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Yari Z, Nikooyeh B, Neyestani TR. Circulating 25-hydroxyvitamin D is associated with metabolic phenotypes of obesity: National Food and Nutrition Surveillance. Nutr Res 2023; 110:14-22. [PMID: 36640580 DOI: 10.1016/j.nutres.2022.12.006] [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: 07/22/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Different phenotypes of obesity are each related with different complications and comorbidities. We hypothesized that suboptimal vitamin D status is directly associated with an unhealthy metabolic status, especially if allied with obesity. This cross-sectional study was performed in the framework of the National Food and Nutrition Surveillance. Overall, 1098 men and women participated in this study. In addition to height and weight, serum concentrations of 25-hydroxyvitamin D (25(OH)D) and glycemic and lipidemic status were evaluated. Then participants were classified into 4 groups based on body mass index and lipidemic and glycemic profile status, as follows: hyperglycemic-dyslipidemic obese (HDO), hyperglycemic-dyslipidemic nonobese (HDNO), normoglycemic-normolipidemic obese (NNO), and normoglycemic-normolipidemic nonobese (NNNO). In this study, 31.6% of participants were classified as HDO, 7.5% as HDNO, 34.5% as NNO, and 26.4% as NNNO. The frequency of suboptimal vitamin D status was more prevalent in HDO (81.8%) than in other phenotypes (HDNO, 80%; NNO, 77.6%; NNNO, 73.8%; P = .015). In the multivariate model, suboptimal vitamin D status significantly increased the odds of being NNO (odds ratio [OR], 1.28; 95% CI, 0.84-1.95), HDNO (OR, 1.48; 95% CI, 0.77-2.83), and HDO (OR, 1.73; 95% CI, 1.11-2.7) compared with the NNNO group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25(OH)D concentration, the odds of HDNO and HDO decreased significantly by 4% (OR, 0.96; 95% CI, 0.94-0.98) and 7% (OR, 0.93; 95% CI, 0.92-0.95), respectively. The results of the study showed a significant relationship between serum 25(OH)D concentrations and metabolic obesity phenotypes; these data confirm the association between suboptimal vitamin D status and metabolic complications, especially in obese individuals.
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Affiliation(s)
- Zahra Yari
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R Neyestani
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Daoust L, Pilon G, Marette A. Perspective: Nutritional Strategies Targeting the Gut Microbiome to Mitigate COVID-19 Outcomes. Adv Nutr 2021; 12:1074-1086. [PMID: 33783468 PMCID: PMC8083677 DOI: 10.1093/advances/nmab031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023] Open
Abstract
More than a year has passed since the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection in the city of Wuhan in China's Hubei Province. Until now, few antiviral medications (e.g., remdesivir) or drugs that target inflammatory complications associated with SARS-CoV2 infection have been considered safe by public health authorities. By the end of November 2020, this crisis had led to >1 million deaths and revealed the high susceptibility of people with pre-existing comorbidities (e.g., obesity, diabetes, coronary heart disease, hypertension) to suffer from a severe form of the disease. Elderly people have also been found to be highly susceptible to SARS-CoV2 infection and morbidity. Gastrointestinal manifestations and gut microbial alterations observed in SARS-CoV2-infected hospitalized patients have raised awareness of the potential role of intestinal mechanisms in increasing the severity of the disease. It is therefore critically important to find alternative or complementary approaches, not only to prevent or treat the disease, but also to reduce its growing societal and economic burden. In this review, we explore potential nutritional strategies that implicate the use of polyphenols, probiotics, vitamin D, and ω-3 fatty acids with a focus on the gut microbiome, and that could lead to concrete recommendations that are easily applicable to both vulnerable people with pre-existing metabolic comorbidities and the elderly, but also to the general population.
