1
|
Yu B, Kong D, Ge S, Zhou Y, Ma J. Associations between Vitamin D Levels and Insulin Resistance in Non-Diabetic Obesity: Results from NHANES 2001-2018. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-8. [PMID: 38935368 DOI: 10.1080/27697061.2024.2370997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Obesity is often accompanied by insulin resistance (IR) and diabetes. We explored the association between vitamin D levels and IR in non-diabetic obesity. METHODS We conducted a cross-sectional study based on the data of National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. Non-diabetic individuals (aged ≥20 years) with obesity (BMI ≥ 30kg/m2) were included in the study. And HOMA-IR ≥ 2.5 was defined as IR. The multivariable linear regression models were constructed to evaluate the associations between levels of 25(OH)D and HOMA-IR. We calculated the odds ratio (OR) and 95% confidential intervals (CIs) for associations between 25(OH)D deficiency and IR in obesity using multivariable logistic regression models. RESULTS Overall, a total of 3887 individuals were included in this study. Serum vitamin D level was significant lower in obesity participants with IR than that of non-IRs. The linear regression models showed that vitamin D level was inversely associated with HOMA-IR in obesity after adjusting for covariables (β=-0.15, 95%CI (-0.28, -0.02), p = 0.028). And the multivariable logistic regression models indicated an association between vitamin D deficiency and IR in obesity ((OR= 1.38, 95%CI (1.09-1.73), p = 0.007)). The further stratified regression analyses among different BMI demonstrated that vitamin D deficiency (OR = 1.4, 95%CI (1.05,1.86), p = 0.022) only contributed to developing IR in class I obesity. CONCLUSION This study suggested an association of vitamin D levels with IR in obesity. And vitamin D deficiency contributed to IR in class I obesity.
Collapse
Affiliation(s)
- Baowen Yu
- Department of Endocrinology, Nanjing Medical University affiliated Nanjing Hospital: Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Deyue Kong
- Department of Endocrinology, Nanjing Medical University affiliated Nanjing Hospital: Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shenghui Ge
- Department of Endocrinology, Nanjing Medical University affiliated Nanjing Hospital: Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yunting Zhou
- Department of Endocrinology, Nanjing Medical University affiliated Nanjing Hospital: Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing Medical University affiliated Nanjing Hospital: Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| |
Collapse
|
2
|
Valer-Martinez A, Sayon-Orea C, Martinez JA, Basterra-Gortari FJ, Martinez-Gonzalez MA, Bes-Rastrollo M. Vitamin D and risk of developing type 2 diabetes in the SUN project: a prospective cohort study. J Endocrinol Invest 2024:10.1007/s40618-024-02324-3. [PMID: 38459212 DOI: 10.1007/s40618-024-02324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/28/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Vitamin D deficiency has been associated with multiple chronic diseases, including metabolic disorders such as insulin resistance and type 2 diabetes (T2D). The aim of the study was to analyze the association between validated predicted serum vitamin D status and the risk of developing T2D in a large prospective cohort based on a Mediterranean population. METHODS The SUN project is a prospective and dynamic Spanish cohort that gathers university graduates who have answered lifestyle questionnaires, including a validated Food Frequency Questionnaire. The association between predicted serum vitamin D and the risk of T2D was assessed through Cox regression models according to quartiles (Q) of predicted vitamin D at baseline. The models were adjusted for potential confounders and sensitivity analyses were performed to ensure the robustness of our findings. RESULTS Our study included a total of 18,594 participants and after a total follow-up of 238,078 person-years (median follow-up of 13.5 years), 209 individuals were diagnosed with incident T2D. We found a significant inverse association between predicted levels of serum vitamin D and the risk of developing T2D, after adjusting for potential confounders and performing different sensitivity analyses (hazard ratio Q4 vs. Q1: 0.48, 95% CI 0.26-0.88; p for trend = 0.032). CONCLUSION The outcomes suggest that higher levels of vitamin D at baseline may be associated with a reduced risk of developing T2D.
Collapse
Affiliation(s)
- A Valer-Martinez
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Department of Family Medicine, Aragon Health Service (SALUD), Zaragoza, Spain
| | - C Sayon-Orea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain.
- Navarra Public Health Institute, Pamplona, Spain.
