evidence is insufficient to create a definite conclusion that nutritional supplements including chromium, n-3 PUFAs, vitamin D, zinc and magnesium might be beneficial for the prevention and treatment of T2DM and therefore, the general recommendation to use these supplements in the management of diabetes cannot be justified. The results of most studies lack uniformity across multiple aspects, including different dose and formation of supplements, duration, and subjects under intervention. CONCLUSIONS There is a need for well-designed, high quality, large and long-term studies to strengthen the available evidence and ensure the safety and efficacy of products.
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Affiliation(s)
- Vahideh Behrouz
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Dastkhosh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Golbon Sohrab
- Department of Clinical Nutrition and Dietetics, 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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Fagundes GE, Macan TP, Rohr P, Damiani AP, Da Rocha FR, Pereira M, Longaretti LM, Vilela TC, Ceretta LB, Mendes C, Silveira PCL, Teixeira JPF, de Andrade VM. Vitamin D3 as adjuvant in the treatment of type 2 diabetes mellitus: modulation of genomic and biochemical instability. Mutagenesis 2020; 34:135-145. [PMID: 30726950 DOI: 10.1093/mutage/gez001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/17/2018] [Accepted: 01/24/2019] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes mellitus has undergone a worldwide growth in incidence in the world and has now acquired epidemic status. There is a strong link between type 2 diabetes and vitamin D deficiency. Because vitamin D has beneficial effects on glucose homeostasis, the aim of this study was to evaluate the influence of vitamin D3 supplementation on the modulation of glycaemic control and other metabolic effects, as well as modulation of genomic instability in patients with type 2 diabetes. We evaluated 75 patients with type 2 diabetes, registered in the Integrated Clinics of the University of Southern Santa Catarina. Participants received 4000 IU of vitamin D3 (25(OH)D) supplementation daily for 8 weeks. Blood samples were collected at the beginning and at the end of the supplementation, and 4 weeks after the end of supplementation. The glycidic and lipid profiles [total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglycerides], oxidative stress, DNA damage and 25(OH)D levels were evaluated. Vitamin D3 supplementation for 8 weeks showed enough to significantly increase blood levels of 25(OH)D. A significant difference in lipid profile was observed only in non-HDL cholesterol. Significant changes were observed in glucose homeostasis (fasting glucose and serum insulin) and, in addition, a reduction in the parameters of oxidative stress and DNA damage. There was a significant reduction in the values of 25(OH)D 4 weeks after the end of the supplementation, but levels still remained above baseline. Use of vitamin D supplementation can be an ally in the health modulation of patients with type 2 diabetes mellitus.
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Affiliation(s)
- Gabriela Elibio Fagundes
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Tamires Pavei Macan
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Paula Rohr
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Adriani Paganini Damiani
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Franciani Rodrigues Da Rocha
- Laboratory of Exercise Biochemistry and Physiology, Department of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Maiara Pereira
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Luiza Martins Longaretti
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Thais Ceresér Vilela
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Luciane Bisognin Ceretta
- Graduate Program in Public Health, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Carolini Mendes
- Laboratory of Exercise Biochemistry and Physiology, Department of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Exercise Biochemistry and Physiology, Department of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
| | | | - Vanessa Moraes de Andrade
- Translational Biomedicine Laboratory, Graduate Programme of Health Sciences, University of Southern Santa Catarina, UNESC, Criciúma, Santa Catarina, Brazil
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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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Melamud E, Taylor DL, Sethi A, Cule M, Baryshnikova A, Saleheen D, van Bruggen N, FitzGerald GA. The promise and reality of therapeutic discovery from large cohorts. J Clin Invest 2020; 130:575-581. [PMID: 31929188 PMCID: PMC6994121 DOI: 10.1172/jci129196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Technological advances in rapid data acquisition have transformed medical biology into a data mining field, where new data sets are routinely dissected and analyzed by statistical models of ever-increasing complexity. Many hypotheses can be generated and tested within a single large data set, and even small effects can be statistically discriminated from a sea of noise. On the other hand, the development of therapeutic interventions moves at a much slower pace. They are determined from carefully randomized and well-controlled experiments with explicitly stated outcomes as the principal mechanism by which a single hypothesis is tested. In this paradigm, only a small fraction of interventions can be tested, and an even smaller fraction are ultimately deemed therapeutically successful. In this Review, we propose strategies to leverage large-cohort data to inform the selection of targets and the design of randomized trials of novel therapeutics. Ultimately, the incorporation of big data and experimental medicine approaches should aim to reduce the failure rate of clinical trials as well as expedite and lower the cost of drug development.
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Affiliation(s)
- Eugene Melamud
- Calico Life Sciences LLC, South San Francisco, California, USA
| | | | - Anurag Sethi
- Calico Life Sciences LLC, South San Francisco, California, USA
| | - Madeleine Cule
- Calico Life Sciences LLC, South San Francisco, California, USA
| | | | | | | | - Garret A. FitzGerald
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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25
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Alaidarous TA, Alkahtani NM, Aljuraiban GS, Abulmeaty MMA. Impact of the Glycemic Control and Duration of Type 2 Diabetes on Vitamin D Level and Cardiovascular Disease Risk. J Diabetes Res 2020; 2020:8431976. [PMID: 32149154 PMCID: PMC7054776 DOI: 10.1155/2020/8431976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/28/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS To investigate the impact of glycemic control and T2D duration on vitamin D status and cardiovascular disease (CVD) risk among Saudi patients. METHODS This case-control study was conducted in King Faisal Specialist Hospital, Saudi Arabia. A total of 25 nondiabetic controls and 92 patients with confirmed T2D, aged 20-60 years, were included. Patients with T2D were divided into the following groups based on disease duration (newly diagnosed: ≈6 months and long duration: ≥5 years) and glycemic control based on their glycated hemoglobin (HbA1C) level with a threshold of ≤0.053 mol/mol: newly diagnosed controlled (NC, n = 25), newly diagnosed uncontrolled (NU, n = 25), newly diagnosed uncontrolled (NU, n = 25), newly diagnosed uncontrolled (NU, n = 25), newly diagnosed uncontrolled (NU. RESULTS Our study showed that T2D duration was an independent predictor of vitamin D deficiency. The longer disease duration, the lower odds of being vitamin D deficient (odds ratio (OR) = 0.05, 95% CI: 0.01-0.29, p < 0.05). No significant association was observed between vitamin D and HbA1C levels. In the NU group, CVD risk scores were directly correlated with serum 25(OH)D (r = 0.53, p < 0.05). No significant association was observed between vitamin D and HbA1C levels. In the NU group, CVD risk scores were directly correlated with serum 25(OH)D (r = 0.53, p < 0.05). No significant association was observed between vitamin D and HbA1C levels. In the NU group, CVD risk scores were directly correlated with serum 25(OH)D (. CONCLUSION Duration of diabetes rather than glycemic control is associated with vitamin D deficiency. Glycemic uncontrol may augment vitamin D deficiency-associated CVD risk in both newly diagnosed and old patients with type 2 diabetes.