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Affiliation(s)
- Laurence Daoust
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
| | - Geneviève Pilon
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
| | - André Marette
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
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Esmaili H, Heshmat R, Ejtahed HS, Rastad H, Motlagh ME, Asayesh H, Jafarnejad M, Seif E, Qorbani M, Kelishadi R. Association of Serum 25-Hydroxyvitamin D Level With Metabolic Phenotypes of Obesity in Children and Adolescents: The CASPIAN-V Study. Front Endocrinol (Lausanne) 2020; 11:310. [PMID: 32612573 PMCID: PMC7308554 DOI: 10.3389/fendo.2020.00310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/23/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Different metabolic phenotypes of obesity are related to cardiometabolic risk factors in children and adolescents. Vitamin D, as one important factor, could be related to different subgroups of metabolic obesity and might affect metabolic disorders. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents. Methods: This nationwide cross-sectional study was conducted in the framework of the fifth survey of a national surveillance program, the CASPIAN study. Overall, 2,594 students aged 7-18 years were assessed for 25-hydroxyvitamin D status. Metabolic syndrome (MetS) was defined according to the ATP III criteria modified for the pediatric age group. Participants were classified into four metabolic phenotypes of obesity according to categories of the BMI and metabolic status: "metabolically healthy obese" (MHO), "metabolically non-healthy non-obese" (MNHNO), "metabolically non-healthy obese" (MNHO), and "metabolically healthy non-obese" (MHNO). Multinomial logistic regression analysis was performed for evaluating the association of 25-hydroxyvitamin D status with different metabolic phenotypes of obesity. Results: In this study, 85.2% of participants were classified as MHNO, 11.0 % as MHO, 2.5% as MNHNO, and 1.3% as MNHO. The frequency of hypovitaminosis D was more prevalent in MNHO (85.3%) than in other phenotypes (MHNO: 70%; MHO: 76.5%; MNHNO: 78.1%, respectively; p < 0.05). In the multivariate model, hypovitaminosis D significantly increased the odds of being MHO (OR: 1.46; 95% CI: 1.07-1.77) and MNHO (OR: 2.89; 1.05-8.31) compared to the healthy group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25-hydroxyvitamin D concentration, the odds of MNHNO and MNHO decreased significantly by 7% (OR: 0.93; 0.91-0.96) and 6% (OR: 0.94; 0.91-0.98) respectively. Conclusion: Our results support the hypothesis that 25-hydroxyvitamin D concentration is associated with metabolic obesity phenotypes. Longitudinal studies are necessary to assess the clinical impacts of this finding.
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Affiliation(s)
- Haleh Esmaili
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadith Rastad
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Marzieh Jafarnejad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Qorbani
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Roya Kelishadi
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Saande CJ, Webb JL, Curry PE, Rowling MJ, Schalinske KL. Dietary Whole Egg Reduces Body Weight Gain in a Dose-Dependent Manner in Zucker Diabetic Fatty Rats. J Nutr 2019; 149:1766-1775. [PMID: 31254347 DOI: 10.1093/jn/nxz143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We previously reported that a whole-egg-based diet attenuated weight gain in rats with type 2 diabetes (T2D) and more effectively maintained vitamin D status than an equivalent amount of supplemental cholecalciferol. OBJECTIVES The objective of this study was to determine the lowest dose of whole egg effective at maintaining vitamin D homeostasis and attenuating the obese phenotype in T2D rats. METHODS Zucker diabetic fatty (ZDF) rats (n = 40; age 6 wk; prediabetic) and their lean controls (n = 40; age 6 wk) were randomly assigned to a diet containing 20% casein (CAS) or 20%, 10%, 5%, or 2.5% protein from whole egg (20% EGG, 10% EGG, 5% EGG, and 2.5% EGG, respectively). All diets contained 20% total protein (wt:wt). All rats received their respective diets for 8 wk, at a stage of growth and development that translates to adolescence in humans, until 14 wk of age, a point at which ZDF rats exhibit overt T2D. Weight gain was measured 5 d/wk, and circulating 25-hydroxyvitamin D [25(OH)D] was measured by ELISA. Mean values were compared by 2-factor ANOVA. RESULTS The 20% EGG diet maintained serum 25(OH)D at 30 nmol/L in ZDF rats, whereas the 10%, 5%, and 2.5% EGG diets did not prevent insufficiency, resulting in mean serum 25(OH)D concentrations of 24 nmol/L in ZDF rats. Body weight gain was reduced by 29% (P < 0.001) and 31% (P < 0.001) in ZDF rats consuming 20% and 10% EGG diets, respectively, and by 16% (P = 0.004) and 12% (P = 0.030) in ZDF rats consuming 5% and 2.5% EGG diets, respectively, compared with CAS. CONCLUSIONS Whole-egg-based diets exerted a dose-dependent response with respect to attenuating weight gain. These data could support dietary recommendations aimed at body weight management in individuals predisposed to obesity and T2D.