| | - J A Martinez
- Institute IMDEA Food, Madrid, Spain
- Department of Nutrition, Food Science and Physiology/Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - F J Basterra-Gortari
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
| | - M A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, C/Irunlarrea, 1 (Ed. Investigación), 31008, Pamplona, Navarra, Spain
| |
Collapse
|
3
|
Donin A, Nightingale CM, Sattar N, Fraser WD, Owen CG, Cook DG, Whincup PH. Cross-sectional study of the associations between circulating vitamin D concentrations and insulin resistance in children aged 9-10 years of South Asian, black African Caribbean and white European origins. J Epidemiol Community Health 2023; 78:jech-2023-220626. [PMID: 38123968 PMCID: PMC11045364 DOI: 10.1136/jech-2023-220626] [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: 04/25/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Lower circulating vitamin D 25-hydroxyvitamin D (25(OH)D) concentrations are associated with higher type 2 diabetes risk in adults, although causality remains uncertain. However, associations between 25(OH)D and type 2 diabetes risk markers in children have been little studied, particularly in ethnic minority populations. We examined whether 25(OH)D concentrations were associated with insulin resistance in children and whether lower 25(OH)D concentrations in South Asians and black African Caribbeans could contribute to their higher insulin resistance. METHODS Cross-sectional study of 4650 UK primary school children aged 9-10 years of predominantly South Asian, black African Caribbean and white European ethnicity. Children had fasting blood measurements of circulating 25(OH)D metabolite concentrations, insulin and glucose. RESULTS Lower 25(OH)D concentrations were observed in girls, South Asians and black African Caribbeans. In analyses adjusted for age, sex, month, ethnic group and school, circulating 25(OH)D was inversely associated with fasting insulin (-0.38%, 95% CI -0.49% to -0.27%), homoeostasis model assessment (HOMA) insulin resistance (-0.39%, 95% CI -0.50% to -0.28%) and fasting glucose (-0.03%, 95% CI -0.05% to -0.02%) per nmol/L increase in 25(OH)D; associations did not differ between ethnic groups. Ethnic differences in fasting insulin and HOMA insulin resistance (higher among South Asian and black African Caribbeans) were reduced by >40% after adjustment for circulating 25(OH)D concentrations. CONCLUSION Circulating vitamin D was inversely associated with insulin resistance in all ethnic groups; higher insulin resistance in South Asian and black African children were partly explained by their lower vitamin D levels. Whether vitamin D supplementation can reduce emerging type 2 diabetes risk needs further evaluation.
Collapse
Affiliation(s)
- Angela Donin
- Population Health Research Institute, St George's University of London, London, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George's University of London, London, UK
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - William D Fraser
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Chris G Owen
- Population Health Research Institute, St George's University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George's University of London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| |
Collapse
|
4
|
Li P, Li K, Yuan W, Xu Y, Li P, Wu R, Han J, Yin Z, Lu L, Gao Y. 1α,25(OH) 2D 3 ameliorates insulin resistance by alleviating γδ T cell inflammation via enhancing fructose-1,6-bisphosphatase 1 expression. Theranostics 2023; 13:5290-5304. [PMID: 37908738 PMCID: PMC10614678 DOI: 10.7150/thno.84645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/16/2023] [Indexed: 11/02/2023] Open
Abstract
Background: Chronic inflammation caused by immune cells is the central link between obesity and insulin resistance. Targeting the inflammatory process is a highly promising method for reversing systemic insulin resistance. Methods: Blood samples were prospectively collected from 68 patients with type 2 diabetes. C57BL/6J mice were fed either a high-fat diet (HFD) or normal chow (NC). We performed phenotypical and functional analyses of immune cells using flow cytometry. Vitamin D receptor (VDR) knockout γδ T cells were constructed using Cas9-gRNA targeted approaches to identify 1α,25(OH)2D3/VDR signaling pathway-mediated transcriptional regulation of fructose-1,6-bisphosphatase (FBP1) in γδ T cells. Results: Serum vitamin D deficiency aggravates inflammation in circulating γδ T cells in type 2 diabetes patients. We defined a critical role for 1α,25(OH)2D3 in regulating glycolysis metabolism, protecting against inflammation, and alleviating insulin resistance. Mechanistically, 1α,25(OH)2D3-VDR promoted FBP1 expression to suppress glycolysis in γδ T cells, thereby inhibiting Akt/p38 MAPK phosphorylation and reducing inflammatory cytokine production. Notably, therapeutic administration of 1α,25(OH)2D3 restrained inflammation in γδ T cells and ameliorated systemic insulin resistance in obese mice. Conclusions: Collectively, these findings show that 1α,25(OH)2D3 plays an important role in maintaining γδ T cell homeostasis by orchestrating metabolic programs, and is a highly promising target for preventing obesity, inflammation, and insulin resistance.