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Affiliation(s)
- Thuraya A. Alaidarous
- Clinical Nutrition Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Noura M. Alkahtani
- Department of Endocrinology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud M. A. Abulmeaty
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Medical Physiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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26
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Liu B, Xiang Y, Liu Z, Zhou Z. Past, present and future of latent autoimmune diabetes in adults. Diabetes Metab Res Rev 2020; 36:e3205. [PMID: 31318117 DOI: 10.1002/dmrr.3205] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/14/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Abstract
Latent autoimmune diabetes in adults (LADA) is the most common form of autoimmune diabetes diagnosed in adults. Similar to type 1 diabetes, the prevalence of LADA is impacted by ethnicity and geography. LADA is characterized by β cell loss due to autoimmunity and insulin resistance and has highly heterogeneous clinical features, autoimmunity, and genetics in a glutamic acid decarboxylase antibody (GADA) titre-dependent manner, suggesting LADA is part of a continuum spectrum between type 1 and type 2 diabetes. Although LADA is the most frequent form of autoimmune diabetes diagnosed in adults, clinical trials involving LADA are scarce. Here we review the recent advancements in LADA epidemiology, clinical features, pathogenesis, and interventions. We also highlight the environmental factors that are thought to play an important role in addition to genetics in the pathogenesis of LADA. In the future, high-throughput molecular profiles might shed light on the nature of LADA among the wide spectrum of diabetes and offer new opportunities to identify novel LADA-specific biomarkers.
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Affiliation(s)
- Bingwen Liu
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Central South University, Changsha, China
| | - Yufei Xiang
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Central South University, Changsha, China
| | - Zhenqi Liu
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA
| | - Zhiguang Zhou
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Central South University, Changsha, China
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27
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Aliashrafi S, Ebrahimi-Mameghani M, Jafarabadi MA, Lotfi-Dizaji L, Vaghef-Mehrabany E, Arefhosseini SR. Effect of high-dose vitamin D supplementation in combination with weight loss diet on glucose homeostasis, insulin resistance, and matrix metalloproteinases in obese subjects with vitamin D deficiency: a double-blind, placebo-controlled, randomized clinical trial. Appl Physiol Nutr Metab 2019; 45:1092-1098. [PMID: 31874050 DOI: 10.1139/apnm-2018-0773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As there is limited and inconsistent evidence in potential role of vitamin D on insulin resistance and matrix metalloproteinases, this study aimed to examine the effect of vitamin D supplementation on glucose homeostasis, insulin resistance, and matrix metalloproteinases in obese subjects with vitamin D deficiency. A total of 44 participants with serum 25-hydroxyvitamin D (25(OH)D) level ≤ 50 nmol/L and body mass index (BMI) 30-40 kg/m2 were randomly allocated into receiving weight reduction diet with either 50 000 IU vitamin D3 pearl (n = 22) or placebo (n = 22) once weekly for 12 weeks. Primary outcomes were changes in fasting serum glucose (FSG), homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and matrix metalloproteinases (MMPs). Secondary outcomes were changes in weight, BMI, 25(OH)D, calcium, phosphorous and parathyroid hormone (PTH). Sun exposure and dietary intakes were also assessed. Serum levels of 25(OH)D3 increased significantly with a simultaneous decrease in serum concentration of PTH in the vitamin D group. Weight, BMI, FSG, and MMP-9 decreased significantly in both groups, and there were significant differences in changes in weight, serum 25(OH)D3, PTH, and MMP-9 levels between the groups. Within- and between-groups analysis revealed no significant differences in serum calcium, phosphorous, serum insulin, HOMA-IR, QUICKI, and MMP-2 after intervention. Our results indicated that improvement in vitamin D status resulted in greater reductions in weight and MMP-9 during weight loss. These preliminary results are sufficient to warrant a bigger study group.
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Affiliation(s)
- Soodabeh Aliashrafi
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical science, Tabriz, Iran
| | | | - Lida Lotfi-Dizaji
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Vaghef-Mehrabany
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed-Rafie Arefhosseini
- Nutritional Biochemistry, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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28
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Liu JM, Zhu DL, Mu YM, Xia WB. Management of fracture risk in patients with diabetes-Chinese Expert Consensus. J Diabetes 2019; 11:906-919. [PMID: 31219236 DOI: 10.1111/1753-0407.12962] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/20/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jian-Min Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai, China
| | - Da-Long Zhu
- Department of Endocrinology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Yi-Ming Mu
- Department of Endocrinology, The General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Wei-Bo Xia
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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25-Hydroxyvitamin D and the risk of incident diabetes in Hong Kong Chinese. Public Health Nutr 2019; 23:1201-1207. [PMID: 31169100 DOI: 10.1017/s1368980019000582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) and risk of incident diabetes in Hong Kong Chinese, after accounting for the effect of multiple bone- and mineral-related markers. DESIGN We conducted a retrospective study on the Hong Kong Osteoporosis Study cohort. Incident diabetes was ascertained using electronic medical records. Serum 25(OH)D was measured at baseline and its association with incident diabetes was evaluated using multivariable Cox proportional-hazard regression. PARTICIPANTS Individuals (n 4342) aged 20 years or above (1395 men, 2947 women; mean age 54·3 (sd 16·5) years) from the Hong Kong Osteoporosis Study, who were free of diabetes at baseline, were included. RESULTS During 40 124·7 person-years of follow-up (a median of 9·2 years), 443 participants developed diabetes. Mean 25(OH)D was 63·34 (sd 13·07) nmol/l. Age-, sex- and BMI-adjusted Cox proportional-hazard regression showed no significant difference in the risk of incident diabetes between the lowest and the highest quintiles of 25(OH)D. In the analysis of the interaction effect between 25(OH)D and serum Ca, the interaction term did not affect the risk of incident diabetes significantly (P = 0·694). Similarly, there was no significant interaction of different subgroups (age, sex, BMI, femoral-neck T-score, serum Ca levels) with serum 25(OH)D. CONCLUSIONS The present study finds that serum vitamin D level is not associated with the risk of incident diabetes in Hong Kong Chinese and this relationship is not modified by serum Ca level.
