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Zhang N, Wang Y, Li W, Wang Y, Zhang H, Xu D, Chen R, Tang L, Tang H. Association between serum vitamin D level and cardiovascular disease in Chinese patients with type 2 diabetes mellitus: a cross-sectional study. Sci Rep 2025; 15:6454. [PMID: 39987347 PMCID: PMC11846893 DOI: 10.1038/s41598-025-90785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 02/17/2025] [Indexed: 02/24/2025] Open
Abstract
The relationship between 25-hydroxyvitamin D (25(OH)D) status and cardiovascular disease (CVD) in the diabetes population still needs to be clarified. This study aimed to explore the association of 25(OH)D with CVD and cardiometabolic risk factors in Chinese population with type 2 diabetes mellitus (T2DM). This cross-sectional study was performed with 1378 hospitalized patients with T2DM. Participants were classified into three groups according to the serum 25(OH)D levels: vitamin D adequate, vitamin D insufficiency and vitamin D deficient. Multivariate logistic regression analysis, stratified analysis and interaction analysis were performed to determine the relationship between serum 25(OH)D levels and CVD outcome. After adjusting for confounders, serum 25(OH)D levels were significantly negatively associated with cardiovascular disease in type 2 diabetic patients [OR: 0.97 (0.94, 0.99), p = 0.0131]. Taking the vitamin D-sufficient group (≥ 20 ng/mL) as a reference, the vitamin D-deficiency group (< 12 ng/mL) was associated with a significantly higher risk of cardiovascular disease, with a 1.25-fold increased risk after adjusting for all potential confounders [OR: 2.25 (1.33, 3.79), p = 0.0023]. Stratification analysis showed that the association between vitamin D deficiency and increased risk of cardiovascular disease was particularly significant in women [OR: 4.32 (1.54, 12.12), p = 0.0055], older adults [OR: 4.14 (1.10, 15.56), p = 0.0355], normal-weight [OR: 4.09 (1.51, 11.10), p = 0.0056] and obese subjects [OR: 3.66 (1.03, 13.05), p = 0.0453]. Vitamin D deficiency was significantly associated with an increased risk of overweight/obesity [OR: 1.57 (1.10, 2.24), p = 0.0134], hypertension [OR: 1.81 (1.30, 2.51), p = 0.0004], hypertriglyceridemia [OR: 1.56 (1.12, 2.16), p = 0.0078] and reduced HDL-C [OR: 1.67 (1.19, 2.35), p = 0.0033]. Serum 25(OH)D levels were significantly negatively associated with CVD in T2DM patients and vitamin D deficiency was significantly associated with an increased risk of overweight/obesity, hypertension and dyslipidemia.
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Affiliation(s)
- Ningjie Zhang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 4500552, China
| | - Wei Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yongjun Wang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Hui Zhang
- Hunan Provincial Key Laboratory of the Traditional Chinese Medicine Agricultural Biogenomics, Department of Basic Medical Sciences, Changsha Medical University, Changsha, 410000, China
| | - Danning Xu
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Ruohong Chen
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Lingli Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Haoneng Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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Zerrouki D, Rami I, Assarrar I, Bouichrat N, Rouf S, Latrech H. Is there any association between vitamin D status and PCOS disease? Gynecol Endocrinol 2024; 40:2381501. [PMID: 39481002 DOI: 10.1080/09513590.2024.2381501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/25/2024] [Accepted: 07/12/2024] [Indexed: 11/02/2024] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. The current study sought to assess vitamin D status in women with PCOS compared to the control group and to describe the association between vitamin D deficiency and the features of PCOS. MATERIAL AND METHODOLOGY A descriptive retrospective study about 176 women of reproductive age was conducted. The sample was divided into two groups: individuals with PCOS (82 women) and healthy individuals without PCOS (94 women). Vitamin D deficiency was defined as a serum concentration less than 10 ng/ml. We used the Statistical Package for the Social Sciences (SPSS), version 21 for all analyses. RESULTS In our study, vitamin D deficiency was observed in 40.2% PCOS patients and 24% controls. The 25(OH)D level was lower in PCOS women and the incidence of vitamin D deficiency and insufficiency were significantly higher in comparison with the control group (p < 0.05). Furthermore, PCOS women with insulin resistance or obesity had lower 25(OH)D levels in comparison with PCOS individuals without IR or obesity. Furthermore, a significant correlation was found between homeostatic model assessment for insulin resistance (HOMA-IR)/body mass index (BMI) and vitamin D status. DISCUSSION AND CONCLUSION Vitamin D deficiency could be one of the etiological mechanisms of PCOS. In fact, the prevalence of vitamin D deficiency in PCOS women is evident, principally in those with obesity or IR. Also, the serum 25(OH)D level was correlated with parameters of insulin resistance and metabolic syndrome. Therefore, it is proposed that vitamin D supplementation may be beneficial for the management of PCOS patients.
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Affiliation(s)
- Dounia Zerrouki
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
| | - Imane Rami
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
| | - Imane Assarrar
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
| | - Nisrine Bouichrat
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
| | - Siham Rouf
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, Mohamed the First University, Oujda, Morocco
| | - Hanane Latrech
- Department of Endocrinology-Diabetology-Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, Mohamed the First University, Oujda, Morocco
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Kahar LA, Yusrawati Y, Jamsari J, Maskoen T. Association between Vitamin D Levels and Mortality in Sepsis Patients Admitted to an Intensive Care at General Hospital Dr. M. Djamil, West Sumatera, Indonesia. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND: Vitamin D deficiency is associated with an increased risk and progression of the disease, especially sepsis. Low serum Vitamin D levels when patients enter the Intensive Care Unit (ICU) can affect patient care outcomes.
AIM: This study aims to determine the relationship between Vitamin D levels and sepsis patients’ treatment outcomes in the Intensive Care Unit.
METHODS: We analyzed 80 sepsis patients admitted from July 2022 to September 2022. This study used a cohort design. Sampling and collection were carried out from July 2022 to September 2022 in the Intensive Care Unit of Dr. M. Djamil Hospital, Padang. This study was conducted on 40 case samples and 40 control samples. The relationship between Vitamin D levels and treatment outcomes for sepsis patients was analyzed using the Chi-Square/Fisher Exact Test.
RESULTS: Patients with the most Vitamin D deficiency were women (77.5%), obese (57.5%), with the most comorbid Chronic Kidney Injury (12.5%), the mean APACHE II score was 21, and SOFA score of 7. Patients with non-deficiency Vitamin D most was male (7%), obese (52.5%), with the most comorbid Cardiovascular Disease (15.0%), the mean APACHE II score was 19, and SOFA score of 5. In 40 patients with Vitamin D deficiency, 24 patients (57.1%) non-survived, and 16 patients (42.1%) survived (RR = 1.833).
CONCLUSION: Vitamin D deficiency increases the risk of death in septic patients, so further intervention is needed.
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Sundari LPR, Purnawati S, Tunas IK, Weta IW. Low 25 Hydroxyvitamin D and High Leptin Level as Risk Factors of Metabolic Syndrome in Obese Women. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Obesity is associated with low vitamin D levels and high leptin levels. The aim of this study is to see if low vitamin D levels and high leptin levels are risk factors for metabolic syndrome in obese women.This study use case control study to observe the difference of leptin and vitamin D plasma level as risk factor of metabolic syndrome on obesity women. There are 34 obese women as the sample of study. Subject is divided randomly into 2 groups, where each of groups consists of 17 obese with syndrome metabolic case and 17 obese women as control. Each group was tested for its vitamin D and leptin level. The relationship between vitamin D and leptin levels and metabolic syndrome was then investigated using the Chi Square test, and logistic regression was taken to discover odds ratio (OR). The result is p=0.031 (p<0.05), and OR=5.25; CI 95% which means the group with low vitamin D has risk factors for metabolic syndrome by 5 times than the control group high vitamin D. It was obtained p=0.001 (p<0.05), and OR= 256; CI 95% means that the case group with high leptin is the risk factors of the occurred metabolic syndrome by 256 times than low level of leptin in control group. It is concluded that in this study there is a link between low vitamin D levels and high leptin levels as risk factors of metabolic syndrome found in obesity.
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Affiliation(s)
| | - Susy Purnawati
- 1Department of Physiology, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - I Ketut Tunas
- 2Department of Health Information Management, Faculty of Health Sciences, Bali International University, Bali. Indonesia
| | - I Wayan Weta
- 3Department of Clinical Nutrition Science, Faculty of Medicine, Udayana University, Bali
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Chen YC, Li WC, Ke PH, Chen IC, Yu W, Huang HY, Xiong XJ, Chen JY. Association between metabolic body composition status and vitamin D deficiency: A cross-sectional study. Front Nutr 2022; 9:940183. [PMID: 35967768 PMCID: PMC9365955 DOI: 10.3389/fnut.2022.940183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the risk of vitamin D deficiency in a relatively healthy Asian population, with (i) metabolically healthy normal weight (MHNW) (homeostasis model assessment-insulin resistance [HOMA-IR] < 2. 5 without metabolic syndrome [MS], body mass index [BMI] < 25), (ii) metabolically healthy obesity (MHO) (HOMA-IR < 2.5, without MS, BMI ≥ 25), (iii) metabolically unhealthy normal weight (MUNW) (HOMA-IR ≥ 2.5, or with MS, BMI < 25), and (iv) metabolically unhealthy obesity (MUO) (HOMA-IR ≥ 2.5, or with MS, BMI ≥ 25) stratified by age and sex. This cross-sectional study involved 6,655 participants aged ≥ 18 years who underwent health checkups between 2013 and 2016 at the Chang Gung Memorial Hospital. Cardiometabolic and inflammatory markers including anthropometric variables, glycemic indices, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and serum 25-hydroxy vitamin D levels, were retrospectively investigated. Compared to the MHNW group, the MHO group showed a higher odds ratio (OR) [1.35, 95% confidence interval (CI) 1.05-1.73] for vitamin D deficiency in men aged < 50 years. By contrast, in men aged > 50 years, the risk of vitamin D deficiency was higher in the MUO group (OR 1.44, 95% CI 1.05-1.97). Among women aged < and ≥ 50 years, the MUO group demonstrated the highest risk for vitamin D deficiency, OR 2.33 vs. 1.54, respectively. Our study revealed that in women of all ages and men aged > 50 years, MUO is associated with vitamin D deficiency and elevated levels of metabolic biomarkers. Among men aged < 50 years, MHO had the highest OR for vitamin D deficiency.