Collapse
Affiliation(s)
- Peng Li
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ke Li
- Department of Geriatrics, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Wenhui Yuan
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Yuqi Xu
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ping Li
- Department of Endocrinology, Guangdong Second Provincial General Hospital, Guangzhou, 510310, Guangdong, China
| | - Ruan Wu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, 230601, Anhui, China
| | - Jingru Han
- Department of Oncology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Zhinan Yin
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ligong Lu
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
| | - Yunfei Gao
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, 519000, Guangdong, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, 510632, Guangdong, China
| |
Collapse
|
5
|
Riaz MH, Jamil A, Yousaf H, Hassan M, Sohaib MA, Babar S, Ahmad MH, Allahi I, Mehmood MZ, Khan TM. Incidence of Vitamin D Deficiency and Its Association With Microalbuminuria in Patients With Type 2 Diabetes Mellitus. Cureus 2023; 15:e45854. [PMID: 37881399 PMCID: PMC10596171 DOI: 10.7759/cureus.45854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/27/2023] Open
Abstract
Background Vitamin D (VD) deficiency is common in patients with type 2 diabetes mellitus (T2DM). VD deficiency and its associated factors are understudied in Pakistan. This study aimed to estimate the incidence of VD deficiency and its association with microalbuminuria in patients with T2DM. Methods This descriptive cross-sectional study was performed on 110 patients diagnosed with T2DM aged between 30 and 65 years in the outpatient department clinic of diabetes in Benazir Bhutto Hospital, Rawalpindi, for around eight months from November 2022 to June 2023. Non-probability sampling technique and established inclusion and exclusion criteria were used for patient recruitment. Ethical approval and informed consent were also waived before data collection. Data collection was done by an interview-based and self-designed questionnaire. Data analysis was carried out via descriptive statistics along with chi-square, independent-samples t-test, and Pearson correlation in Statistical Package for the Social Sciences (SPSS) version 25 (Armonk, NY: IBM Corp.). Results The means of the study population for age, serum VD, and UACR (urine spot for albumin-to-creatinine ratio) were 48.50±15.67 years, 28.16±15.34 ng/mL, and 29.69± 87.22 µg/mg, respectively. The incidences of VD deficiency and microalbuminuria in the study population were 43.64% and 28.20%, respectively. VD deficiency was significantly associated with age group (p=0.002), gender (p=0.008), and albuminuria status (p=0.004). The comparison of means of UACR between the VD deficiency group and the non-VD deficiency group was also significant (0.001). VD deficiency was higher among older age groups, female gender, and patients with microalbuminuria. A significant negative correlation between serum VD level and UACR (microalbuminuria) (p=0.002) was present. Conclusion VD deficiency incidence was notably high in the study population. Older age, female gender, and microalbuminuria were found to elevate the VD deficiency to a crucial level. Serum VD deficiency and microalbuminuria were significantly and negatively correlated. Therefore, VD level should be monitored intermittently in T2DM, so that we could prevent the progression of T2DM timely.
Collapse
Affiliation(s)
| | - Ammar Jamil
- Emergency Medicine, Holy Family Hospital, Rawalpindi, PAK
| | - Hira Yousaf
- Analytical Chemistry, University of Huddersfield, Huddersfield, GBR
| | - Muhammad Hassan
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | | | | | - Ibtesam Allahi
- General Surgery, Allama Iqbal Medical College, Lahore, PAK
| | | | | |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Danese VC, Pepe J, Ferrone F, Colangelo L, De Martino V, Nieddu L, Ferrazza G, Panzini E, Pascone R, Blocki F, Minisola S, Cipriani C. The Mutual Interplay between Bone, Glucose and Lipid Metabolism: The Role of Vitamin D and PTH. Nutrients 2023; 15:2998. [PMID: 37447323 DOI: 10.3390/nu15132998] [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: 06/13/2023] [Revised: 06/24/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND We sought to investigate the mutual interplay between bone, glucose and lipid metabolism in a wide cohort of community-based subjects. METHODS We studied 1240 blood donors (F/M ratio 1/3.2, mean age 41.9 ± 11.7 SD). Serum ionized (Ca++), magnesium (Mg++), 25-hydroxy-vitamin D [25(OH)D], PTH-1-84, 1,25-dihydroxyvitamin D [1,25(OH)2D], total cholesterol (C), HDL-C, triglycerides and glucose were measured and LDL-C levels were calculated in all subjects. RESULTS 25(OH)D negatively correlated with BMI (R = -0.11), PTH (R = -0.16) (p < 0.0001), total C (R = -0.06, p < 0.05) and triglycerides (R = -0.13, p < 0.0001) and positively with 1,25(OH)2D (R = 0.12) and creatinine (R = 0.17) (p < 0.0001). Serum PTH positively correlated with total C (R = 0.08, p < 0.01), LDL-C (R = 0.1, p < 0.001), triglycerides (R = 0.09, p < 0.01) and glucose (R = 0.15, p < 0.0001) and negatively with HDL-C (R = -0.09, p < 0.01). The odds of showing abnormal serum triglycerides and HDL-C increased as 25(OH)D decreased (p < 0.0001 and p < 0.03) and PTH increased (p < 0.03 and p = 0.05), while the odds of showing abnormal LDL-C levels increased in association with elevated PTH (p < 0.01). CONCLUSION Vitamin D, PTH, glucose and lipid metabolism are mutually influenced. Hypovitaminosis D predisposes toward worsening lipid profiles through the actions of PTH, while serum PTH levels per se associate with higher glucose and LDL-C levels.