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Jafari T, Fallah AA, Rostampour N, Mahmoodnia L. Vitamin D ameliorates systolic but not diastolic blood pressure in patients with type 2 diabetes: Results from a meta-analysis of randomized controlled trials. INT J VITAM NUTR RES 2019; 88:90-99. [PMID: 31038034 DOI: 10.1024/0300-9831/a000291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Inconsistent findings have been reported regarding the effects of vitamin D on blood pressure in patients with type 2 diabetes (T2D). This study aimed to evaluate the subject through a meta-analysis. A computerized literature search on five databases was performed and randomized controlled trials (RCTs) published until March 2016 were identified. The eligibility criteria for articles to be selected were parallel-group RCTs in which consumption of a kind of vitamin D was compared with placebo in patients with T2D. Un-standardized mean difference and its corresponding 95 % confidence interval (CI) was calculated from the effect sizes by using random effects model. Studies comparing intervention group (received vitamin D) with control group (received placebo) were enrolled in meta-analysis. Meta-analysis on 26 studies with 1789 type 2 diabetic subjects showed that vitamin D significantly reduced systolic blood pressure (SBP; -0.97 mmHg, 95 % CI: -1.94, -0.001, P = 0.050), but not diastolic blood pressure (DBP; -0.10 mmHg, 95 % CI: -0.22, 0.02, P = 0.087). Subgroup analyses showed that administration of vitamin D in patients with baseline serum 25-hydroxy vitamin D < 50 nmol/l and baseline SBP < 140 mmHg significantly reduced SBP. Moreover, the patients who received vitamin D without Ca co-supplementation showed significant reduction in SBP. Vitamin D doses (≤ 2000 or > 2000 IU/day) and method of vitamin D application (Supplementation or food fortification) did not affect the blood pressure. This study demonstrated that vitamin D improved SBP in type 2 diabetic patients. Therefore, this vitamin can be considered as an adjuvant therapy in these patients.
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Affiliation(s)
- Tina Jafari
- 1 Department of Biochemistry and Nutrition, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.,2 Medical Plants Research Center, Shahrekord University of Medical Sciences, Sharhekord, Iran
| | - Aziz A Fallah
- 3 Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
| | - Noushin Rostampour
- 4 Department of Pediatrics Endocrinology, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Leila Mahmoodnia
- 5 Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Jahn D, Dorbath D, Schilling AK, Gildein L, Meier C, Vuille-Dit-Bille RN, Schmitt J, Kraus D, Fleet JC, Hermanns HM, Geier A. Intestinal vitamin D receptor modulates lipid metabolism, adipose tissue inflammation and liver steatosis in obese mice. Biochim Biophys Acta Mol Basis Dis 2019; 1865:1567-1578. [PMID: 30905785 DOI: 10.1016/j.bbadis.2019.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/06/2019] [Accepted: 03/19/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Hypovitaminosis D is common in the obese population and patients suffering from obesity-associated disorders such as type 2 diabetes and fatty liver disease, resulting in suggestions for vitamin D supplementation as a potential therapeutic option. However, the pathomechanistic contribution of the vitamin D-vitamin D receptor (VDR) axis to metabolic disorders is largely unknown. METHODS We analyzed the pathophysiological role of global and intestinal VDR signaling in diet-induced obesity (DIO) using global Vdr-/- mice and mice re-expressing an intestine-specific human VDR transgene in the Vdr deficient background (Vdr-/- hTg). RESULTS Vdr-/- mice were protected from DIO, hepatosteatosis and metabolic inflammation in adipose tissue and liver. Furthermore, Vdr-/- mice displayed a decreased adipose tissue lipoprotein lipase (LPL) activity and a reduced capacity to harvest triglycerides from the circulation. Intriguingly, all these phenotypes were partially reversed in Vdr-/- hTg animals. This clearly suggested an intestine-based VDR activity on systemic lipid homeostasis. Scrutinizing this hypothesis, we identified the potent LPL inhibitor angiopoietin-like 4 (Angptl4) as a novel transcriptional target of VDR. CONCLUSION Our study suggests a VDR-mediated metabolic cross-talk between gut and adipose tissue, which significantly contributes to systemic lipid homeostasis. These results have important implications for use of the intestinal VDR as a therapeutic target for obesity and associated disorders.
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Affiliation(s)
- Daniel Jahn
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany
| | - Donata Dorbath
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany
| | | | - Lisa Gildein
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany
| | - Chantal Meier
- University of Zürich, Institute of Physiology, Zürich, Switzerland
| | | | - Johannes Schmitt
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany
| | - Daniel Kraus
- University Hospital Würzburg, Division of Nephrology, Würzburg, Germany
| | - James C Fleet
- Purdue University, Department of Nutrition Science, West Lafayette, IN, USA
| | - Heike M Hermanns
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany
| | - Andreas Geier
- University Hospital Würzburg, Division of Hepatology, Würzburg, Germany; University Hospital Zürich, Division of Gastroenterology and Hepatology, Zürich, Switzerland.
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32
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Bora K, Ruram AA. No association of 25-hydroxyvitamin D and parathormone levels with glucose homeostasis in type 2 diabetes - a study from Shillong, Meghalaya. INT J VITAM NUTR RES 2019; 89:285-292. [PMID: 30856083 DOI: 10.1024/0300-9831/a000567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Although inadequate vitamin D and altered parathyroid hormone (PTH) are implicated in deranged glucose metabolism and risk of future diabetes, their role in regulating glucose homeostasis in established cases of diabetes is unclear. We aimed to (i) evaluate vitamin D status, and (ii) determine if vitamin D and PTH were associated with parameters of glucose homeostasis in type 2 diabetes (T2D) patients from Meghalaya, India. Methods: We determined 25-hydroxyvitamin D (25-OH-D) and PTH concentrations in 251 T2D patients (not on insulin), and examined their associations with the following parameters of glucose homeostasis: fasting blood sugar (FBS), post-prandial blood sugar (PPBS), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Results: None of the patients had adequate vitamin D (mean 25-OH-D = 19.3 ng/mL); 47.8% patients were deficient (25-OH-D < 20 ng/mL), while 52.2% were insufficient (25-OH-D < 30 ng/mL) vitamin D. Significant (P < 0.05) univariate associations were observed between: 25-OH-D and FI (r = 0.14); 25-OH-D and HOMA-β (r = 0.13); PTH and FI (r = -0.18), and PTH and HOMA-β (r = -0.11). However these associations disappeared after controlling for potential confounders. The 25-OH-D and PTH levels were not associated with any of the tested parameters of glucose homeostasis. Conclusion: There was widespread prevalence of vitamin D deficiency/insufficiency in our sample T2D patients. However, neither vitamin D nor PTH appeared to play a major role in influencing glucose homeostasis in this present selection of T2D cases.