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Affiliation(s)
- Yi-Chuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan.,Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Pin-Hsuan Ke
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - I-Chun Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Hsiung-Ying Huang
- Department of Pulmonary and Critical Care Medicine, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Xue-Jie Xiong
- Department of Oncology, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
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Vigna L, Lonati C, Tirelli AS, Napolitano F, Turolo S, Ingenito MR, Tomaino L, Rossi P, Riboldi L. Effects of Vitamin D Supplefmentation on Outcome of Low-Calorie Diet in Workers Presenting Obesity or Overweight: A Retrospective Observational Study. J Am Coll Nutr 2021; 41:343-351. [PMID: 34125662 DOI: 10.1080/07315724.2021.1902879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM Growing evidence underscores the inverse association between serum vitamin D (vit D) and chronic conditions such as metabolic syndrome, diabetes and obesity. The aim of this retrospective study was to compare weight loss and metabolic serum biomarkers in subjects on low-calorie diet receiving vit D supplementation versus those not receiving it. METHODS The study considered 405 indoor sedentary workers with overweight/obesity and vit D insufficiency, who participated to a health fitness program between 2011-2013. Participants were recommended a moderately-low calorie diet plus vit D supplementation with 150,000 or 900,000 IU cumulative over 6 months in case of hypovitaminosis D (according to the guidelines at the enrollment), while those with optimal levels were recommended only diet. Participants were evaluated at baseline (T0), and after 6 months (T1). Anthropometric parameters, BMI, waist circumference (WC), serum 25-hydroxyvitamin D concentration ([25(OH)D]) and glycated hemoglobin (HbA1c) were assessed at T0 and T1. RESULTS Participants fell into one of three groups: (A) not supplemented, (B) receiving 150,000 IU and (C) receiving 900,000 IU cumulative over 6 months. Overall, the supplementation was associated with increased [25(OH)D], but only the dosage of group C was associated with the achievement of optimal vit D status. A significantly greater weight decrease was observed in group B (-4.1 kg) and C (-4.5 kg) compared to untreated (-1.2 kg). WC reduction was higher in the vit D groups (group B: -3.95 cm; group C; -6.20 cm; untreated: -3.21 cm; p < 0.05). When setting the threshold for obesity at BMI > 30kg/m2, [25(OH)D] no longer correlated with body fat or weight. [25(OH)D] inversely correlated with the Homeostatic Model Assessment for Insulin Resistance and remained significant after adjustment for BMI. CONCLUSIONS Higher [25(OH)D] levels were associated to a greater weight loss and enhanced the beneficial effects of a reduced-calorie diet in individuals with BMI > 30 kg/m2.
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Affiliation(s)
- Luisella Vigna
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Caterina Lonati
- Center for Preclinical Research, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Amedea Silvia Tirelli
- Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Filomena Napolitano
- Department of Clinical and Community Sciences (DISCCO), Università degli Studi di Milano, Milan, Italy
| | - Stefano Turolo
- UOC Nephrology Dialysis and Pediatric Transplantation, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosaria Ingenito
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Tomaino
- Department of Clinical and Community Sciences (DISCCO), Università degli Studi di Milano, Milan, Italy
| | - Paola Rossi
- Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Luciano Riboldi
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Gonçalves TJM, Gonçalves SEAB, Guarnieri A, Risegato RC, Guimarães MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN 2020; 40:110-114. [PMID: 33183522 PMCID: PMC7552968 DOI: 10.1016/j.clnesp.2020.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/19/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIM Verify the prevalence of hypovitaminosis D and obesity in elderly patients infected by new coronavirus. The patients developed severe symptoms and were admitted in intensive care unit (ICU) to receive invasive ventilation due to diagnosis of acute respiratory distress syndrome (ARDS). METHODS A cross-sectional descriptive study composed of elderly (age ≥ 60 years) admitted to the ICU. Were collected demographic (sex, age), anthropometric data, presence of comorbidities (hypertension, diabetes, heart disease, lung, neurological and oncological diseases), severity score in ICU (SAPS III), PaO2/FiO2 ratio, analysis of C-reactive protein (CRP) and serum dosage of 25-hydroxy vitamin D (25 OHD) in the first day of hospitalization to identify elderly with hypovitaminosis D (low values < 30 ng/mL). The diagnosis of obesity in elderly was determined by calculating the body mass index (BMI) ≥ 30 kg/m2. RESULTS A total of 176 elderly met the inclusion criteria. 54% were elderly men and mean age of 72.9 ± 9.1 years. The median BMI was 30.5 (28.1-33) kg/m2 with 68.7% having a nutritional diagnosis of obesity and 15.3% had BMI ≥ 35 kg/m2. The most prevalent comorbidities were hypertension (72.2%) and diabetes (40.9%). Prevalence of hypovitaminosis D with values of 25 OHD <30 ng/mL, < 20 ng/mL and <10 ng/mL was 93.8%, 65.9% and 21% respectively. The prevalence of hypovitaminosis D (<30 ng/mL) in obese elderly was 94.2%. There was a negative and significant bivariate correlation between BMI and levels of 25 OHD (r = - 0.15; p = 0.04). CONCLUSION Hypovitaminosis D and obesity in elderly have a high prevalence in critically ill patients in ICU infected by the new coronavirus. Laboratory investigation of vitamin D becomes important, especially in obese elderly patients.
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Affiliation(s)
| | | | - Andreia Guarnieri
- Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil
| | | | | | | | - Alvaro Razuk-Filho
- Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil
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Sundari LPR, Bakta M, Astawa NM, Adiatmika PG, Arijana GKN, Tunas K. The Effect of Vitamin D Administration on Leptin, Adiponectin and mRNA MCP-1 Levels in Adipose Tissue of Obese Female Wistar Rats. ACTA ACUST UNITED AC 2020. [DOI: 10.12944/crnfsj.8.2.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In obesity, there is an accumulation of adipocytes which produces adipokine that are pro-inflammatory substance, such as leptin and MCP-1 and anti-inflammatory substance, such as adiponectin, while the bioavailability of vitamin D is decreased. This research aimed to study the effect of vitamin D administration on leptin, MCP-1, and adiponectin levels in adipose tissue rats with obesity. Vitamin D was administered to the obese model of 6-9 months old female Wistar rats. This experiment was a randomized control group design with a post-test group design only. Twenty-seven (27) female obese Wistar rats were included in this study. The animals were divided randomly into 3 groups: 9 rats were given 2400 IU vitamin D (group A), 9 rats were given 800 IU vitamin D (group B) and 9 rats were given a placebo as control (group C). The administration of Vitamin D was given once daily for 8 weeks. The visceral adipose tissue was taken to measure the level of leptin, adiponectin and mRNA MCP-1. Data among groups was analyzed by using one-way ANOVA and followed by LSD test, at a significance level of p <0.05. The lowest level of leptin (1059.15+135.20 pg/ml) and mRNA MCP-1 (2.36 + 0.75 fg/ml) and the highest adiponectin level (3.43 + 0.47 ng/ml) were found in group A. In conclusion, oral administration of vitamin D (2400 IU) decreased pro-inflammatory substances, such as leptin and mRNA MCP-1 and increased anti-inflammatory substances, such as adiponectin, in visceral adipose tissue of obese female Wistar rats.
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Affiliation(s)
| | - Made Bakta
- Internal Medicine Department, Faculty of Medicine-Sanglah Hospital, Udayana University, Bali, Indonesia
| | - Nyoman Mantik Astawa
- Immunology Laboratory, Faculty of Veterinary, Udayana University, Bali Indonesia
| | - Putu Gede Adiatmika
- Physiology Department, Faculty of Medicine, Udayana University, Bali, Indonesia
| | | | - Ketut Tunas
- Department of Public Health, Faculty of Health, Science and Technology, Dhyana Pura University, Bali, Indonesia
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de Alencar GR, da Silva Freire L, de Mello Pereira B, da Silva VR, Holanda AC, de Moura RC, Severo JS, Braz DC, Marreiro DDN, de Jesus e Silva de Almendra Freitas B, de Carvalho CM. Effects of Vitamin D Status on Inflammatory Markers in Obese Subjects: A Systematic Review. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666190311151319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Recent studies have demonstrated the role of micronutrients in the manifestation
of comorbidities associated with obesity. Vitamin D deficiency, in particular, appears to be associated
with increased levels of inflammatory markers, which may lead to chronic low-grade inflammation,
elevating the risk of chronic diseases such as diabetes, metabolic syndrome, and cardiovascular
disease. The objective of this study was to perform a systematic review of observational
studies conducted to investigate the effect of vitamin D deficiency on inflammatory markers in obese
subjects.
Methodology:
This systematic review was conducted in accordance with the “STROBE” and PRISMA
recommendations. Observational studies that evaluated the effect of vitamin D status on inflammatory
markers in obese subjects were selected and reviewed. Searches were conducted in the
PubMed, SciVerse Scopus, and Web of Science databases from February 21 to 22, 2018.
Results:
After the selection and removal of duplicate articles, 10 eligible articles were identified. Results
from eight observational studies showed an association between vitamin D deficiency or insufficiency
in the body and increased concentrations of inflammatory markers in obese individuals. On
the other hand, two of the studies did not demonstrate any correlation. With regard to the inflammatory
markers evaluated, eight studies showed high concentrations of ultra-sensitive C-reactive protein,
five studies found an increase in interleukin-6 concentrations, and two studies noted increased
levels of tumor necrosis factor.
Conclusion:
The data presented in this systematic review provide evidence of the association between
vitamin D deficiency and increased inflammation in obesity.