Collapse
Affiliation(s)
- Vittoria Carmela Danese
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Jessica Pepe
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Federica Ferrone
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Luciano Colangelo
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Viviana De Martino
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Luciano Nieddu
- Faculty of Economics, Università degli Studi Internazionali di Roma, Via Cristoforo Colombo 200, 00147 Rome, Italy
| | - Giancarlo Ferrazza
- Department of Immunohematology and Transfusion Medicine, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Enrico Panzini
- Department of Immunohematology and Transfusion Medicine, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Roberto Pascone
- Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Frank Blocki
- DiaSorin Inc., 1951 Northwestern Avenue, Stillwater, MN 55082, USA
| | - Salvatore Minisola
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Cristiana Cipriani
- Department of Clinical, Internal Medicine, Cardiovascular and Anesthesiological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| |
Collapse
|
8
|
Carbone F, Liberale L, Libby P, Montecucco F. Vitamin D in atherosclerosis and cardiovascular events. Eur Heart J 2023; 44:2078-2094. [PMID: 36943351 PMCID: PMC10281557 DOI: 10.1093/eurheartj/ehad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/30/2023] [Accepted: 03/04/2023] [Indexed: 03/23/2023] Open
Abstract
Both experimental and clinical findings linking vitamin D to cardiovascular (CV) risk have prompted consideration of its supplementation to improve overall health. Yet several meta-analyses do not provide support for the clinical effectiveness of this strategy. Meanwhile, the understanding of the roles of vitamin D in the pathophysiology of CV diseases has evolved. Specifically, recent work has revealed some non-classical pleiotropic effects of vitamin D, increasing the complexity of vitamin D signalling. Within particular microenvironments (e.g. dysfunctional adipose tissue and atherosclerotic plaque), vitamin D can act locally at cellular level through intracrine/autocrine/paracrine feedforward and feedback circuits. Within atherosclerotic tissues, 'local' vitamin D levels may influence relevant systemic consequences independently of its circulating pool. Moreover, vitamin D links closely to other signalling pathways of CV relevance including those driving cellular senescence, ageing, and age-related diseases-among them CV conditions. This review updates knowledge on vitamin D biology aiming to clarify the widening gap between experimental and clinical evidence. It highlights the potential reverse causation confounding correlation between vitamin D status and CV health, and the need to consider novel pathophysiological concepts in the design of future clinical trials that explore the effects of vitamin D on atherosclerosis and risk of CV events.
Collapse
Affiliation(s)
- Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
| | - Peter Libby
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
| |
Collapse
|
9
|
Corsello A, Macchi M, D'Oria V, Pigazzi C, Alberti I, Treglia G, Cosmi VD, Mazzocchi A, Agostoni C, Milani GP. Effects of vitamin D supplementation in obese and overweight children and adolescents: a systematic review and meta-analysis. Pharmacol Res 2023; 192:106793. [PMID: 37178775 DOI: 10.1016/j.phrs.2023.106793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/15/2023]
Abstract
Due to the lipophilic nature of vitamin D, overweight and obese patients have an increased risk of inadequate circulating 25-hydroxy-vitamin D (25(OH)D) concentrations. Vitamin D deficiency has in turn several consequences especially among children and adolescents. Therefore, a few supplementation strategies of vitamin D for pediatric subjects with an excessive body weight have been proposed, but their efficacy remains controversial. The aim of this systematic review and meta-analysis is to evaluate the effect of vitamin D supplementation in overweight and obese children and adolescents. Three databases (PubMed, Embase and Web of Science) were searched to collect randomized controlled trials on the effect of vitamin D supplementation in the pediatric overweight or obese population. Twenty-three studies were included in the systematic review. Results on modification of metabolic or cardiovascular outcomes were controversial. On the other hand, the meta-analysis showed a mean difference by 1.6ng/mL in subjects supplemented with vitamin D as compared to placebo. In conclusion, vitamin D supplementation slightly increases 25(OH)D levels in pediatric subjects with overweight and obesity. However, the effects on metabolic and cardiovascular outcomes remain controversial. New efforts should be devoted to promoting effective interventions to improve the health of children and adolescents with overweight and obesity.
Collapse
Affiliation(s)
- Antonio Corsello
- Department of Health Science and Community Health, University of Milan, Italy
| | - Marina Macchi
- Department of Health Science and Community Health, University of Milan, Italy
| | - Veronica D'Oria
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Pigazzi
- Department of Health Science and Community Health, University of Milan, Italy
| | - Ilaria Alberti
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Valentina De Cosmi
- Department of Health Science and Community Health, University of Milan, Italy; Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Alessandra Mazzocchi
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Gregorio Paolo Milani
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
10
|
Xia J, Yu J, Xu H, Zhou Y, Li H, Yin S, Xu D, Wang Y, Xia H, Liao W, Wang S, Sun G. Comparative effects of vitamin and mineral supplements in the management of type 2 diabetes in primary care: A systematic review and network meta-analysis of randomized controlled trials. Pharmacol Res 2023; 188:106647. [PMID: 36638933 DOI: 10.1016/j.phrs.2023.106647] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/08/2023] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
Medical nutrition treatment can manage diabetes and slow or prevent its complications. The comparative effects of micronutrient supplements, however, have not yet been well established. We aimed at evaluating the comparative effects of vitamin and mineral supplements on managing glycemic control and lipid metabolism for type 2 diabetes mellitus (T2DM) to inform clinical practice. Electronic and hand searches for randomized controlled trials (RCTs) were performed until June 1, 2022. We selected RCTs enrolling patients with T2DM who were treated with vitamin supplements, mineral supplements, or placebo/no treatment. Data were pooled via frequentist random-effects network meta-analyses. A total of 170 eligible trials and 14223 participants were included. Low to very low certainty evidence established chromium supplements as the most effective in reducing fasting blood glucose levels and homeostasis model assessment of insulin resistance (SUCRAs: 90.4% and 78.3%, respectively). Vitamin K supplements ranked best in reducing glycated hemoglobin A1c and fasting insulin levels (SUCRAs: 97.0% and 82.3%, respectively), with moderate to very low certainty evidence. Vanadium supplements ranked best in lowering total cholesterol levels with very low evidence certainty (SUCRAs:100%). Niacin supplements ranked best in triglyceride reductions and increasing high-density lipoprotein cholesterol levels with low to very low evidence certainty (SUCRAs:93.7% and 94.6%, respectively). Vitamin E supplements ranked best in reducing low-density lipoprotein cholesterol levels with very low evidence certainty (SUCRAs:80.0%). Our analyses indicated that micronutrient supplements, especially chromium, vitamin E, vitamin K, vanadium, and niacin supplements, may be more efficacious in managing T2DM than other micronutrients. Considering the clinical importance of these findings, new research is needed to get better insight into this issue.