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Affiliation(s)
- Cassondra J Saande
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Joseph L Webb
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Paige E Curry
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Matthew J Rowling
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Kevin L Schalinske
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
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Rahimi MH, Mollahosseini M, Mirzababaei A, Yekaninejad MS, Maghbooli Z, Mirzaei K. Interactions between vitamin D binding protein variants and major dietary patterns on the odds of metabolic syndrome and its components in apparently healthy adults. Diabetol Metab Syndr 2019; 11:28. [PMID: 31007727 PMCID: PMC6454781 DOI: 10.1186/s13098-019-0422-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/14/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies have shown that the risks of chronic diseases resulting from high-risk alleles, such as cardiovascular diseases and metabolic syndrome (MetS), can be affected by various dietary patterns. Among the genes affected by environmental factors are those associated with vitamin D binding protein (DBP). METHODS This cross-sectional study was conducted on a random sample of 265 apparently healthy adults aged 18-50. MetS was defined according to the adult treatment panel III criteria. Major dietary patterns were determined using factor analysis on 24 food groups, using a valid and reliable 147-item food frequency questionnaire (FFQ). DBP genotypes were determined by polymerase chain reactions-restriction fragment length polymorphism (PCR-RFLP). RESULTS After adjustment for confounder factors, results demonstrated strong interactions between, on the one hand, a high intake of healthy pattern and DBP haplotype (rs7041/rs4588 major alleles) and on the other, low MetS odds (OR = 0.64, 95% CI 0.47-0.87, P ≤ 0.001), serum triglyceride levels (OR = 0.72, 95% CI 0.56-0.93, P = 0.01) and fasting blood glucose (OR = 0.36, 95% CI 0.14-0.96, P = 0.04). Also, individuals with a higher adherence to traditional dietary patterns demonstrated reduced odds of high waist circumference among the major allele (low-risk allele) carriers of rs7041/rs4588 (OR = 0.69, 95% CI 0.55-0.88, P = 0. 003). Interactions were also seen between high traditional pattern intake and DBP haplotype elevated blood pressure odds (OR = 1.31, 95% CI 1.02-1.68, P = 0.02). CONCLUSIONS The present evidence indicates that interactions between healthy dietary patterns with DBP haplotypes (Gc 1F, Gc 1S and Gc 2) and traditional dietary patterns with DBP haplotypes may be effective in reducing the odds of MetS and some of its components through consuming healthy food groups and inherited low risk alleles.
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Affiliation(s)
- Mohammad Hossein Rahimi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mollahosseini
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhila Maghbooli
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
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Rafiq S, Jeppesen PB. Body Mass Index, Vitamin D, and Type 2 Diabetes: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10091182. [PMID: 30154381 PMCID: PMC6164132 DOI: 10.3390/nu10091182] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
The deficiency of vitamin D is prevalent all over the world. Studies have shown that vitamin D may play an important role in the development of obesity. The current study was conducted to quantitatively evaluate the association between serum 25-(OH) vitamin D levels and the risk of obesity in both diabetic and non-diabetic subjects. A systematic review and meta-analysis of observational studies was carried out for that purpose. We searched the Medline, PubMed, and Embase databases throughout all of March 2018. A total of fifty five observational studies for both diabetic and non-diabetic subjects were finally included in the meta-analysis. The data were analyzed by comprehensive meta-analysis software version 3 and the random effects model was used to analyze the data. The meta-analysis showed an overall inverse relationship between serum vitamin D status and body mass index (BMI) in studies of both diabetic (r = −0.173, 95% = −0.241 to −0.103, p = 0.000) and non-diabetic (r = −0.152, 95% = −0.187 to −0.116, p = 0.000) subjects. The evidence of publication bias was not found in this meta-analysis. In conclusion, the deficiency of vitamin D is associated with an increased level of BMI in the studies of both diabetic and non-diabetic subjects. Reliable evidence from well-designed future randomized controlled trials is required to confirm the findings from observational studies and to find out the potential regulatory effects of vitamin D supplementation to lower BMI.