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Affiliation(s)
- Geórgia R.R. de Alencar
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Lailton da Silva Freire
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Beatriz de Mello Pereira
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Verbena R. da Silva
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Aline C. Holanda
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Rayane C. de Moura
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Juliana S. Severo
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Debora C. Braz
- Department of Pharmacy, Federal University of Piaui, Campus Minister Petronio Portela, Ininga, Teresina, Piaui, Brazil
| | - Dilina do Nascimento Marreiro
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | | | - Cecília M.R.G. de Carvalho
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
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Cipponeri E, Vitturi N, Mariano V, Boscari F, Galasso S, Crepaldi C, Fadini GP, Vigili de Kreutzenberg S, Marescotti MC, Iori E, Cavallin F, Sartori L, Baritussio A, Avogaro A, Bruttomesso D. Vitamin D status and non-alcoholic fatty liver disease in patients with type 1 diabetes. J Endocrinol Invest 2019; 42:1099-1107. [PMID: 30847862 DOI: 10.1007/s40618-019-01031-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/27/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE In patients with type 1 diabetes (T1D), the prevalence of non-alcoholic fatty liver disease (NAFLD) ranges from 10 to 53% and contrasting evidence suggests that vitamin D deficiency may favor liver fat accumulation. Here, we investigated the association between vitamin D status and NAFLD in adults with T1D. METHODS 220 consecutive adult T1D patients on multiple daily injections or continuous subcutaneous insulin infusion and not taking calcium or vitamin D supplements were included. Patient characteristics, 25(OH)D serum levels, and metabolic parameters were analyzed. Vitamin D status was defined as sufficiency ( ≥ 75 nmol/L; 30 ng/ml), insufficiency (50-75 nmol/L; 20-30 ng/ml), or deficiency ( < 50 nmol/L; 20 ng/ml). NAFLD was diagnosed at ultrasound examination and graded 0-3. RESULTS NAFLD was present in 57 patients (29.5%): 51 grade 1, 5 grade 2, and 1 grade 3. Median 25(OH)D levels were 53 nmol/L (IQR 38-70) in patients with NAFLD and 50 nmol/L (34-69) in patients without (p = 0.46). At multivariable analysis, NAFLD was not associated with 25(OH)D levels (p = 0.42) or vitamin D deficiency (p = 0.55), while BMI (OR 1.16, 95% CI 1.07-1.27) and serum triglycerides (OR 1.02, 95% CI 1.01-1.03) were independently associated with NAFLD. CONCLUSIONS Vitamin D status appears to have no link with low-grade NAFLD in patients with type 1 diabetes.
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Affiliation(s)
- E Cipponeri
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - N Vitturi
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - V Mariano
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - F Boscari
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - S Galasso
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - C Crepaldi
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - G P Fadini
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - S Vigili de Kreutzenberg
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - M C Marescotti
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - E Iori
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | | | - L Sartori
- Department of Medicine, Clinica Medica 1, University of Padova, Padova, Italy
| | - A Baritussio
- Department of Medicine, Clinica Medica 1, University of Padova, Padova, Italy
| | - A Avogaro
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - D Bruttomesso
- Division of Metabolic Diseases, Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
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Migliaccio S, Di Nisio A, Mele C, Scappaticcio L, Savastano S, Colao A. Obesity and hypovitaminosis D: causality or casualty? INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2019; 9:20-31. [PMID: 31391922 DOI: 10.1038/s41367-019-0010-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epidemiological studies reported that vitamin D deficiency represents an increasingly widespread phenomenon in various populations. Vitamin D deficiency is considered a clinical syndrome determined by low circulating levels of 25-hydroxyvitamin D (25(OH)D), which is the biologically-inactive intermediate and represents the predominant circulating form. Different mechanisms have been hypothesized to explain the association between hypovitaminosis D and obesity, including lower dietary intake of vitamin D, lesser skin exposure to sunlight, due to less outdoor physical activity, decreased intestinal absorption, impaired hydroxylation in adipose tissue and 25(OH)D accumulation in fat. However, several studies speculated that vitamin D deficiency itself could cause obesity or prevent weight loss. The fat-solubility of vitamin D leads to the hypothesis that a sequestration process occurs in body fat depots, resulting in a lower bioavailability in the obese state. After investigating the clinical aspects of vitamin D deficiency and the proposed mechanisms for low 25(OH)D in obesity, in this manuscript we discuss the possible role of vitamin D replacement treatment, with different formulations, to restore normal levels in individuals affected by obesity, and evaluate potential positive effects on obesity itself and its metabolic consequences. Food-based prevention strategies for enhancement of vitamin D status and, therefore, lowering skeletal and extra-skeletal diseases risk have been widely proposed in the past decades; however pharmacological supplementation, namely cholecalciferol and calcifediol, is required in the treatment of vitamin D insufficiency and its comorbidities. In individuals affected by obesity, high doses of vitamin D are required to normalize serum vitamin D levels, but the different liposolubility of different supplements should be taken into account. Although the results are inconsistent, some studies reported that vitamin D supplementation may have some beneficial effects in people with obesity.
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Affiliation(s)
- Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Unit Endocrinology, University Foro Italico, Roma, Italy
| | - Andrea Di Nisio
- 2Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padova, Italy
| | - Chiara Mele
- 3Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,4Division of General Medicine, S. Giuseppe Hospital, Istituto Auxologico Italiano, Piancavallo, Verbania, Italy
| | - Lorenzo Scappaticcio
- Division of Endocrinology and Metabolic Diseases, Dept of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania L. Vanvitelli, Naples, Italy
| | - Silvia Savastano
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
| | - Annamaria Colao
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
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12
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Dziedzic EA, Gąsior JS, Pawłowski M, Wodejko-Kucharska B, Saniewski T, Marcisz A, Dąbrowski MJ. Vitamin D level is associated with severity of coronary artery atherosclerosis and incidence of acute coronary syndromes in non-diabetic cardiac patients. Arch Med Sci 2019; 15:359-368. [PMID: 30899288 PMCID: PMC6425216 DOI: 10.5114/aoms.2019.83291] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/20/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Ischaemic heart disease is the main cause of death in developed countries. There are many modifiable risk factors associated with coronary heart disease (CAD). A growing number of studies point to vitamin D deficiency as a risk factor for heart attacks and the conditions associated with cardiovascular disease. This study aimed to analyse the relationship between the level of 25-hydroxyvitamin D (25(OH)D) and the severity of coronary artery atherosclerosis and to study 25(OH)D levels in non-diabetic patients hospitalised due to acute coronary syndrome and those diagnosed with stable CAD. MATERIAL AND METHODS oronary angiography was performed prospectively in 410 successive cardiac patients. The severity of coronary artery atherosclerosis was assessed according to the Coronary Artery Surgery Study Score (CASSS). The plasma 25(OH)D level was assessed with the electrochemiluminescence method. RESULTS The 25(OH)D level proved to be one of the significant determinants of the CASSS (p < 0.05). In subjects without significant lesions in the coronary arteries the 25(OH)D level was significantly higher compared to patients with one- to three-vessel coronary atherosclerosis (p < 0.05). A significantly higher 25(OH)D level was noted in patients diagnosed with stable CAD compared to patients hospitalised due to acute coronary syndrome (p < 0.01). CONCLUSIONS Patients with one- to three-vessel atherosclerosis have a significantly lower 25(OH)D level compared to patients without significant lesions in the coronary arteries. A lower 25(OH)D level was observed in patients hospitalised due to acute coronary syndrome compared to patients diagnosed with stable CAD.
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Affiliation(s)
| | - Jakub S. Gąsior
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
- Clinical Department of Cardiology of Institute of Cardiology, Bielanski Hospital, Warsaw, Poland
| | - Mariusz Pawłowski
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | | | | | - Anna Marcisz
- Data Mining Group, Faculty of Automatic Control, Electronic and Computer Science, Silesian University of Technology, Gliwice, Poland
| | - Marek J. Dąbrowski
- Department of Cardiology, Bielanski Hospital, Warsaw, Poland
- Clinical Department of Cardiology of Institute of Cardiology, Bielanski Hospital, Warsaw, Poland
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13
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Vitamin D inhibits palmitate-induced macrophage pro-inflammatory cytokine production by targeting the MAPK pathway. Immunol Lett 2018; 202:23-30. [DOI: 10.1016/j.imlet.2018.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/24/2018] [Accepted: 07/31/2018] [Indexed: 02/05/2023]
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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: 9.3] [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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Schiavo L, Busetto L, Cesaretti M, Zelber-Sagi S, Deutsch L, Iannelli A. Nutritional issues in patients with obesity and cirrhosis. World J Gastroenterol 2018; 24:3330-3346. [PMID: 30122874 PMCID: PMC6092576 DOI: 10.3748/wjg.v24.i30.3330] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/15/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis. Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis. Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronic liver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation. Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble, water-soluble vitamins and trace elements and should be supplemented appropriately. Diet, physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations. Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation. The risk of sarcopenia, micronutrient status, and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review. Furthermore, the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.