Collapse
Affiliation(s)
- Jiayue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Junhui Yu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Hai Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Yuhao Zhou
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Hui Li
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Shiyu Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Wang Liao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China; China-DRIs Expert Committee on Macronutrients, P.R. China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China; China-DRIs Expert Committee on Macronutrients, P.R. China.
| |
Collapse
|
11
|
Wu M, Cai YL, Yang Y, Hu HM, Yao Y, Yang J, Deng JJ, Wan L. Vitamin D ameliorates insulin resistance-induced osteopenia by inactivating the nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome. Heliyon 2023; 9:e13215. [PMID: 36816288 PMCID: PMC9929320 DOI: 10.1016/j.heliyon.2023.e13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
Objective Osteoporosis (OP) can be considered a chronic complication of type 2 diabetes mellitus (T2DM). Aberrant activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome is associated with the pathogenesis of various inflammation-related diseases, e.g., T2DM and OP. Vitamin D affects the inflammatory pathway and inhibits an excessive inflammatory response. The current study investigated the inter-relationship between vitamin D and inflammasome activation in T2DM. Method Hepatocellular carcinoma (HepG2) cells and bone marrow stromal cells (BMSCs) were treated with Conditioned Medium of bone marrow mesenchymal stem cells after VitD treatment (CM-VitD), as well as phosphoinositide 3-kinase (PI3K) specific agonist, 740Y-P, or the PI3K specific inhibitor, LY294002, respectively, or both. 40 Eight-week-old female Sprague Dawley rats were selected and established as a DM model. The rats were injected with CM-VitD, as well as the 740Y-P specific agonist, or the LY294002 inhibitor, respectively, or both. A quantitative reverse transcription polymerase chain reaction and western blotting were conducted to evaluate the expression of messenger ribonucleic acid and protein in the RUX2 gene, alkaline phosphatase (ALP), OsteoPontiN (OPN), peroxisome proliferator-activated receptor gamma (PPARγ), fatty acid-binding protein 4 (FABP4), protein kinase B (AKT), PI3K, NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), caspase-1, interleukin (IL)-1 beta (β), IL-18, and tumor necrosis factor alpha (TNF-α) in the BMSCs and liver tissue of rats. Enzyme-linked immunosorbent assay was used to detect the concentration of inflammatory factors in the cell supernatant and serum of rats. Results An isolated co-culture of HepG2/insulin-resistance cells and BMSCs promoted the adipogenic transformation of the latter and inhibited the transformation of BMSCs into osteogenesis. The PI3K specific agonist, 740Y-P, significantly increased the expression of PI3K, AKT, NLRP3, ASC and Caspase-1 while the PI3K specific inhibitor, LY294002, does the opposite. Additionally, CM-VitD reduced the expression of NLRP3, ASC, caspase-1, IL-1β, and IL-18 in BMSCs and rat liver via the PI3K/AKT pathway. Conclusion Vitamin D can inhibit the inflammatory response induced by T2DM and promote the osteogenesis of BMSCs, which may play a key role in the treatment of type 2 diabetes patients with OP.
Collapse
|
12
|
Klammer C, Schindler K, Bugl R, Plazek D, Vötter M, Kirchner T, Martino C, Klammer-Martin J, Brix J, Dämon S, Hoppichler F, Kautzky-Willer A, Kruschitz R, Toplak H, Clodi M, Ludvik B. [Nutrition for diabetic patients (Update 2023)]. Wien Klin Wochenschr 2023; 135:62-77. [PMID: 37101026 PMCID: PMC10133079 DOI: 10.1007/s00508-023-02170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 04/28/2023]
Abstract
All patients with diabetes require individual and personalized nutritional consultation with professionals. The patient's needs should be the primary focus of the dietary therapy, taking their lifestyle and the type of diabetes into consideration. With the recommendations to the patient's diet, there need to be specific metabolic goals to reduce the disease's progression and to avoid long term health effects. Therefore, practical guidelines such as portion size and meal planning tips should be the main focus.According to the latest national and international standards, patients suffering from diabetes should have access to nutrition consulting and nutritional training. During consultation they can be supported on- how to manage their health condition and choosing food and beverage to improve their health.These practical recommendations sum up the latest literature on nutritional aspects of diabetes treatment.