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Affiliation(s)
- Shamaila Rafiq
- Department of Clinical Medicine Aarhus University, 8200 Aarhus, Denmark.
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Saande CJ, Jones SK, Hahn KE, Reed CH, Rowling MJ, Schalinske KL. Dietary Whole Egg Consumption Attenuates Body Weight Gain and Is More Effective than Supplemental Cholecalciferol in Maintaining Vitamin D Balance in Type 2 Diabetic Rats. J Nutr 2017; 147:1715-1721. [PMID: 28794211 DOI: 10.3945/jn.117.254193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/07/2017] [Accepted: 07/10/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Type 2 diabetes (T2D) is characterized by vitamin D insufficiency owing to excessive urinary loss of 25-hydroxycholecalciferol [25(OH)D]. We previously reported that a diet containing dried whole egg, a rich source of vitamin D, was effective at maintaining circulating 25(OH)D concentrations in rats with T2D. Furthermore, whole egg consumption reduced body weight gain in rats with T2D.Objective: This study was conducted to compare whole egg consumption with supplemental cholecalciferol with respect to vitamin D balance, weight gain, and body composition in rats with T2D.Methods: Male Zucker diabetic fatty (ZDF) rats (n = 24) and their lean controls (n = 24) were obtained at 5 wk of age and randomly assigned to 3 treatment groups: a casein-based diet (CAS), a dried whole egg-based diet (WE), or a casein-based diet containing supplemental cholecalciferol (CAS+D) at the same amount of cholecalciferol provided by WE (37.6 μg/kg diet). Rats were fed their respective diets for 8 wk. Weight gain and food intake were measured daily, circulating 25(OH)D concentrations were measured by ELISA, and body composition was analyzed by dual X-ray absorptiometry.Results: Weight gain and percentage of body fat were reduced by ∼20% and 11%, respectively, in ZDF rats fed WE compared with ZDF rats fed CAS or CAS+D. ZDF rats fed CAS had 21% lower serum 25(OH)D concentrations than lean rats fed CAS. In ZDF rats, WE consumption increased serum 25(OH)D concentrations 130% compared with CAS, whereas consumption of CAS+D increased serum 25(OH)D concentrations 35% compared with CAS.Conclusions: Our data suggest that dietary consumption of whole eggs is more effective than supplemental cholecalciferol in maintaining circulating 25(OH)D concentrations in rats with T2D. Moreover, whole egg consumption attenuated weight gain and reduced percentage of body fat in ZDF rats. These data may support new dietary recommendations targeting the prevention of vitamin D insufficiency in T2D.
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Affiliation(s)
- Cassondra J Saande
- Department of Food Science and Human Nutrition and.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA
| | - Samantha K Jones
- Department of Food Science and Human Nutrition and.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA
| | | | | | - Matthew J Rowling
- Department of Food Science and Human Nutrition and.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA
| | - Kevin L Schalinske
- Department of Food Science and Human Nutrition and .,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA
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RAŠKA I, RAŠKOVÁ M, ZIKÁN V, ŠKRHA J. Body Composition is Associated With Bone and Glucose Metabolism in Postmenopausal Women With Type 2 Diabetes Mellitus. Physiol Res 2017; 66:99-111. [DOI: 10.33549/physiolres.933310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with increased fracture risk; the underlying mechanism remains unexplained. This study aimed to investigate the relationships between body composition and bone and glucose metabolism in postmenopausal women with T2DM. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) and body composition. A total of 68 postmenopausal women with T2DM and 71 controls were eligible for the study. In contrast to normal BMD in T2DM, a similar prevalence of low-trauma fractures was observed in both groups. T2DM women had significantly higher Trunk fat% and A/G ratio and significantly lower Legs LM% and Legs FM%. Legs LM% was significantly lower in fractured T2DM group and negatively correlated with glycaemia and HbA1c (p<0.01). Serum osteocalcin was significantly lower in T2DM and inversely correlated with FM%, Trunk FM% and A/G ratio (p<0.01) and positively correlated with Legs FM% and total LM% (p<0.05). In conclusion, abdominal obesity and decrease in muscle mass may contribute to low bone formation in T2DM women. Further research is needed to unravel underlying pathophysiological mechanisms and to determine whether maintenance of muscle mass, especially in the lower extremities and/or reduction of central fat mass can prevent fractures.