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Affiliation(s)
- Luigi Schiavo
- Department of Translational Medical Science, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
- IX Division of General Surgery, Vascular Surgery and Applied Biotechnology, Naples University Policlinic, Naples 80131, Italy
| | - Luca Busetto
- Department of Medicine, University of Padua, Padua 35128, Italy
- Center for the Study and the Integrated Management of Obesity, University Hospital of Padua, Padua 35128, Italy
| | - Manuela Cesaretti
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, AP-HP, Clichy 92110, France
- Department of Nanophysics, Italian Institute of Technology, Genova 16163, Italy
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Department of Gastroenterology and Liver disease, Tel Aviv Medical Center, 62431, Tel-Aviv 62431, Israel
| | - Liat Deutsch
- Department of Gastroenterology and Liver disease, Tel Aviv Medical Center, 62431, Tel-Aviv 62431, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 62431, Israel
| | - Antonio Iannelli
- Digestive Unit, Archet 2 Hospital, University Hospital of Nice, F-06202, Nice, France; Inserm, U1065, Team 8 “Hepatic complications of obesity”, Nice F-06204, France
- University of Nice Sophia-Antipolis, Nice F-06107, France
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16
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Ismail MM, Abdel Hamid TA, Ibrahim AA, Marzouk H. Serum adipokines and vitamin D levels in patients with type 1 diabetes mellitus. Arch Med Sci 2017; 13:738-744. [PMID: 28721140 PMCID: PMC5510519 DOI: 10.5114/aoms.2016.60680] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/20/2015] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Adiponectin, leptin and resistin are adipokines that play important roles in the regulation of lipid and carbohydrate metabolism in type 2 diabetes (T2DM). However, their influence in type 1 diabetes mellitus is still unknown. The aim of this study was to measure serum adiponectin, leptin and resistin levels and to investigate their relationships with vitamin D and other clinical and laboratory parameters in patients with type 1 diabetes. MATERIAL AND METHODS Fifty subjects with type 1 diabetes and 50 healthy age- and sex-matched subjects were selected from the Endocrinology Outpatient Clinic of Cairo University Pediatrics Hospital. Enzyme-linked immunosorbent assay was used to measure the levels of leptin, adiponectin and resistin. Vitamin D levels were measured using electro-chemiluminescence immunoassay. RESULTS There were no significant differences in adiponectin and leptin levels between diabetic and control subjects (p = 0.6 and p = 0.5 respectively). Resistin levels were significantly higher in the diabetic group compared to controls (p < 0.001) and in postpubertal patients compared to prepubertal patients (p < 0.04). Serum resistin in type 1 diabetes showed a negative correlation with vitamin D (p < 0.001) and a positive correlation with glycated hemoglobin (HbA1c) (p = 0.006), while other adipokines were not interrelated. CONCLUSIONS These results strongly support a role of resistin and vitamin D deficiency in the pathophysiology of type 1 diabetes. Vitamin D may be involved in resistin regulation through an unknown mechanism. Further studies are recommended to understand resistin regulation in type 1 diabetes.
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Affiliation(s)
- Mohamed M Ismail
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Alshaymaa A Ibrahim
- Clinical and Chemical Pathology Department, National Research Centre, Cairo, Egypt
| | - Huda Marzouk
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord 2017; 18:215-225. [PMID: 28229265 DOI: 10.1007/s11154-017-9410-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Low vitamin D status and obesity have concomitantly reached epidemic levels worldwide. Up to now the direction of the association between low vitamin D status and obesity, the exact mechanisms responsible for this association and the clinical usefulness to increase vitamin D status for reducing adiposity still warrant further evaluation. The aim of the present review was to examine the current evidence linking low vitamin D status and obesity in relation to the role of the nutritionist. On the one side, considering obesity as a causal factor, low sun exposure in obese individuals due to their sedentary lifestyle and less outdoor activity, vitamin D sequestration in adipose tissue, and volumetric dilution of ingested or cutaneously synthesized vitamin D3 in the large fat mass of obese patients, might represent some of the factors playing a major role in the pathogenesis of the low vitamin D status. On the other side, the expression of both vitamin D3 receptors and enzymes responsible for vitamin D3 metabolism in adipocytes depicted a role for the low vitamin D status per se in the development of obesity by modulating adipocyte differentiation and lipid metabolism. Nutritionists need to accurately address the aspects influencing the low vitamin D status in obesity and the vitamin D supplementation in obese individuals.
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Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Barrea
- I.O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | | | | | | | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
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18
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Barrea L, Savastano S, Di Somma C, Savanelli MC, Nappi F, Albanese L, Orio F, Colao A. Low serum vitamin D-status, air pollution and obesity: A dangerous liaison. Rev Endocr Metab Disord 2017; 18:207-214. [PMID: 27645613 PMCID: PMC5486902 DOI: 10.1007/s11154-016-9388-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this review is to provide a general overview of the possible associations among the vitamin D status, air pollution and obesity. Sunlight exposure accounts in humans for more than 90 % of the production of vitamin D. Among emerging factors influencing sunlight-induced synthesis of vitamin D, prospective and observational studies proved that air pollution constitutes an independent risk factor in the pathogenesis of vitamin D hypovitaminosis. In addition, environmental pollutants can affect risk of obesity when inhaled, in combination with unhealthy diet and lifestyle. In turn, obesity is closely associated with a low vitamin D status and many possible mechanisms have been proposed to explain this association. The associations of air pollution with low vitamin D status on the hand and with obesity on the other hand, could provide a rationale for considering obesity as a further link between air pollution and low vitamin D status. In this respect, a vicious cycle could operate among low vitamin D status, air pollution, and obesity, with additive detrimental effects on cardio-metabolic risk in obese individuals. Besides vitamin D supplementation, nutrient combination, used to maximize the protective effects against air pollution, might also contribute to improve the vitamin D status by attenuating the "obesogen" effects of air pollution.
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Affiliation(s)
- Luigi Barrea
- I. O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | | | | | | | - Lidia Albanese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, “Parthenope” University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Vigna L, Cassinelli L, Tirelli AS, Felicetta I, Napolitano F, Tomaino L, Mutti M, Barberi CE, Riboldi L. 25(OH)D Levels in Relation to Gender, Overweight, Insulin Resistance, and Inflammation in a Cross-Sectional Cohort of Northern Italian Workers: Evidence in Support of Preventive Health Care Programs. J Am Coll Nutr 2017; 36:253-260. [DOI: 10.1080/07315724.2016.1264280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Luisella Vigna
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Letizia Cassinelli
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Amedea Silvia Tirelli
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Irene Felicetta
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Filomena Napolitano
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Laura Tomaino
- Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore, Milano, ITALY
| | - Michela Mutti
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Claudia Eleonora Barberi
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore, Milano, ITALY
| | - Luciano Riboldi
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
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Relationship between serum 25-hydroxyvitamin D levels and the SYNTAX score in patients with acute coronary syndrome. Anatol J Cardiol 2017; 17:293-297. [PMID: 28179617 PMCID: PMC5469109 DOI: 10.14744/anatoljcardiol.2016.6977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The extent of severity and complexity of coronary artery disease (CAD) in patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and possible correlations between serum 25-hydroxyvitamin D (25(OH)D) have not yet been adequately studied. We evaluated the relationship between 25(OH)D levels and the burden of CAD as assessed by the SYNTAX score (SXscore) in patients with acute coronary syndrome (ACS) including STEMI and NSTEMI. METHODS After exclusion, a total of 113 patients who were admitted to our hospital due to ACS and who were referred for undergoing coronary angiography were prospectively included. Their mean age was 63.3±18.5 years, and 80.5% of them were men. In total, 44.2% of the patients had NSTEMI and the remaining had STEMI. Blood samples were drawn at admission to evaluate serum 25(OH)D levels. CAD severity was assessed using the SXscore. Patients were classified as having low (SXscore ≤22) or high (SXscore >22) SXscores. Pearson's and Spearman's correlation coefficients were used to examine the relationship between serum 25(OH)D levels and the SXscore. RESULTS 25(OH)D levels were significantly lower in the group with a high SXscore than in the group with a low SXscore (21.0±8.0 vs. 16.7±6.8, p=0.005). Correlation analysis showed a significant correlation between 25(OH)D levels and the SXscore. Multiple linear regression (MLR) analysis was used to determine the significance of the relationship between the SXscore and 25(OH)D, parathyroid hormone, and C-reactive protein levels and eGFR. MLR analysis revealed that only 25(OH)D levels (coefficient beta, -0.217, p=0.029) was significantly associated with the severity of CAD. CONCLUSION The present study showed that serum 25(OH)D levels were significantly lower in patients with STEMI/NSTEMI and that low serum 25(OH)D levels were significantly correlated with CAD severity and extent.
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Verdoia M, Pergolini P, Rolla R, Nardin M, Schaffer A, Barbieri L, Daffara V, Marino P, Bellomo G, Suryapranata H, De Luca G. Impact of high-dose statins on vitamin D levels and platelet function in patients with coronary artery disease. Thromb Res 2016; 150:90-95. [PMID: 28068529 DOI: 10.1016/j.thromres.2016.12.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/15/2016] [Accepted: 12/21/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Statins represent a pivotal treatment in coronary artery disease, offering a reduction in cardiovascular risk even beyond their lipid-lowering action. However, the mechanism of these "pleiotropic" benefits of statins is poorly understood. Vitamin D has been suggested as a potential mediator of the anti-inflammatory, anti-thrombotic and vascular protecting effects of statins. Aim of present study was to assess the impact of a high-intensity statin therapy on vitamin D levels and platelet function in patients with coronary artery disease. METHODS Patients discharged on dual antiplatelet therapy and high-intensity statins after an ACS or elective PCI were scheduled for main chemistry and vitamin D levels assessment at 30-90days post-discharge. Vitamin D (25-OHD) dosing was performed by chemiluminescence method through the LIAISON® Vitamin D assay (Diasorin Inc). Platelet function was assessed by Multiplate® (multiple platelet function analyser; Roche Diagnostics AG). RESULTS Among 246 patients included, 142 were discharged on a new statin therapy or with an increase in previous dose (Inc-S), while 104 were already receiving a high-dose statin at admission, that remained unchanged (Eq-S). Median follow-up was 75.5days. Patients in the Inc-S group were younger (p=0.01), smokers (p<0.001), with a less frequent history of hypercholesterolemia (p=0.05), diabetes (p=0.03), hypertension (p=0.02), or previous cardiovascular events (p<0.001). They were more often admitted for an acute coronary syndrome (p<0.001) and used less anti-hypertensive drugs or nitrates. Higher total circulating calcium was observed in the Inc-S group (p=0.004), while baseline vitamin D levels were similar in the 2 groups (p=0.30). A significant reduction in the circulating low-density lipoprotein (LDL) cholesterol was observed in the Inc-S group. Vitamin D levels increased in the Inc-S patients but not in the Eq-S group (delta-25OHD: 23.2±20.5% vs 3.1±4.7%, p=0.003), with a linear relationship between the magnitude of vitamin D elevation and the reduction of LDL cholesterol (r=-0.17, p=0.01). Platelet reactivity was significantly lower in the Inc-S patients, when evaluating aggregation with different platelet activating stimuli (arachidonic acid, p=0.02, collagen, p=0.004, thrombin-activating peptide, p=0.07, ADP, p=0.002). CONCLUSIONS In patients with coronary artery disease, the addition of a high-intensity statin treatment, besides the lipid-lowering effects, is associated to a significant increase in vitamin D levels and lower platelet reactivity, potentially providing explanation of the "pleiotropic" benefits of statins therapy in cardiovascular disease.