Collapse
Affiliation(s)
- Carmen Klammer
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich
| | - Karin Schindler
- Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz, Wien, Österreich
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Rita Bugl
- Wiener Gesundheitsverband Klinik Ottakring, Wien, Österreich
| | | | | | - Tanja Kirchner
- Österreichische Gesundheitskasse Mein Peterhof Baden, Baden, Österreich
| | - Claudia Martino
- Österreichische Gesundheitskasse Mein Gesundheitszentrum Floridsdorf, Wien, Österreich
| | | | - Johanna Brix
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
| | - Sabine Dämon
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
| | - Friedrich Hoppichler
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
- Abteilung für Innere Medizin, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Österreich
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Renate Kruschitz
- Abteilung für Innere Medizin, Krankenhaus der Elisabethinen, Klagenfurt, Österreich
| | - Hermann Toplak
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Martin Clodi
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich.
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich.
| | - Bernhard Ludvik
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
| |
Collapse
|
13
|
Hoseini R, Rahim HA, Ahmed JK. Decreased inflammatory gene expression accompanies the improvement of liver enzyme and lipid profile following aerobic training and vitamin D supplementation in T2DM patients. BMC Endocr Disord 2022; 22:245. [PMID: 36209084 PMCID: PMC9547373 DOI: 10.1186/s12902-022-01152-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is one of the health issues causing untoward low-grade systemic inflammation. Aerobic Training (AT) and Vitamin D (Vit D) supplementation are among the approaches that improve lipid profile and liver enzymes in T2DM. However, the mechanisms responsible for these improvements are not fully elucidated. OBJECTIVES This study aimed to evaluate the effects of AT and Vit D supplementation on lipid profile, liver enzymes, Interleukin-6 (IL-6), Interleukin-10 (IL-10), Cluster of differentiation 27 (CD27), Chemokine (C-X-C motif) Ligand 13 (CXCL13), Interferon-Gamma (IFN-γ) and Transforming Growth Factor-Beta 1 (TGF-β1) gene expressions in patients with T2DM. METHODS In this study, 40 male T2DM patients aged 35-50 years were randomly selected and assigned into four groups (n = 10 for each); AT+vitamin D supplementation (AT+Vit D), AT+placebo (AT), Vit D supplementation (Vit D), and control+placebo (C). The intervention consisted of 8 weeks of 20-40 minutes AT protocol at 60-75% HRmax 3 sessions/week and taking 50,000 IU of Vit D supplement once a week. Serum levels of lipid profile and liver enzymes and gene expression of IL-6, IL-10, CD27, CXCL13, IFN-γ, and TGF-β1 in Peripheral Blood Mononuclear Cells (PBMCs) were measured. One-way analysis of variance (ANOVA), Tukey's post hoc, and paired sample t-test at P-values less than 0.05 were used to analyze the data using SPSS software. RESULTS AT+Vit D, AT, and Vit D significantly decreased TC, TG, LDL, AST, ALT, and GGT while increased HDL after 8 weeks in favor of AT+Vit D. Also, gene expressions of IL-6, IL-10, CD27, CXCL13, IFN-γ, and TGF-β1 were downregulated significantly in AT+Vit D, AT, and Vit D, while upregulated in C. Furthermore, compared to individual AT or Vit D, AT+Vit D significantly downregulated IL-6 (P = 0.013; P = 0.025), IL-10 (P = 0.012; P = 0.026), CD27 (P = 0.023; P = 0.041), CXCL13 (P = 0.014; P = 0.025), IFN-γ (P = 0.017; P = 0.026), and TGF-β1 (P = 0.001; P = 0.028). CONCLUSION In comparison to individual AT or Vit D, AT+Vit D may enhance lipid profile, and liver enzymes and drive the balance to favor inhibition of inflammation by downregulating gene expression of inflammation-related factors. As a result, AT+Vit D may be considered appropriate therapy for managing T2DM.
Collapse
Affiliation(s)
- Rastegar Hoseini
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, P.O.Box. 6714414971, Kermanshah, Iran.