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Affiliation(s)
- Kaustubh Bora
- Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India.,ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, India
| | - Alice Abraham Ruram
- Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India
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Erkus E, Aktas G, Kocak MZ, Duman TT, Atak BM, Savli H. Diabetic regulation of subjects with type 2 diabetes mellitus is associated with serum vitamin D levels. ACTA ACUST UNITED AC 2019; 65:51-55. [PMID: 30758420 DOI: 10.1590/1806-9282.65.1.51] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 05/27/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Vitamin D deficiency is not only associated with bone metabolism but also with diabetes mellitus. We aimed to study the possible association between serum vitamin D concentration and HbA1c level in patients with type 2 diabetes mellitus (T2DM) in this retrospective report. METHODS Patients with T2DM were enrolled to the study either in regulated or non-regulated T2DM groups, according to HbA1c levels. An HbA1c level of <8% was considered as relatively controlled and others were considered as poorly controlled T2DM. RESULTS Serum vitamin D levels in poorly controlled T2DM subjects (9.4 (4.9-34) ng/ml) were significantly lower than that of the relatively well regulated T2DM patients (13.5 (3.4-36) ng/ml) (p=0.03). Vitamin D was strongly and inversely correlated with HbA1c levels (r= -0.295, p=0.005). CONCLUSION Whatever the cause or result of the diabetes mellitus, it is clear that lower vitamin D is strongly associated with worse diabetic regulation in T2DM subjects. Randomized controlled larger studies, which research the relation between diabetic regulation and vitamin D status, are needed to claim whether it could be a therapeutic target in future in diabetic subjects.
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Affiliation(s)
- Edip Erkus
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
| | - Gulali Aktas
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
| | - M Zahid Kocak
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
| | - Tuba T Duman
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
| | - Burcin M Atak
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
| | - Haluk Savli
- Abant Izzet Baysal University Hospital, Faculty of Medicine, Department of Internal Medicine, Bolu, Turkey
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Grammatiki M, Karras S, Kotsa K. The role of vitamin D in the pathogenesis and treatment of diabetes mellitus: a narrative review. Hormones (Athens) 2019; 18:37-48. [PMID: 30255482 DOI: 10.1007/s42000-018-0063-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/09/2018] [Indexed: 12/21/2022]
Abstract
Diabetes mellitus, a metabolic disorder associated with chronic complications, is traditionally classified into two main subtypes. Type 1 diabetes mellitus (T1DM) results from gradual pancreatic islet β cell autoimmune destruction, extending over months or years. Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, with both insulin resistance and impairment in insulin secretion contributing to its pathogenesis. Vitamin D is a fat-soluble vitamin with an established role in calcium metabolism. Recently, several studies have provided evidence suggesting a role for it in various non-skeletal metabolic conditions, including both types of diabetes mellitus. Preclinical studies of vitamin D action on insulin secretion, insulin action, inflammatory processes, and immune regulation, along with evidence of an increase of hypovitaminosis D worldwide, have prompted several epidemiological, observational, and supplementation clinical studies investigating a potential biological interaction between hypovitaminosis D and diabetes. This narrative review aims to summarize current knowledge on the effect of vitamin D on T1DM and T2DM pathogenesis, prevention, and treatment, as well as on micro- and macrovascular complications of the disease. Furthermore, on the basis of current existing evidence, we aim to highlight areas for potential future research.
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Affiliation(s)
- Maria Grammatiki
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Spiros Karras
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece.
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Senyigit A. The association between 25-hydroxy vitamin D deficiency and diabetic complications in patients with type 2 diabetes mellitus. Diabetes Metab Syndr 2019; 13:1381-1386. [PMID: 31336496 DOI: 10.1016/j.dsx.2019.01.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/22/2019] [Indexed: 12/26/2022]
Abstract
AIMS To evaluation the relationship between serum 25-hydroxy vitamin D [25-(OH)D] deficiency and diabetic complications in patients with type 2 diabetes (T2DM). METHODS One hundred and sixty three patients with T2DM [DM + uncomplicated (n = 36), DM + nephropathy (n = 31), DM + neuropathy (n = 30), DM + retinopathy (n = 30), DM + cardiovascular disease (CAD) (n = 36)], 35 CAD and 40 healthy volunteers were included. RESULTS Serum 25-(OH)D levels were found as significantly lower in all patients compared to the control group (p < 0.05). 25-(OH)D in patients with DM + retinopathy (p < 0.006), DM + nephropathy (p < 0.001) and DM + neuropathy (p < 0.001) was significantly lower than that of the control group. 25-(OH)D in patients with DM + nephropathy (p < 0.001), DM + neuropathy (p < 0.01) and DM + retinopathy (p < 0.001) was significantly lower than in the DM + uncomplicated group. 25-(OH)D levels were found as significantly lower in DM + CAD compared to the CAD group (p < 0.01). Serum 25-(OH)D and HbA1c and parathyroid hormone (PTH) were found to be negatively correlated with each other in DM + all complications. CONCLUSIONS Low serum 25-OHD levels were found to be associated with the development of diabetes and complications. Low serum 25-OHD levels may be a consequence of even worse metabolic control of diabetes.
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Affiliation(s)
- Abdulhalim Senyigit
- Department of Internal Medicine, Istanbul Medicine Hospital, Medical School, University of Biruni, Istanbul, Turkey.
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Ghadiri-Anari A, Mozafari Z, Gholami S, Khodaei SA, Aboutorabi-Zarchi M, Sepehri F, Nadjarzade A, Rahmanian M, Namiranian N. Dose vitamin D supplementations improve peripheral diabetic neuropathy? A before-after clinical trial. Diabetes Metab Syndr 2019; 13:890-893. [PMID: 30641826 DOI: 10.1016/j.dsx.2018.12.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 12/19/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Peripheral neuropathy is a common complication of diabetes mellitus. This study was set to assess the effect of vitamin D supplementation on peripheral neuropathy in patients with type 2 diabetes (T2DM). MATERIALS AND METHODS This study was a quasi-experimental trial in Yazd diabetic research center. Sixty T2DM subjects (30-65 years old) with painful diabetic neuropathy enrolled in this study from March 2017 till April 2018. Patients received weekly 50000 IU of vitamin D3 for 12 weeks orally. Evaluation of diabetic neuropathy was performed by using Michigan Neuropathy Screening Instrument (MNSI) before and after trial. Also fasting plasma glucose, HbA1c, calcium and vitamin D checked before and after the trial. SPSS version 20 software was used for statistical analysis. P ≤ 0.05 was considered to be statistically significant. RESULTS Among 60 T2DM patients, 58 completed the study. Most of them (53.4%) were male. At the end of study, HbA1c, vitamin D, MNSI (both questionnaire and physical examination) improved that is statistically significant (p-value: <0.001). CONCLUSION Oral supplementation of vitamin D 3 (50,000 IU) once weekly for 12 weeks was associated with improvement in the serum level of vitamin D and significant decrease in the symptoms and sign of diabetic neuropathy. So serum vitamin D level should be checked in persons with diabetic neuropathy and low levels of it should be corrected in order to reducing neuropathy severity.