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Affiliation(s)
- Monica Verdoia
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy.
| | - Patrizia Pergolini
- Clinical Chemistry, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Roberta Rolla
- Clinical Chemistry, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Matteo Nardin
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy; Department of Internal Medicine, Spedali Civili Hospital, Brescia, Italy
| | - Alon Schaffer
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Lucia Barbieri
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy; Cardiologia, Ospedale S. Andrea, Vercelli, Italy
| | - Veronica Daffara
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Paolo Marino
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Giorgio Bellomo
- Clinical Chemistry, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | | | - Giuseppe De Luca
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy.
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Dziedzic EA, Przychodzeń S, Dąbrowski M. The effects of vitamin D on severity of coronary artery atherosclerosis and lipid profile of cardiac patients. Arch Med Sci 2016; 12:1199-1206. [PMID: 27904508 PMCID: PMC5108383 DOI: 10.5114/aoms.2016.60640] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/28/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION A deficiency of 25-hydroxyvitamin D (25(OH)D) (the standard biomarker for vitamin D status) can have multiple impacts on the cardiovascular system. The aim of the study was to assess of the influence of 25(OH)D on severity of coronary atherosclerosis and lipid profile. MATERIAL AND METHODS The study involved prospectively 637 patients subject to coronary catheterization. The stage of coronary atherosclerosis was assessed using the Coronary Artery Surgery Study score (CASSS). Plasma concentration of 25(OH)D was measured using an electrochemiluminescent immunoassay. The levels of total cholesterol (TC), high-density cholesterol (HDL-C) and triglycerides (TG) were measured using the enzymatic method, and the concentration of low-density cholesterol (LDL-C) was calculated with the Friedewald equation. RESULTS The average level of 25(OH)D was 15.85 ng/ml. A higher level of 25(OH)D was observed in men (16.28 ng/ml vs. 15.1 ng/ml; p = 0.027). The study did not reveal any significant correlation between the level of 25(OH)D and severity of coronary atherosclerosis. It was observed however that the increase of 25(OH)D level results in an increased number of patients without significant lesions in the coronary arteries. In the whole group of women and men in the age group of 70-80 years an inverse relationship was observed between the level of 25(OH) and the severity of coronary atherosclerosis. The whole study group showed a statistically significant inverse correlation of the 25(OH)D level with TC (p = 0.0057), LDL-C (p = 0.00037) and TG (p = 0.00017). CONCLUSIONS Women and men over 70 years showed an inverse correlation of the 25(OH)D level and the stage of coronary atherosclerosis. Deficiency of 25(OH)D affects the levels of TC, LDL-C and TG.
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Affiliation(s)
- Ewelina A. Dziedzic
- Cardiology Clinic of Physiotherapy Division, 2 Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| | - Sebastian Przychodzeń
- Cardiology Clinic of Physiotherapy Division, 2 Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| | - Marek Dąbrowski
- Cardiology Clinic of Physiotherapy Division, 2 Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
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Nguyen VT, Li X, Elli EF, Ayloo SM, Castellanos KJ, Fantuzzi G, Freels S, Braunschweig CL. Vitamin D, inflammation, and relations to insulin resistance in premenopausal women with morbid obesity. Obesity (Silver Spring) 2015; 23:1591-7. [PMID: 26148304 DOI: 10.1002/oby.21131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 03/21/2015] [Accepted: 03/31/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVE In this study, the associations between vitamin D, insulin sensitivity, and inflammation and their relationships with adipose tissue expression of vitamin D receptor (VDR) and inflammatory markers in women with morbid obesity were determined. METHODS An oral glucose tolerance test prior to surgery was completed by healthy premenopausal women (n = 76) seeking bariatric surgery. Abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were collected during surgery. RESULTS Approximately, 70% of our subjects were vitamin D sufficient or optimal, and 80% had normal glucose tolerance. No significant association between serum 25-hydroxyvitamin D [25(OH)D] with circulating inflammatory markers or insulin sensitivity was identified. In subjects with waist circumference of <139 cm (n = 42), log25(OH)D positively predicted VAT logIL-6 mRNA expression (P = 0.003). LogVDR expression was positively correlated with the expression of inflammatory markers in both SAT (logIL-1β mRNA: r = 0.95, P < 0.0001; logTNF mRNA: r = 0.82, P < 0.0001) and VAT (logIL-1β mRNA: r = 0.89, P < 0.0001; logTNF mRNA: r = 0.75, P < 0.0001). VAT logVDR expression positively predicted logHOMA-IR in non-African American subjects (P = 0.05). CONCLUSIONS The beneficial effects of vitamin D on inflammation and insulin sensitivity were not supported by our findings. VDR does not appear to possess a protective effect in adipose tissue.
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Affiliation(s)
- Van T Nguyen
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Xianjun Li
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Enrique F Elli
- Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Subhashini M Ayloo
- Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Karla J Castellanos
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Giamila Fantuzzi
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Carol L Braunschweig
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
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Morisset AS, Tardio V, Weisnagel J, Lemieux S, Bergeron J, Gagnon C. Associations Between Serum 25-Hydroxyvitamin D, Insulin Sensitivity, Insulin Secretion, and β-Cell Function According to Glucose Tolerance Status. Metab Syndr Relat Disord 2015; 13:208-13. [PMID: 25781493 DOI: 10.1089/met.2014.0159] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The objective of this study was to determine whether glucose tolerance status influences the associations between serum 25-hydroxyvitamin D [25(OH)D], insulin sensitivity, insulin secretion, and β-cell function. METHODS This cross-sectional study included 112 French Canadian postmenopausal women with normal glucose tolerance (NGT; n = 65) or abnormal glucose tolerance (AGT; n = 47). Estimates of insulin sensitivity [homeostasis model assessment of insulin sensitivity (HOMA %S) and glucose disposal rate (GDR)], insulin secretion [area under the curve of C-peptide (AUC C-peptide)], and β-cell function (GDR × AUC C-peptide) were derived from a 2-hr euglycemic-hyperinsulinemic clamp and a 75-gram 3-hr oral glucose tolerance test (OGTT). Measures of adiposity were taken (waist circumference, body mass index, fat mass by the hydrostatic weighting technique, and computed tomography (CT)-derived total and visceral adiposity), questionnaires on physical activity, dietary calcium, and vitamin D intake were administered, and blood was sampled for measurement of parathyroid hormone, interleukin-6, and adiponectin. RESULTS AGT status was significantly associated with lower insulin sensitivity and β-cell function (P ≤ 0.01 for all) but not with insulin secretion. Lower serum 25(OH)D concentrations were significantly associated with lower insulin sensitivity and secretion (P ≤ 0.01 for all) but not with β-cell function. The interaction between glucose tolerance status and serum 25(OH)D concentration was not significant for either insulin sensitivity, insulin secretion, or β-cell function, even after adjustment for potential confounders. CONCLUSION Vitamin D and glucose tolerance status are both independently associated with measures of insulin sensitivity, insulin secretion, and β-cell function. However, the association between serum 25(OH)D and these surrogate markers of type 2 diabetes mellitus risk is not influenced by glucose tolerance status.
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Affiliation(s)
- Anne-Sophie Morisset
- 1 Endocrinology and Nephrology Unit, CHU de Québec Research Centre, Laval University , Quebec, Canada
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Abstract
BACKGROUND The increasing incidence of obesity in children is a significant risk factor for nonalcoholic fatty liver disease and obesity-associated morbidity. Vitamin D has a major role in bone mineral metabolism and has antimicrobial, antioxidant properties. In this study we aimed to investigate the role of vitamin D in children with obesity with hepatosteatosis. METHODS A total of 101 children with obesity were included in this study. Hepatosteatosis was diagnosed and graded using ultrasonography. Serum levels of 25-hydroxyvitamin D (25-(OH) vitamin D), calcium, phosphate, alkaline phosphatase, and parathormone were tested. Two-sided t test and Pearson χ tests were used for the relation between vitamin D and hepatosteatosis. RESULTS In our study group, 45.5% were girls (n=46) and the mean age was 11.5 ± 2.8 years (range 3-17 years). Hepatosteatosis was identified in 58 children (57.4%). The diagnosis of grade 1 and grade 2 hepatosteatosis was made in 41 (40.6%) and 17 (16.8%) children, respectively. Median serum 25-(OH) vitamin D levels in children without hepatosteatosis was 16.4 ng/mL (interquartile range 12.4-24.8 ng/mL), whereas children with grade 1 and grade 2 hepatosteatosis had 25-(OH) vitamin D levels of 14.2 ng/mL (interquartile range 9.5-21.2 ng/mL) and 11.5 ng/mL (interquartile range 7.5-16.7 ng/mL), respectively (P=0.005). There was a positive correlation between insulin resistance and the grade of hepatosteatosis (P=0.03). CONCLUSIONS Serum vitamin D levels in children with obesity with hepatosteatosis are significantly lower than vitamin D levels in children with obesity without hepatosteatosis. In this observational study we only refer to the association of vitamin D deficiency/insufficiency with hepatosteatosis.