| | - Hiwa Ahmed Rahim
- Physical Education and Sport Sciences Department, University of Halabja, Halabja, Kurdistan Region, 46018, Iraq
| | - Jalal Khdhr Ahmed
- Physical Education and Sport Sciences Department, University of Halabja, Halabja, Kurdistan Region, 46018, Iraq
| |
Collapse
|
14
|
Han Y, Zhang Y, Zeng X. Assessment of causal associations between uric acid and 25-hydroxyvitamin D levels. Front Endocrinol (Lausanne) 2022; 13:1024675. [PMID: 36583002 PMCID: PMC9792848 DOI: 10.3389/fendo.2022.1024675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Previous observational studies have revealed the association between serum uric acid and 25-hydroxyvitamin D. However, the causality and the direction of the associations remain unknown. Thus, we performed a two-sample bidirectional Mendelian Randomization (MR) analysis to investigate the causal association between uric acid and 25-hydroxyvitamin D and to determine the direction of the association. METHOD Based on the summary-level GWAS data from large genome-wide association studies, several steps were taken in our analysis to select eligible single-nucleotide polymorphisms (SNPs), which were strongly related to exposure as the instrumental variables. We used different analytical methods, such as inverse-variance weighting (IVW) method, weighted median, MR-Egger regression, and weighted mode method, to make our result more robust and reliable. The IVW method was used as the primary analysis. The Cochran's Q test, MR-Egger intercept test, MR-PRESSO method, and "leave-one-out" sensitivity analysis was performed to evaluate the heterogeneities, horizontal pleiotropy, and robustness of the results. MR analyses were also conducted using genetic risk scores (GRS) as instrumental variables in both directions by using the same summary-level GWAS data. RESULTS Our two-sample MR analysis suggested a causal association of genetically predicted uric acid on 25-hydroxyvitamin D [IVW method: β(SE), -0.0352(0.0149); p = 0.0178], which suggested that a per mg/dl increase in uric acid was associated with a decrease of 0.74 nmol/L of 25-hydroxyvitamin D, and the above results remained stable in the sensitivity analysis. By contrast, four MR methods suggested no causal relationship of 25-hydroxyvitamin D on serum uric acid [IVW β(SE), 0.0139 (0.0635); p = 0.826; MR-Egger β(SE), 0.0671 (0.108); p = 0.537; weighted median β(SE), 0.0933 (0.0495); p = 0.0598; weighted mode β(SE), 0.0562 (0.0463); p = 0.228, respectively]. After excluding the SNPs, which were associated with confounding factors and outlier SNPs, the IVW method suggested that there was still no causal association of 25-hydroxyvitamin D on serum uric acid. The GRS approach showed similar results. CONCLUSIONS Serum uric acid may causally affect the 25-hydroxyvitamin D levels, whereas the causal role of 25-hydroxyvitamin D on uric acid was not supported in our MR analysis. Our findings suggest that increased levels of uric acid should prompt investigation for vitamin D deficiency.
Collapse
Affiliation(s)
- Yingdong Han
- Department of family medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
- Division of General Internal Medicine, Department of medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
| | - Yun Zhang
- Department of family medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
- Division of General Internal Medicine, Department of medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
- *Correspondence: Yun Zhang, ; Xuejun Zeng,
| | - Xuejun Zeng
- Department of family medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
- Division of General Internal Medicine, Department of medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China
- *Correspondence: Yun Zhang, ; Xuejun Zeng,
| |
Collapse
|
15
|
Zhang HX, Zhai L, Gao Z, Yuan J. Relationship Between Serum Vitamin D and Perirenal Fat Thickness in Patients with Metabolic Syndrome in Community. Diabetes Metab Syndr Obes 2022; 15:2149-2156. [PMID: 35911500 PMCID: PMC9332927 DOI: 10.2147/dmso.s371445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Visceral obesity is independently associated with hypovitaminosis D. Perirenal fat is a visceral fat type active in performing endocrine functions. However, the relationship between perirenal fat thickness (PrFT) and serum 25-hydroxy vitamin D [25(OH)D] is unclear. The aim of this study is to investigate the relationship between serum 25(OH)D and PrFT in patients with metabolic syndrome (MS) in the community. METHODS From May to September 2020, 332 MS subjects in Qinfengyuan and Dongfang communities in Taiyuan City, China were enrolled in an MS survey. All the participants completed the questionnaire survey and physical examination, and their fasting blood samples were collected for biochemical examination. Abdominal ultrasonography was performed to measure the perirenal fat thickness. RESULTS The mean serum 25(OH)D level for the 332 MS subjects was 13.5 ng/mL, the proportions of vitamin D deficiency [serum 25(OH)D < 20 ng/mL] and insufficiency [serum 25(OH)D = 20-29.9 ng/mL] were 60.8% (202) and 24.4% (81), respectively. Among the hypovitaminosis D [serum 25(OH)D < 30 ng/mL] subjects, the prevalence of abdominal obesity (waist circumference ≥ 90cm for men and ≥ 80cm for women) is 61.1%. Pearson correlation analysis showed that lg25(OH)D was significantly and negatively associated with body mass index (BMI), waist circumference (W), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), insulin resistance index (HOMA-IR), uric acid (UA)) and PrFT (all P<0.05), and positively correlated with high-density lipoprotein cholesterol (HDL-C) (P<0.05). Multivariate analysis showed that PrFT and HOMA-IR were independently correlated with 25(OH)D. CONCLUSION In screening MS patients, approximately 85% of the community MS patients in Taiyuan had hypovitaminosis D; in which 3/5 is abdominal obesity. PrFT is an independent risk factor for hypovitaminosis D in MS subjects.