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Affiliation(s)
- Akram Ghadiri-Anari
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zohre Mozafari
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Somaye Gholami
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed-Ali Khodaei
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marzieh Aboutorabi-Zarchi
- Assistant Professor of Neurology, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fariba Sepehri
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azade Nadjarzade
- Associate Professor of Nutritional Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Rahmanian
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Namiranian
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Bellan M, Marzullo P. New Insights on Low Vitamin D Plasma Concentration as a Potential Cardiovascular Risk Factor. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The role of Vitamin D hormone in human health and disease is still debated. Recently, growing attention has been paid to its putative role in cardiovascular system homeostasis with several studies that suggested a correlation between low vitamin D levels and increased cardiovascular risk. Several mechanisms are involved in the development of cardiovascular diseases: systemic inflammation, endothelial dysfunction, arterial hypertension and insulin resistance. In the present paper, we have revised the current literature supporting a role for vitamin D in the development of these pathogenetic processes. Finally, we have evaluated the current evidence linking vitamin D to atherosclerosis and its natural consequence, cardiovascular diseases.
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Ebeling PR, Adler RA, Jones G, Liberman UA, Mazziotti G, Minisola S, Munns CF, Napoli N, Pittas AG, Giustina A, Bilezikian JP, Rizzoli R. MANAGEMENT OF ENDOCRINE DISEASE: Therapeutics of Vitamin D. Eur J Endocrinol 2018; 179:R239-R259. [PMID: 30131372 DOI: 10.1530/eje-18-0151] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The central role of vitamin D in bone health is well recognized. However, controversies regarding its clinical application remain. We therefore aimed to review the definition of hypovitaminosis D, the skeletal and extra-skeletal effects of vitamin D and the available therapeutic modalities. DESIGN Narrative and systematic literature review. METHODS An international working group that reviewed the current evidence linking bone and extra-skeletal health and vitamin D therapy to identify knowledge gaps for future research. RESULTS Findings from observational studies and randomized controlled trials (RCTs) in vitamin D deficiency are discordant, with findings of RCTs being largely negative. This may be due to reverse causality with the illness itself contributing to low vitamin D levels. The results of many RCTs have also been inconsistent. However, overall evidence from RCTs shows vitamin D reduces fractures (when administered with calcium) in the institutionalized elderly. Although controversial, vitamin D reduces acute respiratory tract infections (if not given as bolus monthly or annual doses) and may reduce falls in those with the lowest serum 25-hydroxyvitamin D (25OHD) levels. However, despite large ongoing RCTs with 21 000–26 000 participants not recruiting based on baseline 25OHD levels, they will contain a large subset of participants with vitamin D deficiency and are adequately powered to meet their primary end-points. CONCLUSIONS The effects of long-term vitamin D supplementation on non-skeletal outcomes, such as type 2 diabetes mellitus (T2DM), cancer and cardiovascular disease (CVD) and the optimal dose and serum 25OHD level that balances extra-skeletal benefits (T2DM) vs risks (e.g. CVD), may soon be determined by data from large RCTs.
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Affiliation(s)
- P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - R A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - G Jones
- Department of Biomedical and Molecular Sciences in the School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - U A Liberman
- Department of Physiology and Pharmacology and The Felsenstein Medical Research Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Mazziotti
- Endocrine Unit, ASST Carlo Poma, Mantua, Italy
| | | | - C F Munns
- Department of Paediatrics, Westmead Children's Hospital, The University of Sydney, Westmead, New South Wales, Australia
| | - N Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
- IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - A G Pittas
- Division of Endocrinology, Tufts Medical Center, Boston, Massachusetts, USA
| | - A Giustina
- Vita-Salute, San Raffaele University, Milan, Italy
| | - J P Bilezikian
- Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - R Rizzoli
- Divison of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Out M, Top WMC, Lehert P, Schalkwijk CA, Stehouwer CDA, Kooy A. Long-term treatment with metformin in type 2 diabetes and vitamin D levels: A post-hoc analysis of a randomized placebo-controlled trial. Diabetes Obes Metab 2018; 20:1951-1956. [PMID: 29667290 DOI: 10.1111/dom.13327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/03/2018] [Accepted: 04/13/2018] [Indexed: 01/02/2023]
Abstract
AIMS To study the effects of metformin, as compared to placebo, on serum levels of vitamin D (25-hydroxyvitamin D [25(OH)D]) in patients with advanced type 2 diabetes. MATERIALS AND METHODS In the HOME trial, a randomized placebo-controlled trial, 390 insulin-treated patients with type 2 diabetes were treated with 850 mg metformin or placebo thrice daily for 52 months. In a post-hoc analysis, we examined changes in the combined levels of 25(OH)D2 and 25(OH)D3 at 4 and 16 months during the study. RESULTS Mean combined 25(OH)D at baseline was 68.2 nmoL/L (95% confidence interval [CI]: 65.5-71.1). In mixed model analysis, metformin, as compared to placebo, had no effect on 25(OH)D levels during 16 months (coefficient: 1.002 per month, multiplicative model; 95% CI: 0.998-1.006, P = .30). Metformin was associated with a small increase of 25(OH)D2 (coefficient: 1.012 per month; 95% CI: 1.003-1.021, P = .008). However, 25(OH)D2 is only a very small fraction (3%) of 25(OH)D. Seasonal variation had the biggest impact on 25(OH)D levels. Vitamin B12 levels were not associated with the levels of 25(OH)D. CONCLUSION Metformin had no effect on serum 25(OH)D during 16 months in the setting of a clinical randomized controlled trial in patients with type 2 diabetes. Our results show that metformin doesn't lead to vitamin D deficiency.