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26
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Dasarathy J, Periyalwar P, Allampati S, Bhinder V, Hawkins C, Brandt P, Khiyami A, McCullough AJ, Dasarathy S. Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non-alcoholic fatty liver disease. Liver Int 2014; 34:e118-27. [PMID: 24118743 PMCID: PMC4012003 DOI: 10.1111/liv.12312] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/29/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Hypovitaminosis D is common in obesity and insulin-resistant states. Increased fat mass in patients with non-alcoholic fatty liver disease (NAFLD) may contribute to hypovitaminosis D. To determine the relation among plasma vitamin D concentration, severity of disease and body composition in NAFLD. METHODS Plasma vitamin D concentration was quantified in 148 consecutive biopsy-proven patients with NAFLD (non-alcoholic steatohepatitis - NASH: n = 81; and hepatic steatosis: n = 67) and healthy controls (n = 39). NAFLD was scored using the NASH CRN criteria. Body composition was quantified by bioelectrical impedance analysis and abdominal CT image analysis. RESULTS Plasma vitamin D concentration was significantly lower in NAFLD (21.2 ± 10.4 ng/ml) compared with healthy controls (35.7 ± 6.0 ng/ml). Higher NAFLD activity scores were associated with lower plasma concentration of vitamin D (r(2) = 0.29; P < 0.001). Subgroup analysis among patients with NAFLD showed that patients with NASH had significantly lower (P < 0.01) vitamin D levels than those with steatosis alone (18.1 ± 8.4 vs. 25.0 ± 11.3 ng/ml). Low concentrations of vitamin D were associated with greater severity of steatosis, hepatocyte ballooning and fibrosis (P < 0.05).On multivariate regression analysis, only severity of hepatocyte ballooning was independently associated (P = 0.02) with low vitamin D concentrations. Plasma vitamin D (P = 0.004) and insulin concentrations (P = 0.03) were independent predictors of the NAFLD activity score on biopsy. Patients with NAFLD had higher fat mass that correlated with low vitamin D (r(2) = 0.26; P = 0.008). CONCLUSIONS Low plasma vitamin D concentration is an independent predictor of the severity of NAFLD. Further prospective studies demonstrating the impact of vitamin D replacement in NAFLD patients are required.
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Affiliation(s)
| | - Pranav Periyalwar
- Department of Gastroenterology, MetroHealth Medical Center, Cleveland OH
| | - Sanath Allampati
- Department of Gastroenterology, MetroHealth Medical Center, Cleveland OH
| | - Vikram Bhinder
- Department of Gastroenterology, Cleveland Clinic, Cleveland OH
| | - Carol Hawkins
- Department of Gastroenterology, MetroHealth Medical Center, Cleveland OH
| | - Patricia Brandt
- Department of Gastroenterology, MetroHealth Medical Center, Cleveland OH
| | - Amer Khiyami
- Department of Pathology, MetroHealth Medical Center, Cleveland OH
| | - Arthur J McCullough
- Department of Gastroenterology, Cleveland Clinic, Cleveland OH,Department of Pathobiology, Cleveland Clinic, Cleveland OH
| | - Srinivasan Dasarathy
- Department of Gastroenterology, MetroHealth Medical Center, Cleveland OH,Department of Gastroenterology, Cleveland Clinic, Cleveland OH,Department of Pathobiology, Cleveland Clinic, Cleveland OH
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27
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Verdoia M, Schaffer A, Sartori C, Barbieri L, Cassetti E, Marino P, Galasso G, De Luca G. Vitamin D deficiency is independently associated with the extent of coronary artery disease. Eur J Clin Invest 2014; 44:634-42. [PMID: 24829065 DOI: 10.1111/eci.12281] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 05/09/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Vitamin D (25-OH D3) deficiency represents a rising social and economic problem in Western countries. Vitamin D has been recently reported to modulate inflammatory processes, endothelium and smooth muscle cell proliferation and even platelet function, thus potentially modulating atherothrombosis. Great interest has been addressed on its impact on cardiovascular outcome, with contrasting results. The aim of current study was to evaluate the relationship between 25-OH D3 and the extent of coronary artery disease (CAD) in a consecutive cohort of patients undergoing coronary angiography. MATERIALS AND METHODS Patients undergoing elective coronary angiography were included in a cross-sectional study. Fasting samples were collected for 25-OH D3 levels assessment. Significant CAD was defined as at least 1 vessel stenosis > 50%, while severe CAD as left main and/or trivessel disease, as evaluated by quantitative coronary angiography. RESULTS Hypovitaminosis D was observed in 70·4% of 1484 patients. Patients were divided according to vitamin D tertiles (< 9·6; 9·6-18·4; ≥ 18·4). Lower vitamin D levels were associated with age, female gender (P < 0·001), renal failure (P = 0·05), active smoking (P = 0·001), acute coronary syndrome at presentation (P < 0·001), therapy with calcium antagonists (P = 0·02) and diuretics (P < 0·001), less beta-blockers (P = 0·02) and statins (P = 0·001) use. Vitamin D was directly related to haemoglobin (P < 0·001) and inversely with platelet count (P = 0·002), total and low-density-lipoprotein cholesterol (P = 0·002 and P < 0·001) and triglycerides (P = 0·01). Vitamin D did not influence angiographic features of coronary lesions, but was associated with higher prevalence of left main or right CAD (P = 0·03). Vitamin D deficiency was significantly associated with higher prevalence of CAD (adjusted OR [95%CI] = 1·32[1·1-1·6], P = 0·004) and severe CAD (adjusted OR [95%CI] = 1·18[1-1·39], P = 0·05). CONCLUSION Hypovitaminosis D was observed in the vast majority of patients undergoing coronary angiography. Vitamin D deficiency is significantly associated with the prevalence and extent of CAD, especially for patients with values < 10 ng/mL. Therefore, future large studies are needed to evaluate whether vitamin D supplementation may prevent CAD and its progression.
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Affiliation(s)
- Monica Verdoia
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
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Wannenes F, Papa V, Greco EA, Fornari R, Marocco C, Baldari C, Di Luigi L, Emerenziani GP, Poggiogalle E, Guidetti L, Donini LM, Lenzi A, Migliaccio S. Abdominal Fat and Sarcopenia in Women Significantly Alter Osteoblasts Homeostasis In Vitro by a WNT/ β -Catenin Dependent Mechanism. Int J Endocrinol 2014; 2014:278316. [PMID: 24963291 PMCID: PMC4054618 DOI: 10.1155/2014/278316] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 04/14/2014] [Accepted: 04/29/2014] [Indexed: 01/14/2023] Open
Abstract
Obesity and sarcopenia have been associated with mineral metabolism derangement and low bone mineral density (BMD). We investigated whether imbalance of serum factors in obese or obese sarcopenic patients could affect bone cell activity in vitro. To evaluate and characterize potential cellular and molecular changes of human osteoblasts, cells were exposed to sera of four groups of patients: (1) affected by obesity with normal BMD (O), (2) affected by obesity with low BMD (OO), (3) affected by obesity and sarcopenia (OS), and (4) affected by obesity, sarcopenia, and low BMD (OOS) as compared to subjects with normal body weight and normal BMD (CTL). Patients were previously investigated and characterized for body composition, biochemical and bone turnover markers. Then, sera of different groups of patients were used to incubate human osteoblasts and evaluate potential alterations in cell homeostasis. Exposure to OO, OS, and OOS sera significantly reduced alkaline phosphatase, osteopontin, and BMP4 expression compared to cells exposed to O and CTL, indicating a detrimental effect on osteoblast differentiation. Interestingly, sera of all groups of patients induced intracellular alteration in Wnt/ β -catenin molecular pathway, as demonstrated by the significant alteration of specific target genes expression and by altered β -catenin cellular compartmentalization and GSK3 β phosphorylation. In conclusion our results show for the first time that sera of obese subjects with low bone mineral density and sarcopenia significantly alter osteoblasts homeostasis in vitro, indicating potential detrimental effects of trunk fat on bone formation and skeletal homeostasis.
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Affiliation(s)
- Francesca Wannenes
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Vincenza Papa
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Emanuela A. Greco
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Rachele Fornari
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Chiara Marocco
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Carlo Baldari
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Luigi Di Luigi
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Gian Pietro Emerenziani
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Eleonora Poggiogalle
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Laura Guidetti
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
| | - Lorenzo M. Donini
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Andrea Lenzi
- Section of Medical Pathophysiology, Department of Experimental Medicine, Endocrinology and Nutrition, “Sapienza” University of Rome, Italy
| | - Silvia Migliaccio
- Section of Health Sciences, Department of Movement, Human and Health Sciences, “Foro Italico” University of Rome, Largo Lauro De Bosis 15, 00195 Rome, Italy
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Esteghamati A, Aryan Z, Esteghamati A, Nakhjavani M. Differences in vitamin D concentration between metabolically healthy and unhealthy obese adults: associations with inflammatory and cardiometabolic markers in 4391 subjects. DIABETES & METABOLISM 2014; 40:347-55. [PMID: 24811744 DOI: 10.1016/j.diabet.2014.02.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 02/16/2014] [Accepted: 02/18/2014] [Indexed: 02/06/2023]
Abstract
AIM This study aimed to compare concentrations of serum 25-hydroxy vitamin D and inflammatory markers in metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), and to determine whether the relationship between vitamin D levels and both cardiometabolic and inflammatory markers differs between MHO and MUO. METHODS This cross-sectional study comprised 4391 obese subjects aged>18 years. A panel of cardiometabolic and inflammatory markers, including anthropometric variables, glycaemic indices, lipid profiles, liver enzymes, homocysteine, C-reactive protein (CRP), fibrinogen and serum 25-hydroxy vitamin D levels, was investigated. All cardiometabolic and inflammatory markers in MHO and MUO as well as in vitamin D deficiency were compared. RESULTS Prevalence of MHO was 41.9% in our obese subjects using International Diabetes Federation criteria. Considering insulin resistance and inflammation, the prevalence of MHO was 38.4%. Individuals with MHO had significantly higher vitamin D concentrations compared with MUO, and this difference in vitamin D status persisted after accounting for BMI and waist circumference. Subjects with MHO had significantly better metabolic status, lower liver enzymes, lower inflammatory markers and higher serum 25-hydroxy vitamin D than those with MUO. Associations between vitamin D levels and inflammatory and cardiometabolic markers differed according to MHO/MUO status. Among MUO subjects, vitamin D deficiency was associated with higher liver marker and homocysteine levels. Serum vitamin D was negatively associated with fasting plasma glucose and HbA1c in MHO only. CONCLUSION Serum 25-hydroxy vitamin D levels were lower in MUO vs MHO, and reduced vitamin D concentrations were more strongly associated with cardiometabolic and inflammatory markers in MUO than in MHO subjects. These findings suggest that a deficiency in vitamin D could be a key component of MUO.
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Affiliation(s)
- A Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran.
| | - Z Aryan
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran; Department of Public Health, Tehran University of Medical Sciences, Iran.
| | - A Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran.
| | - M Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran.