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Affiliation(s)
| | | | - V. ZIKÁN
- Third Department of Medicine – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
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McKinney TJ, Patel JJ, Benns MV, Nash NA, Miller KR. Vitamin D Status and Supplementation in the Critically Ill. Curr Gastroenterol Rep 2016; 18:18. [PMID: 26951231 DOI: 10.1007/s11894-016-0492-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Vitamin D deficiency has recently been recognized as a widespread global disorder. Generally considered a direct extension of malnutrition, even subclinical hypovitaminosis D is now recognized in adequately nourished populations. Compared to the general population, the prevalence of hypovitaminosis D is greater in the critically ill population. In fact, several studies have shown poorer outcomes in critically ill patients discovered to be vitamin D deficient or insufficient. Controversy persists regarding vitamin D measurements, quantity of supplementation, and appropriate target level in various populations. Vitamin D has a vital role in calcium homeostasis and extra-skeletal health, such as immune function. Therefore, vitamin D supplementation may have a role for improving outcomes in critically ill patients. In this review, we will first discuss the metabolism and function of vitamin D under normal physiologic conditions. We will then explore the prevalence and prognostic value of vitamin D deficiency in critical illness. Finally, we will examine recent trials focusing on appropriate dosing, route of administration, and outcomes associated with vitamin D supplementation in the ICU.
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Affiliation(s)
- T J McKinney
- Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA
| | - Jayshil J Patel
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Matthew V Benns
- Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA
| | - Nicholas A Nash
- Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA
| | - Keith R Miller
- Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA.
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Wang X, Chang X, Zhu Y, Wang H, Sun K. Metabolically Obese Individuals of Normal Weight Have a High Risk of 25-Hydroxyvitamin D Deficiency. Am J Med Sci 2016; 352:360-367. [DOI: 10.1016/j.amjms.2016.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 06/22/2016] [Accepted: 06/28/2016] [Indexed: 01/23/2023]
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Choi SW, Kweon SS, Lee YH, Ryu SY, Choi JS, Rhee JA, Nam HS, Jeong SK, Park KS, Kim HN, Shin MH. 25-Hydroxyvitamin D and Parathyroid Hormone Levels Are Independently Associated with the Hemoglobin A1c Level of Korean Type 2 Diabetic Patients: The Dong-Gu Study. PLoS One 2016; 11:e0158764. [PMID: 27362844 PMCID: PMC4928954 DOI: 10.1371/journal.pone.0158764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/21/2016] [Indexed: 11/19/2022] Open
Abstract
In type 2 diabetic patients, the relationships between 25-hydroxyvitamin D and parathyroid hormone levels, and glycemic control, remain unclear. We evaluated associations between 25-hydroxyvitamin D, parathyroid hormone, and hemoglobin A1c levels after adjusting for other covariates, including log transformed 25-hydroxyvitamin D levels and log transformed parathyroid hormone levels, in Korean patients with type 2 diabetes. In total, 1,175 patients with type 2 diabetes were selected from 8,857 individuals who completed the baseline survey of the Dong-gu study, conducted in Korea from 2007 to 2010. After adjusting for other covariates, we found that the mean hemoglobin A1c level was inversely associated with the 25-hydroxyvitamin D level (Q1: 7.47% [7.30–7.63], Q2: 7.25% [7.09–7.40], Q3: 7.17% [7.02–7.32], Q4: 7.19% [7.02–7.35]; p for trend = 0.021, p for between groups = 0.050) and the parathyroid hormone level (Q1: 7.35% [7.19–7.51], Q2: 7.34% [7.19–7.50], Q3: 7.28% [7.13–7.43], Q4: 7.09% [6.94–7.24]; p for trend = 0.022, p for between groups = 0.048). However, the mean fasting glucose level was not associated with either the 25-hydroxyvitamin D or parathyroid hormone level. In conclusion, inverse associations were evident between hemoglobin A1c, 25-hydroxyvitamin D and parathyroid hormone levels in Korean patients with type 2 diabetes. The associations remained significant after adjusting for other covariates, including the log transformed 25-hydroxyvitamin D levels and log transformed parathyroid hormone levels.