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Affiliation(s)
- Mattijs Out
- Department of Internal Medicine, Bethesda Hospital Hoogeveen - Care Group Treant, Hoogeveen, The Netherlands
- Bethesda Diabetes Research Center Hoogeveen, Hoogeveen, The Netherlands
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Wiebe M C Top
- Department of Internal Medicine, Bethesda Hospital Hoogeveen - Care Group Treant, Hoogeveen, The Netherlands
- Bethesda Diabetes Research Center Hoogeveen, Hoogeveen, The Netherlands
| | - Philippe Lehert
- Department of Statistics, Faculty of Economics, Facultés Universitaires Catholiques de Mons, Louvain Academy, Mons, Belgium
| | - Casper A Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Adriaan Kooy
- Department of Internal Medicine, Bethesda Hospital Hoogeveen - Care Group Treant, Hoogeveen, The Netherlands
- Bethesda Diabetes Research Center Hoogeveen, Hoogeveen, The Netherlands
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Mirhosseini N, Rainsbury J, Kimball SM. Vitamin D Supplementation, Serum 25(OH)D Concentrations and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2018; 5:87. [PMID: 30050908 PMCID: PMC6052909 DOI: 10.3389/fcvm.2018.00087] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Cardiovascular disease (CVD) risk factors are associated with low serum 25 hydroxyvitamin D (25(OH)D) concentrations in observational studies; however, clinical trial findings are inconsistent. Objective: We assessed the effect of vitamin D supplementation and increased serum 25(OH)D concentrations on CVD risk factors in a systemic review and meta-analysis of randomized controlled trials (RCTs). Design: MEDLINE, CINAHL, EMBASE, and Google Scholar were searched for RCTs that evaluated vitamin D supplementation and cardiovascular outcomes [blood pressure, parathyroid hormone (PTH), serum high-sensitivity C-reactive protein (hs-CRP), total cholesterol, high and low density lipoprotein (HDL and LDL, respectively), triglycerides, peak wave velocity (PWV) and Augmentation Index (AI)] from 1992 through 2017. Meta-analysis was based on a random-effects model and inverse variance method to calculate standardized mean difference (SMD) as effect sizes, followed by a leave-one-out method for sensitivity analysis. Risk of publication bias was assessed using Cochrane checklist and Begg funnel plots. The systematic review is registered as CRD42015025346. Results: We identified 2341 studies from which 81 met inclusion criteria. The meta-analysis indicated a significant reduction in systolic blood pressure (SMD = −0.102 ± 0.04 mmHg, 95% confidence interval (CI), −0.20 to −0.03), diastolic blood pressure (SMD = −0.07 ± 0.03 mmHg, 95% CI, −0.14 to −0.006), serum PTH (SMD = −0.66 ± 0.08 ng/L, 95% CI, −0.82 to −0.49), hs-CRP (SMD = −0.20 ± 0.07 mg/L, 95% CI, −0.34 to −0.06), total cholesterol (SMD = −0.15 ± 0.06 mmol/L, 95% CI, −0.25 to −0.04), LDL (SMD = −0.10 ± 0.05 mmol/L, 95% CI, −0.20 to −0.003), triglycerides (SMD = −0.12 ± 0.06 mmol/L, 95% CI, −0.23 to −0.003) and a significant increase in HDL (SMD = 0.09 ± 0.04 mmol/L, 95% CI, 0.00 to 0.17) with vitamin D supplementation. These findings remained significant in sensitivity analyses for blood pressure, lipid profile, serum PTH, and serum hs-CRP. There was no significant effect of vitamin D supplementation on PWV (SMD = −0.20 ± 0.13 m/s, 95% CI, −0.46 to 0.06, p = 0.14) and AI (SMD = −0.09 ± 0.14%, 95% CI, −0.37 to 0.19, p = 0.52) for vitamin D supplemented groups. Conclusion: These findings suggest that vitamin D supplementation may act to protect against CVD through improving risk factors, including high blood pressure, elevated PTH, dyslipidemia, and inflammation.
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Affiliation(s)
| | | | - Samantha M Kimball
- Pure North S'Energy Foundation, Calgary, AB, Canada.,St. Mary's University, Calgary, AB, Canada
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Ávila-Rubio V, García-Fontana B, Novo-Rodríguez C, Cantero-Hinojosa J, Reyes-García R, Muñoz-Torres M. Higher Levels of Serum 25-Hydroxyvitamin D Are Related to Improved Glucose Homeostasis in Women with Postmenopausal Osteoporosis. J Womens Health (Larchmt) 2018; 27:1007-1015. [PMID: 29874115 DOI: 10.1089/jwh.2017.6806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Postmenopausal osteoporosis (PMO) is associated with other comorbidities such as impaired glucose homeostasis and cardiovascular disease. Vitamin D insufficiency is highly prevalent and may be a common link between these disorders. However, the relationship between circulating 25-hydroxyvitamin D [25(OH)D] and insulin resistance in women with PMO has not been well evaluated. The aim of this study was to assess the relationship between circulating levels of 25(OH)D and parameters of glucose homeostasis in a cohort of women with PMO to establish a serum concentration threshold of 25(OH)D for improved glycemic parameters. MATERIALS AND METHODS This cross-sectional study included 40 women with PMO. We measured 25(OH)D serum levels and glucose homeostasis parameters (glucose and insulin levels, insulin sensitivity, and β-secretion index HOMA2-%S and HOMA2-%B, respectively). Anthropometric, biochemical, and clinical parameters and bone markers were also evaluated. RESULTS Circulating levels of 25(OH)D were related to glucose parameters (negatively with HOMA2-%B and insulin levels and positively with HOMA2-%S) in women with PMO, resulting in an indicator of insulin sensitivity independent of age, body mass index, percent body fat, and undercarboxylated osteocalcin. Patients with serum 25(OH)D ≥45 ng/mL showed lower HOMA2-%B values and insulinemia and greater HOMA2-%S. CONCLUSIONS Our results support the hypothesis that circulating 25(OH)D levels are related to improved glucose homeostasis in women with PMO. However, this relationship was apparent only in the presence of high circulating levels of 25(OH)D.
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Affiliation(s)
- Verónica Ávila-Rubio
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,2 Department of Medicine, University of Granada , Granada, Spain
| | - Beatriz García-Fontana
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,3 CIBERFES, Instituto de Salud Carlos III , Madrid, Spain
| | - Cristina Novo-Rodríguez
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain
| | - Jesús Cantero-Hinojosa
- 2 Department of Medicine, University of Granada , Granada, Spain .,4 Unit of Internal Medicine, Hospital Universitario San Cecilio , Granada, Spain
| | - Rebeca Reyes-García
- 5 Endocrinology and Nutrition Unit, Complejo Hospitalario Torrecardenas , Almería, Spain
| | - Manuel Muñoz-Torres
- 1 Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs. GRANADA) , Granada, Spain .,2 Department of Medicine, University of Granada , Granada, Spain .,3 CIBERFES, Instituto de Salud Carlos III , Madrid, Spain
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Role of Vitamin D Beyond the Skeletal Function: A Review of the Molecular and Clinical Studies. Int J Mol Sci 2018; 19:ijms19061618. [PMID: 29849001 PMCID: PMC6032242 DOI: 10.3390/ijms19061618] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
The classical function of Vitamin D, which involves mineral balance and skeletal maintenance, has been known for many years. With the discovery of vitamin D receptors in various tissues, several other biological functions of vitamin D are increasingly recognized and its role in many human diseases like cancer, diabetes, hypertension, cardiovascular, and autoimmune and dermatological diseases is being extensively explored. The non-classical function of vitamin D involves regulation of cellular proliferation, differentiation, apoptosis, and innate and adaptive immunity. In this review, we discuss and summarize the latest findings on the non-classical functions of vitamin D at the cellular/molecular level and its role in complex human diseases.