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Vitamin D: link between osteoporosis, obesity, and diabetes? Int J Mol Sci 2014; 15:6569-91. [PMID: 24747593 PMCID: PMC4013648 DOI: 10.3390/ijms15046569] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 03/24/2014] [Accepted: 04/04/2014] [Indexed: 12/13/2022] Open
Abstract
Vitamin D (1,25(OH)2D3) is a steroid hormone that has a range of physiological functions in skeletal and nonskeletal tissues, and can contribute to prevent and/or treat osteoporosis, obesity, and Type 2 diabetes mellitus (T2DM). In bone metabolism, vitamin D increases the plasma levels of calcium and phosphorus, regulates osteoblast and osteoclast the activity, and combats PTH hypersecretion, promoting bone formation and preventing/treating osteoporosis. This evidence is supported by most clinical studies, especially those that have included calcium and assessed the effects of vitamin D doses (≥800 IU/day) on bone mineral density. However, annual megadoses should be avoided as they impair bone health. Recent findings suggest that low serum vitamin D is the consequence (not the cause) of obesity and the results from randomized double-blind clinical trials are still scarce and inconclusive to establish the relationship between vitamin D, obesity, and T2DM. Nevertheless, there is evidence that vitamin D inhibits fat accumulation, increases insulin synthesis and preserves pancreatic islet cells, decreases insulin resistance and reduces hunger, favoring obesity and T2DM control. To date, there is not enough scientific evidence to support the use of vitamin D as a pathway to prevent and/or treat obesity and T2DM.
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Sahin I, Gungor B, Can MM, Avci II, Guler GB, Okuyan E, Biter H, Yildiz SS, Ayca B, Satilmis S, Dinckal MH. Lower Blood Vitamin D Levels Are Associated With an Increased Incidence of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography. Can J Cardiol 2014; 30:428-33. [DOI: 10.1016/j.cjca.2013.12.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 12/30/2013] [Accepted: 12/30/2013] [Indexed: 11/30/2022] Open
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Bardini G, Giannini S, Romano D, Rotella CM, Mannucci E. Lipid accumulation product and 25-OH-vitamin D deficiency in type 2 diabetes. Rev Diabet Stud 2014; 10:243-51. [PMID: 24841878 DOI: 10.1900/rds.2013.10.243] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emerging data suggest a link between vitamin D (25(OH)D) deficiency, type 2 diabetes (T2D), and visceral adiposity. The lipid accumulation product (LAP), strictly correlated with abdominal fat depots, is proposed as marker of dysfunctional adiposity. AIM To verify the association between 25(OH)D levels and LAP in T2D. METHODS Body mass index (BMI), waist circumference (WC), glucose, HbA1c, lipids, and 25(OH)D were assessed in 420 T2D outpatients and in 150 non-diabetic obese with similar anthropometric characteristics. LAP was computed as the product of sex-specific enlarged WC and triglycerides (TG). RESULTS In T2D patients, 63.0% showed 25(OH)D deficiency (<20 ng/ml) vs. 71.3% in the obese control group. Overweight males showed a higher prevalence of 25(OH)D deficiency (60.3%) than women (48.8%, p < 0.001), while in obese patients this prevalence was not significant. In both genders, 25(OH)D was not significantly associated with HbA1c and fasting glucose. Age-adjusted 25(OH)D levels were inversely correlated with BMI (p < 0.001), WC (p < 0.001), and LAP (p < 0.001) in both genders. Metabolic syndrome presented an odds ratio (OR) for 25(OH)D deficiency of 1.6 (1.1-2.5, p = 0.048) in females and 1.7 (1.2-2.7, p = 0.016) in males, while the highest quartile of LAP showed an OR of 2.1 (1.2-3.6, p = 0.019) in females and 3.2 (1.6-6.5, p = 0.02) in males. A similar trend was observed in the obese control group. CONCLUSIONS In the presence of excess weight, subjects with and without T2D frequently feature low 25(OH)D levels. Subjects with higher LAP exhibit a high risk of 25(OH)D deficiency, suggesting that dysfunctional adiposity is a worsening factor for vitamin D hypovitaminosis.
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Affiliation(s)
- Gianluca Bardini
- Obesity Agency, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Florence, Italy
| | - Stefano Giannini
- Section of Endocrinology, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Italy
| | - Desiderio Romano
- Section of Endocrinology, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Italy
| | - Carlo M Rotella
- Obesity Agency, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Florence, Italy
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Al-Shoumer KAAS, Al-Asoosi AA, Ali AH, Nair VS. Does insulin resistance in type 2 diabetes alter vitamin D status? Prim Care Diabetes 2013; 7:283-287. [PMID: 23685025 DOI: 10.1016/j.pcd.2013.04.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 04/01/2013] [Accepted: 04/03/2013] [Indexed: 02/06/2023]
Abstract
AIMS Data on changes of vitamin D due to insulin resistance are conflicting. We assessed vitamin D concentrations and parameters of glycemia and mineral homeostasis in patients with insulin resistant type 2 diabetes and in matched normal controls. METHODS Sixty-nine patients with type 2 diabetes and 60 matched normal control subjects were studied. After an overnight fast, blood was collected for measuring the parameters of glycemia (glucose, insulin and HbA1c), mineral profile (corrected calcium, phosphate and alkaline phosphatase), total 25(OH) vitamin D and parathyroid hormone (PTH) levels. RESULTS Patients had significantly elevated fasting glucose (P=0.0001), insulin (P=0.0003) and HbA1c (P=0.0005) than the controls had. They had significantly raised calculated insulin resistance compared with control subjects (P=0.0001). Patients and controls had similar levels of serum corrected calcium and ALP, whereas serum phosphate was significantly lower in the patients compared with controls (P=0.001). Patients and controls had similar levels of 25(OH)D, but the levels of 25(OH)D in both were in the deficiency range. Intact PTH was similar in the patients and controls. Levels of 25(OH)D did not demonstrate any relation with fasting insulin, insulin resistance, or HbA1c, but correlated negatively with intact PTH (r=-0.4, P=0.02). CONCLUSION This study demonstrated prevalent vitamin D deficiency in insulin resistant type 2 diabetic and normal subjects. Insulin resistance did not influence the status of vitamin D.
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Affiliation(s)
- Kamal Abdul Aziz Sulaiman Al-Shoumer
- Division of Endocrinology & Metabolic Medicine, Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait; Mubarak Al Kabeer Hospital, Jabriya, Kuwait.
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Migliaccio S, Greco EA, Fornari R, Donini LM, Di Luigi L, Lenzi A. Skeletal alterations in women affected by obesity. Aging Clin Exp Res 2013; 25 Suppl 1:S35-7. [PMID: 24061852 DOI: 10.1007/s40520-013-0090-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 07/05/2013] [Indexed: 01/09/2023]
Abstract
Obesity has always been considered a protective factor for the skeleton and for osteoporosis. However, new epidemiologic and clinical data have shown that high level of fat mass might be a risk factor for osteoporosis and fragility fractures. Further, increasing evidences seem to indicate that the different components of metabolic syndrome (i.e. hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol) are also potential risk factors for the development of low bone mineral density and osteoporosis.
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Xuan Y, Zhao HY, Liu JM. Vitamin D and type 2 diabetes mellitus (D2). J Diabetes 2013; 5:261-7. [PMID: 23302127 DOI: 10.1111/1753-0407.12024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 12/02/2012] [Accepted: 12/14/2012] [Indexed: 02/06/2023] Open
Abstract
Based on increasing evidence from animal and human studies, vitamin D deficiency is now regarded as a potential risk factor for Type 2 diabetes mellitus (T2DM). Vitamin D is involved in the pathogenesis of pancreatic β-cell dysfunction, insulin resistance, and systemic inflammation, conditions that contribute to the development of T2DM. Vitamin D can affect the progress of this disease directly through the activation of its own receptor, and indirectly via the regulation of calcium homeostasis. Observational studies have revealed the association between vitamin D deficiency and incident T2DM. More double-blind randomized control studies that investigate the effects of vitamin D supplementation on insulin sensitivity, insulin secretion, and the occurrence of T2DM are needed.
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Affiliation(s)
- Yan Xuan
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai, China
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de las Heras J, Rajakumar K, Lee S, Bacha F, Holick MF, Arslanian SA. 25-Hydroxyvitamin D in obese youth across the spectrum of glucose tolerance from normal to prediabetes to type 2 diabetes. Diabetes Care 2013; 36:2048-53. [PMID: 23340897 PMCID: PMC3687316 DOI: 10.2337/dc12-1288] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To 1) determine if plasma 25-hydroxyvitamin D (25[OH]D) concentrations differ among obese youth with normal glucose tolerance (NGT) versus prediabetes versus type 2 diabetes and 2) assess the relationships between 25(OH)D and in vivo insulin sensitivity and β-cell function in this cohort. RESEARCH DESIGN AND METHODS Plasma 25(OH)D concentrations were examined in banked specimens in 9- to 20-year-old obese youth (n = 175; male 42.3%, black 46.3%) (NGT, n = 105; impaired glucose tolerance [IGT], n = 43; type 2 diabetes, n = 27) who had in vivo insulin sensitivity and secretion measured by hyperinsulinemic-euglycemic and hyperglycemic clamp techniques and had an assessment of total body composition and abdominal adiposity. RESULTS The mean age and BMI of the subjects were 14.3 ± 2.1 years and 35.7 ± 5.6 kg/m(2), respectively. BMI, plasma 25(OH)D, and the proportion of vitamin D-deficient and -insufficient children did not differ across the three groups. Furthermore, there was no association between 25(OH)D and in vivo insulin sensitivity or β-cell function relative to insulin sensitivity (disposition index) in all groups combined or in each group separately. CONCLUSIONS Our data in obese youth show 1) no differences in plasma 25(OH)D concentrations across the glucose tolerance groups and 2) no relationship between 25(OH)D and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity in any of the groups. It remains uncertain if enhancement of the vitamin D status could improve pathophysiological mechanisms of prediabetes and type 2 diabetes in obese youth.