Collapse
Affiliation(s)
- Hong-Xia Zhang
- Department of Endocrinology, Shanxi Provincial People’s Hospital, Taiyuan, People’ s Republic of China
| | - Lu Zhai
- Department of Endocrinology, Shanxi Provincial People’s Hospital, Taiyuan, People’ s Republic of China
| | - Zhixiang Gao
- Department of Ultrasonography, Shanxi Provincial People’s Hospital, Taiyuan, People’ s Republic of China
| | - Jie Yuan
- Department of Radiology, Shanxi Provincial People’s Hospital, Taiyuan, People’ s Republic of China
- Correspondence: Jie Yuan, Tel +86 13834164698, Email
| |
Collapse
|
16
|
Alemam HM, ElJilani MM, Bashein AM. Effect of Intramuscular Injection of Vitamin D on 25-Hydroxyvitamin D Levels, Glycaemic Control, and Liver Enzymes in Libyan Patients with Type 2 Diabetes Mellitus. LIBYAN INTERNATIONAL MEDICAL UNIVERSITY JOURNAL 2022. [DOI: 10.1055/s-0042-1749117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Background Vitamin D is a fat-soluble hormone that plays an important role in glycaemic control. In addition, it has a positive effect on improving liver enzyme function.
Aim This study was performed to examine the effect of intramuscular injection of vitamin D on serum 25-hydroxyvitamin D [25(OH)D] levels, glycemic control, and liver enzymes in Libyan patients suffering from type 2 diabetes mellitus (T2DM) with vitamin D deficiency.
Methods and Materials This cross-sectional study enrolled 100 T2DM (50 males and 50 females). Their serum 25(OH)D, fasting blood glucose (FBG), and liver enzymes were measured at the baseline and 12 weeks after treatment with vitamin D (200,000 IU) injection monthly for 3 months. Data analysis involved the estimation of mean ± standard error (SE) and comparison of means between pre and post-treatment values using paired t-test. Independent t-test was used to compare the means between males and females. The level of significance was set at p < 0.05.
Results Females had a lower 25(OH)D blood levels than males at baseline (7.03 ± 0.25 ng/mL versus 7.86 ± 0.26 ng/mL, respectively p < 0.02). 25(OH)D levels in both sexes was increased significantly from 7.45 ± 0.18 ng/mL to 26.69 ± 0.24 ng/mL after 12 weeks of vitamin D injections (p < 0.001), with no significant differences between male and females. FBG levels in both sexes was significantly decreased from 144.68 ± 1.84 mg/dL to 85.96 ± 0.34 mg/dL post treatment (p < 0.001). Alanine aminotransferase (ALT) was increased from 10.24 ± 0.17 U/L at baseline to 20.34 ± 1.15 U/L post treatment (p < 0.001). Similarly, aspartate aminotransferase (AST) was increased from 11.23 ± 0.21 to 20.57 ± 0.22 U/L (p < 0.001), and alkaline phosphatase (ALP) was decreased from 124.95 ± 1.15 U/L to 111.17 ± 1.27 U/L (p < 0.001). There were no significant differences between male and female liver enzymes either pre- or post-vitamin D injections
Conclusion Treatment with vitamin D injection showed a significant increase in 25(OH)D accompanied by decreased FBG and ALP levels and increased ALT and AST levels. Vitamin D levels should be monitored and adjusted in diabetic patients.
Collapse
Affiliation(s)
- Hafsa M. Alemam
- Department of Environment, Food, and Biological Applications, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Mouna M. ElJilani
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Abdulla M. Bashein
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| |
Collapse
|
17
|
Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance. Nutrients 2021; 13:nu13124358. [PMID: 34959910 PMCID: PMC8705502 DOI: 10.3390/nu13124358] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.
Collapse
|
18
|
Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice. Nutrients 2021; 13:nu13103491. [PMID: 34684492 PMCID: PMC8539968 DOI: 10.3390/nu13103491] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022] Open
Abstract
Recent evidence has revealed anti-inflammatory properties of vitamin D as well as extra-skeletal activity. In this context, vitamin D seems to be involved in infections, autoimmune diseases, cardiometabolic diseases, and cancer development. In recent years, the relationship between vitamin D and insulin resistance has been a topic of growing interest. Low 25-hydroxyvitamin D (25(OH)D) levels appear to be associated with most of the insulin resistance disorders described to date. In fact, vitamin D deficiency may be one of the factors accelerating the development of insulin resistance. Vitamin D deficiency is a common problem in the population and may be associated with the pathogenesis of diseases related to insulin resistance, such as obesity, diabetes, metabolic syndrome (MS) and polycystic ovary syndrome (PCOS). An important question is the identification of 25(OH)D levels capable of generating an effect on insulin resistance, glucose metabolism and to decrease the risk of developing insulin resistance related disorders. The benefits of 25(OH)D supplementation/repletion on bone health are well known, and although there is a biological plausibility linking the status of vitamin D and insulin resistance supported by basic and clinical research findings, well-designed randomized clinical trials as well as basic research are necessary to know the molecular pathways involved in this association.
Collapse
|