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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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Li X, Liu Y, Zheng Y, Wang P, Zhang Y. The Effect of Vitamin D Supplementation on Glycemic Control in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10030375. [PMID: 29562681 PMCID: PMC5872793 DOI: 10.3390/nu10030375] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 01/13/2023] Open
Abstract
Observational studies have indicated an inverse association between vitamin D levels and the risk of diabetes, yet evidence from population interventions remains inconsistent. PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched up to September 2017. Data from studies regarding serum 25(OH)D, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were pooled. Twenty studies (n = 2703) were included in the meta-analysis. Vitamin D supplementation resulted in a significant improvement in serum 25(OH)D levels (weighted mean difference (WMD) = 33.98; 95%CI: 24.60-43.37) and HOMA-IR (standardized mean difference (SMD) = -0.57; 95%CI: -1.09~-0.04), but not in other outcomes. However, preferred changes were observed in subgroups as follows: short-term (WMDFBG = -8.44; 95%CI: -12.72~-4.15), high dose (WMDFBG = -8.70; 95%CI: -12.96~-4.44), non-obese (SMDFasting insulin = -1.80; 95%CI: -2.66~-0.95), Middle Easterners (WMDFBG = -10.43; 95%CI: -14.80~-6.06), baseline vitamin D deficient individuals (WMDFBG = -5.77; 95%CI: -10.48~-1.05) and well-controlled HbA1c individuals (WMDFBG = -4.09; 95%CI: -15.44~7.27). Vitamin D supplementation was shown to increase serum 25(OH)D and reduce insulin resistance effectively. This effect was especially prominent when vitamin D was given in large doses and for a short period of time, and to patients who were non-obese, Middle Eastern, vitamin D deficient, or with optimal glycemic control at baseline.
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Affiliation(s)
- Xinyi Li
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yan Liu
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yingdong Zheng
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Peiyu Wang
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yumei Zhang
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
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Santos RKF, Brandão-Lima PN, Tete RMDD, Freire ARS, Pires LV. Vitamin D ratio and glycaemic control in individuals with type 2 diabetes mellitus: A systematic review. Diabetes Metab Res Rev 2018; 34. [PMID: 29172025 DOI: 10.1002/dmrr.2969] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/30/2017] [Accepted: 11/17/2017] [Indexed: 01/25/2023]
Abstract
Several studies have suggested a favorable role for vitamin D in glycaemic metabolism and its potential as adjuvant treatment of type 2 diabetes mellitus. This review discusses the role of vitamin D in the glycaemic control of individuals with type 2 diabetes mellitus and evaluates the effect of vitamin D supplementation on glycaemic markers in this population. Literature searches were performed in the BIREME, LILACS, and PubMed databases using the Medical Subject Headings and words related to vitamin D, type 2 diabetes mellitus, and glycaemic control. Interventional and observational studies were considered eligible. The evaluation of the included studies was independently performed by 2 evaluators at all stages of selection, data extraction, and bias risk assessment. The primary outcome was the relationship between vitamin D levels and glucose metabolism markers in type 2 diabetes mellitus individuals. The secondary outcome was the effect of vitamin D supplementation on the glycaemic control markers in individuals with type 2 diabetes mellitus. The inverse relationship between vitamin D and variables of glucose metabolism was verified. Interventional studies revealed that vitamin D supplementation did not alter glycaemic control markers in most studies. Few studies have shown positive effects with a significant reduction in the percentage of glycated haemoglobin, insulin, and glucose concentrations, and changes in homeostatic model assessment-insulin resistance and beta cell, and quantitative insulin sensitivity check index. Therefore, despite the association of vitamin D with glucose metabolism, there is insufficient evidence of the beneficial effects of its supplementation on the metabolic control of type 2 diabetes mellitus.
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Affiliation(s)
| | | | | | - Analícia Rocha Santos Freire
- Nutrition Sciences Post-graduation Program, Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Liliane Viana Pires
- Nutrition Sciences Post-graduation Program, Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
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Lim LL, Ng YM, Kang PS, Lim SK. Association between serum 25-hydroxyvitamin D and glycated hemoglobin levels in type 2 diabetes patients with chronic kidney disease. J Diabetes Investig 2018; 9:375-382. [PMID: 28519964 PMCID: PMC5835453 DOI: 10.1111/jdi.12696] [Citation(s) in RCA: 7] [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: 01/23/2017] [Revised: 04/06/2017] [Accepted: 05/08/2017] [Indexed: 02/07/2023] Open
Abstract
AIMS/INTRODUCTION Vitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25-hydroxyvitamin D (25[OH]D) and glycemic control in non-chronic kidney disease (CKD) patients with type 2 diabetes was reported. We aimed to examine this association among type 2 diabetes patients with CKD. MATERIALS AND METHODS A total of 100 type 2 diabetes participants with stage 3-4 CKD were recruited. Blood for glycated hemoglobin (HbA1c ), serum 25(OH)D, renal and lipid profiles were drawn at enrollment. Correlation and regression analyses were carried out to assess the relationship of serum 25(OH)D, HbA1c and other metabolic traits. RESULTS A total of 30, 42, and 28% of participants were in CKD stage 3a, 3b and 4, respectively. The proportions of participants based on ethnicity were 51% Malay, 24% Chinese and 25% Indian. The mean (±SD) age and body mass index were 60.5 ± 9.0 years and 28.3 ± 5.9 kg/m2 , whereas mean HbA1c and serum 25(OH)D were 7.9 ± 1.6% and 37.1 ± 22.2 nmol/L. HbA1c was negatively correlated with serum 25(OH)D (rs = -0.314, P = 0.002), but positively correlated with body mass index (rs = 0.272, P = 0.006) and serum low-density lipoprotein cholesterol (P = 0.006). There was a significant negative correlation between serum 25(OH)D and total daily dose of insulin prescribed (rs = -0.257, P = 0.042). Regression analyses showed that every 10-nmol/L decline in serum 25(OH)D was associated with a 0.2% increase in HbA1c . CONCLUSIONS Lower serum 25(OH)D was associated with poorer glycemic control and higher insulin use among multi-ethnic Asians with type 2 diabetes and stage 3-4 CKD.