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Affiliation(s)
- Javier de las Heras
- Division of Pediatric Metabolism, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
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Jain SK, Micinski D. Vitamin D upregulates glutamate cysteine ligase and glutathione reductase, and GSH formation, and decreases ROS and MCP-1 and IL-8 secretion in high-glucose exposed U937 monocytes. Biochem Biophys Res Commun 2013; 437:7-11. [PMID: 23770363 DOI: 10.1016/j.bbrc.2013.06.004] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Glutathione is a major endogenous antioxidant and its deficiency is implicated in the etiology and progression of a number of human diseases. Vitamin D is important for the prevention of osteoporosis, cardiovascular disease, diabetes, autoimmune diseases, and some cancers. Using a monocyte cell model, this study examined the hypothesis that vitamin D upregulate glutamate cysteine ligase (GCLC) and glutathione reductase (GR), which catalyzes GSH biosynthesis. METHODS U937 monocytes were pretreated with and without 1,25 (OH)₂ vitamin D (10-25 nM) for 24 h and then exposed to control and high glucose (HG, 25 mM) for 4h. Levels of GSH determined using HPLC; GR activity by oxidation of NADPH; GCLC protein, MCP-1 and IL-8 using ELISA kits. RESULTS 1,25 (OH)₂ vitamin D supplementation significantly upregulated expression of GCLC and GR, levels of GCLC protein and GR activity, and formation of GSH in control and HG-treated monocytes. 1,25 (OH)₂ vitamin D caused significantly (p<0.05) lower secretion of IL-8 and MCP-1, and lower ROS levels in monocytes exposed to control and HG-treated monocytes. CONCLUSIONS This study demonstrates a positive link between vitamin D and GSH levels, and that some beneficial effects of vitamin D supplementation may be mediated by an improvement in the cellular GSH levels and a decrease in ROS and pro-inflammatory cytokines.
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Affiliation(s)
- Sushil K Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
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Vitamin D deficiency in childhood obesity is associated with high levels of circulating inflammatory mediators, and low insulin sensitivity. Int J Obes (Lond) 2013; 38:46-52. [PMID: 23736361 DOI: 10.1038/ijo.2013.75] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 04/09/2013] [Accepted: 05/08/2013] [Indexed: 12/27/2022]
Abstract
HYPOTHESIS Childhood obesity is accompanied by low-grade systemic inflammation, which contributes to the development of insulin resistance and cardiovascular complications later in life. As vitamin D exhibits profound immunomodulatory functions and vitamin D deficiency is highly prevalent in childhood obesity, we hypothesized that vitamin D deficiency in childhood obesity coincides with enhanced systemic inflammation and reduced insulin sensitivity. METHODS In a cross-sectional study of 64 obese and 32 healthy children aged 6-16 years, comprehensive profiling of 32 circulating inflammatory mediators was performed, together with assessment of 25-hydroxyvitamin D (25(OH)D) levels and measures for insulin sensitivity. RESULTS Severe vitamin D insufficiency, which is further referred to as vitamin D deficiency, was defined as a 25(OH)D level ≤37.5 nmol l(-1), and was highly prevalent in obese (56%) versus healthy control children (16%). Throughout the study, 25(OH)D-deficient children were compared with the other children, including 25(OH)D insufficient (37.5-50 nmol l(-1)) and 25(OH)D sufficient children (≥50 nmol l(-1)). First, 25(OH)D-deficient obese children showed a lower insulin sensitivity than other obese children, as measured by a lower quantitative insulin sensitivity check index. Second, the association between 25(OH)D deficiency and insulin resistance in childhood obesity was confirmed with multiple regression analysis. Third, 25(OH)D-deficient obese children showed higher levels of the inflammatory mediators cathepsin S, chemerin and soluble vascular adhesion molecule (sVCAM), compared with the other obese children. Finally, hierarchical cluster analysis revealed an over-representation of 25(OH)D deficiency in obese children expressing inflammatory mediator clusters with high levels of cathepsin S, sVCAM and chemerin. CONCLUSION 25(OH)D deficiency in childhood obesity was associated with enhanced systemic inflammation and reduced insulin sensitivity. The high cathepsin S and sVCAM levels may reflect activation of a pro-inflammatory, pro-diabetic and atherogenic pathway, which could be inhibited by vitamin D supplementation.
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Heaney RP, French CB, Nguyen S, Ferreira M, Baggerly LL, Brunel L, Veugelers P. A novel approach localizes the association of vitamin D status with insulin resistance to one region of the 25-hydroxyvitamin D continuum. Adv Nutr 2013; 4:303-10. [PMID: 23674796 PMCID: PMC3650499 DOI: 10.3945/an.113.003731] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Vitamin D status has been implicated in insulin resistance, type 2 diabetes mellitus, and hypertension, but the range of vitamin D status values over which the association can be found is unknown. Our objective was to define this range in a cohort of nondiabetic adult Canadians. We used a regression modeling strategy, first adjusting insulin-response variables and systolic and diastolic blood pressure for BMI, waist circumference, weight, age, and sex. The resulting residuals were regressed against serum 25-hydroxyvitamin D [25(OH)D] concentration using successive 40% data blocks ranging from the 0th to the 60th percentile of 25(OH)D values. All of the predictor variables were significantly associated with each of the dependent variables, with BMI and waist circumference accounting for >98% of the explained variance. The vitamin D association was localized to the serum 25(OH)D range extending from ∼40 to ∼90 nmol/L (16-36 μg/L). We conclude that vitamin D status is inversely associated with insulin responsiveness and blood pressure. Consistent with the threshold response characteristic typical of nutrients, the association was strongest in a circumscribed region of the range of 25(OH)D values. There was no association at 25(OH)D values >80-90 nmol/L (32-36 μg/L), indicating that the vitamin D association applied principally to values below that level. The differences observed, if they can be further confirmed in prospective studies, are of a magnitude that would be clinically important.
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Affiliation(s)
- Robert P. Heaney
- Creighton University, Omaha, NE,To whom correspondence should be addressed. E-mail:
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Greco EA, Francomano D, Fornari R, Marocco C, Lubrano C, Papa V, Wannenes F, Di Luigi L, Donini LM, Lenzi A, Aversa A, Migliaccio S. Negative association between trunk fat, insulin resistance and skeleton in obese women. World J Diabetes 2013; 4:31-9. [PMID: 23593534 PMCID: PMC3627415 DOI: 10.4239/wjd.v4.i2.31] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 02/14/2013] [Accepted: 03/15/2013] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the potential interference of trunk fat (TF) mass on metabolic and skeletal metabolism. METHODS In this cross-sectional study, 340 obese women (mean age: 44.8 ± 14 years; body mass index: 36.0 ± 5.9 kg/m(2)) were included. Patients were evaluated for serum vitamin D, osteocalcin (OSCA), inflammatory markers, lipids, glucose and insulin (homeostasis model assessment of insulin resistance, HOMA-IR) levels, and hormones profile. Moreover, all patients underwent measurements of bone mineral density (BMD; at lumbar and hip site) and body composition (lean mass, total and trunk fat mass) by dual-energy X-ray absorptiometry. RESULTS Data showed that: (1) high TF mass was inversely correlated with low BMD both at lumbar (P < 0.001) and hip (P < 0.01) sites and with serum vitamin D (P < 0.0005), OSCA (P < 0.0001) and insulin-like growth factor-1 (IGF-1; P < 0.0001) levels; (2) a positive correlation was found between TF and HOMA-IR (P < 0.01), fibrinogen (P < 0.0001) and erythrocyte sedimentation rate (P < 0.0001); (3) vitamin D levels were directly correlated with IGF-1 (P < 0.0005), lumbar (P < 0.006) and hip (P < 0.01) BMD; and (4) inversely with HOMA-IR (P < 0.001) and fibrinogen (P < 0.0005).Multivariate analysis demonstrated that only vitamin D was independent of TF variable. CONCLUSION In obese women, TF negatively correlates with BMD independently from vitamin D levels. Reduced IGF-1 and increased inflammatory markers might be some important determinants that account for this relationship.
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Manna P, Jain SK. Vitamin D up-regulates glucose transporter 4 (GLUT4) translocation and glucose utilization mediated by cystathionine-γ-lyase (CSE) activation and H2S formation in 3T3L1 adipocytes. J Biol Chem 2012; 287:42324-32. [PMID: 23074218 DOI: 10.1074/jbc.m112.407833] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A scientific explanation for the beneficial role of vitamin D supplementation in the lowering of glycemia in diabetes remains to be determined. This study examined the biochemical mechanism by which vitamin D supplementation regulates glucose metabolism in diabetes. 3T3L1 adipocytes were treated with high glucose (HG, 25 mm) in the presence or absence of 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) (25, 50 nm), the active form of vitamin D. 1,25(OH)(2)D(3) treatment caused significant up-regulation of GLUT4 total protein expression and its translocation to cell surface, and an increase in glucose uptake as well as glucose utilization in HG-treated cells. 1,25(OH)(2)D(3) also caused cystathionine-γ-lyase (CSE) activation and H(2)S formation in HG-treated adipocytes. The effect of 1,25(OH)(2)D(3) on GLUT4 translocation, glucose utilization, and H(2)S formation was prevented by propargylglycine, an inhibitor of CSE that catalyzes H(2)S formation. Studies using antisense CSE also demonstrated the inhibition of GLUT4 translocation as well as glucose uptake and utilization in 1,25(OH)(2)D(3)-supplemented CSE-siRNA-transfected adipocytes compared with controls. 1,25(OH)(2)D(3) treatment along with insulin enhanced GLUT4 translocation and glucose utilization compared with either insulin or 1,25(OH)(2)D(3) alone in HG-treated adipocytes. 1,25(OH)(2)D(3) supplementation also inhibited monocyte chemoattractant protein-1 and stimulated adiponectin secretion in HG-treated adipocytes, and this positive effect was prevented in propargylglycine-treated or CSE-knockdown adipocytes. This is the first report to demonstrate that 1,25(OH)(2)D(3) up-regulates GLUT4 translocation and glucose utilization and decreases inflammatory markers, which is mediated by CSE activation and H(2)S formation in adipocytes. This study provides evidence for a novel molecular mechanism by which 1,25(OH)(2)D(3) can up-regulate the GLUT4 translocation essential for maintenance of glucose metabolism.
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Affiliation(s)
- Prasenjit Manna
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103, USA
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