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Affiliation(s)
- Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju 501–759, Republic of Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 501–746, Republic of Korea
- Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun, Jeollanamdo 519–809, Republic of Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, 344–2 Shinyong-dong, Iksan, Jeollabukdo 570–711, Republic of Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju 501–759, Republic of Korea
| | - Jin-Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 501–746, Republic of Korea
| | - Jung-Ae Rhee
- Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 501–746, Republic of Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Munhwa 1(il)-dong, Jung-gu, Daejeon 301–747, Republic of Korea
| | - Seul-Ki Jeong
- Department of Neurology & Research Institute of Clinical Medicine, Biomedical Institute of Chonbuk National University Hospital, Chonbuk National University, San 2–20, Geumam-dong, Deokjin-gu, Jeonju, Jeollabukdo 561–180, Republic of Korea
| | - Kyeong-Soo Park
- Department of Preventive Medicine, Seonam University College of Medicine, 439, Chunhyang-ro, Namwon, Jeollabukdo 590–711, Republic of Korea
| | - Hee Nam Kim
- Center for Creative Biomedical Scientists, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500–757, Republic of Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 501–746, Republic of Korea
- Center for Creative Biomedical Scientists, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500–757, Republic of Korea
- * E-mail:
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Raška I, Rašková M, Zikán V, Škrha J. High Prevalence of Hypovitaminosis D in Postmenopausal Women with Type 2 Diabetes Mellitus. Prague Med Rep 2016; 117:5-17. [DOI: 10.14712/23362936.2016.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The link between vitamin D and type 2 diabetes mellitus (T2DM) is intensively studied. This study aims to define the serum concentration of 25-hydroxyvitamin D (25-OH D) and to investigate the relationship between 25-OH D status, glycated hemoglobin (HbA1c) and body composition in postmenopausal women with T2DM and in non-diabetic controls. In this cross-sectional study, 75 women with T2DM and 32 control subjects were selected. Serum 25-OH D, intact parathyroid hormone (PTH), calcium, fasting glucose and HbA1c, were measured. The mean 25-OH D level was 21.4 ± 11.4 ng/ml (range 4.1–50.7 ng/ml) in diabetic women and 30.3 ± 9.4 ng/ml (range 10.8–54.2 ng/ml) in control group (p<0.001). The prevalence of hypovitaminosis D (< 30 ng/ml) was higher in vitamin D3 non-supplemented T2DM women (89% vs. 63% controls); the difference diminished in vitamin D3 (500–1000 IU per day) supplemented subgroups (45% diabetics vs. 42% controls). In T2DM women, 25-OH D levels were not associated to HbA1c, duration of diabetes, fasting glucose and PTH levels, however, 25-OH D levels negatively associated with body mass index (p=0.011), total body fat mass (p=0.005) and total body lean mass (p=0.004). The prevalence of hypovitaminosis D is higher in non-supplemented postmenopausal women with T2DM than in non-diabetic controls (89% vs. 63%). Obesity is a risk factor for vitamin D insufficiency in T2DM postmenopausal women. Further studies evaluating relationships between fat, muscle, bone and vitamin D metabolism in T2DM patients are warranted.
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The Potential Protective Action of Vitamin D in Hepatic Insulin Resistance and Pancreatic Islet Dysfunction in Type 2 Diabetes Mellitus. Nutrients 2016; 8:147. [PMID: 26959059 PMCID: PMC4808876 DOI: 10.3390/nu8030147] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency (i.e., hypovitaminosis D) is associated with increased insulin resistance, impaired insulin secretion, and poorly controlled glucose homeostasis, and thus is correlated with the risk of metabolic diseases, including type 2 diabetes mellitus (T2DM). The liver plays key roles in glucose and lipid metabolism, and its dysregulation leads to abnormalities in hepatic glucose output and triglyceride accumulation. Meanwhile, the pancreatic islets are constituted in large part by insulin-secreting β cells. Consequently, islet dysfunction, such as occurs in T2DM, produces hyperglycemia. In this review, we provide a critical appraisal of the modulatory actions of vitamin D in hepatic insulin sensitivity and islet insulin secretion, and we discuss the potential roles of a local vitamin D signaling in regulating hepatic and pancreatic islet functions. This information provides a scientific basis for establishing the benefits of the maintenance, or dietary manipulation, of adequate vitamin D status in the prevention and management of obesity-induced T2DM and non-alcoholic fatty liver disease.
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