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Affiliation(s)
- Lee Ling Lim
- Division of EndocrinologyUniversity of MalayaKuala LumpurMalaysia
| | - Yong Muh Ng
- Division of NephrologyDepartment of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Pei San Kang
- Department of Primary Care MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Soo Kun Lim
- Division of NephrologyDepartment of MedicineUniversity of MalayaKuala LumpurMalaysia
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Mathias MG, Coelho‐Landell CDA, Scott‐Boyer M, Lacroix S, Morine MJ, Salomão RG, Toffano RBD, Almada MORDV, Camarneiro JM, Hillesheim E, de Barros TT, Camelo‐Junior JS, Campos Giménez E, Redeuil K, Goyon A, Bertschy E, Lévêques A, Oberson J, Giménez C, Carayol J, Kussmann M, Descombes P, Métairon S, Draper CF, Conus N, Mottaz SC, Corsini GZ, Myoshi SKB, Muniz MM, Hernandes LC, Venâncio VP, Antunes LMG, da Silva RQ, Laurito TF, Rossi IR, Ricci R, Jorge JR, Fagá ML, Quinhoneiro DCG, Reche MC, Silva PVS, Falquetti LL, da Cunha THA, Deminice TMM, Tambellini TH, de Souza GCA, de Oliveira MM, Nogueira‐Pileggi V, Matsumoto MT, Priami C, Kaput J, Monteiro JP. Clinical and Vitamin Response to a Short-Term Multi-Micronutrient Intervention in Brazilian Children and Teens: From Population Data to Interindividual Responses. Mol Nutr Food Res 2018; 62:e1700613. [PMID: 29368422 PMCID: PMC6120145 DOI: 10.1002/mnfr.201700613] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/02/2017] [Indexed: 12/11/2022]
Abstract
SCOPE Micronutrients are in small amounts in foods, act in concert, and require variable amounts of time to see changes in health and risk for disease. These first principles are incorporated into an intervention study designed to develop new experimental strategies for setting target recommendations for food bioactives for populations and individuals. METHODS AND RESULTS A 6-week multivitamin/mineral intervention is conducted in 9-13 year olds. Participants (136) are (i) their own control (n-of-1); (ii) monitored for compliance; (iii) measured for 36 circulating vitamin forms, 30 clinical, anthropometric, and food intake parameters at baseline, post intervention, and following a 6-week washout; and (iv) had their ancestry accounted for as modifier of vitamin baseline or response. The same intervention is repeated the following year (135 participants). Most vitamins respond positively and many clinical parameters change in directions consistent with improved metabolic health to the intervention. Baseline levels of any metabolite predict its own response to the intervention. Elastic net penalized regression models are identified, and significantly predict response to intervention on the basis of multiple vitamin/clinical baseline measures. CONCLUSIONS The study design, computational methods, and results are a step toward developing recommendations for optimizing vitamin levels and health parameters for individuals.
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Affiliation(s)
| | | | - Marie‐Pier Scott‐Boyer
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
| | - Sébastien Lacroix
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
| | - Melissa J. Morine
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
- Department of MathematicsUniversity of TrentoTrentoItaly
| | - Roberta Garcia Salomão
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | - Elaine Hillesheim
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nelly Conus
- Nestlé Institute of Health SciencesLausanneSwitzerland
| | | | | | | | - Mariana Mendes Muniz
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | - Vinícius Paula Venâncio
- School of Pharmaceutical Science of Ribeirao PretoUniversity of São PauloRibeirao PretoBrazil
| | | | | | - Taís Fontellas Laurito
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Isabela Ribeiro Rossi
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Raquel Ricci
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Jéssica Ré Jorge
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | - Mayara Leite Fagá
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | - Letícia Lima Falquetti
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | | | | | | | | | - Vicky Nogueira‐Pileggi
- Department of PediatricsFaculty of MedicineNutrition and MetabolismUniversity of São Paulo
| | | | - Corrado Priami
- The Microsoft Research, Centre for Computational and Systems Biology (COSBI)University of TrentoRoveretoItaly
- Department of MathematicsUniversity of TrentoTrentoItaly
| | - Jim Kaput
- Nestlé Institute of Health SciencesLausanneSwitzerland
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Angellotti E, D'Alessio D, Dawson-Hughes B, Nelson J, Cohen RM, Gastaldelli A, Pittas AG. Vitamin D Supplementation in Patients With Type 2 Diabetes: The Vitamin D for Established Type 2 Diabetes (DDM2) Study. J Endocr Soc 2018; 2:310-321. [PMID: 29577107 PMCID: PMC5848819 DOI: 10.1210/js.2018-00015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/21/2018] [Indexed: 01/10/2023] Open
Abstract
Context Observational data support a role for vitamin D in type 2 diabetes, but evidence from trials is inconclusive. Objective To evaluate the effect of vitamin D supplementation on β-cell function and hemoglobin A1c (HbA1c) in patients with well-controlled type 2 diabetes. Design Double-blind, randomized, placebo-controlled clinical trial. Setting Tufts Medical Center, Boston, MA; VA Medical Center, Cincinnati, OH. Participants A total of 127 patients (mean age, 60 years) with stable (HbA1c ≤7.5%) diabetes managed with lifestyle only or lifestyle plus metformin. Intervention Subjects were given 4000 units of vitamin D3 (cholecalciferol) daily or placebo for 48 weeks. Main Outcome Measure Insulin secretion rate (ISR) was estimated from peripheral plasma C-peptide levels after a 3-hour 75-g oral glucose tolerance test done at baseline and week 24. Changes in HbA1c were assessed at 16, 24, 36, and 48 weeks. Results Baseline mean plasma 25-hydroxyvitamin D [25(OH)D] concentration was 26.6 ng/mL, mean HbA1c was 6.6%, and 78% of patients were on metformin. At week 24, mean 25(OH)D changed by 20.5 and −1.6 ng/mL in the vitamin D and placebo groups, respectively (P < 0.001). The vitamin D and placebo groups did not differ in change in ISR or HbA1c. Among patients treated with lifestyle only (n = 28), vitamin D supplementation reduced HbA1c compared with placebo (−0.1% vs 0.3%, respectively; P = 0.034) at week 24. This result was not observed at the other time points and could be due to chance. Conclusion Vitamin D3 at 4000 IU/d did not change ISR or HbA1c in patients with well-controlled type 2 diabetes on metformin not selected for vitamin D deficiency.
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Affiliation(s)
- Edith Angellotti
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts
| | - David D'Alessio
- Division of Endocrinology, Diabetes and Metabolism, Duke University, Durham, North Carolina
| | - Bess Dawson-Hughes
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts.,Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jason Nelson
- Predictive Analytics and Comparative Effectiveness (PACE) Center, Tufts Medical Center, Boston, Massachusetts
| | - Robert M Cohen
- Division of Endocrinology, Diabetes & Metabolism University of Cincinnati College of Medicine and Cincinnati VA Medical Center, Cincinnati, Ohio
| | - Amalia Gastaldelli
- Cardiometabolic Risk Laboratory, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts
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Vitamin D3-fortified milk did not affect glycemic control, lipid profile, and anthropometric measures in patients with type 2 diabetes, a triple-blind randomized clinical trial. Eur J Clin Nutr 2018; 72:1083-1092. [DOI: 10.1038/s41430-017-0062-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/06/2017] [Accepted: 08/10/2017] [Indexed: 01/29/2023]
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