1
|
Wimalawansa SJ. Enhancing the Design of Nutrient Clinical Trials for Disease Prevention-A Focus on Vitamin D: A Systematic Review. Nutr Rev 2025:nuae164. [PMID: 39928411 DOI: 10.1093/nutrit/nuae164] [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: 02/11/2025] Open
Abstract
OBJECTIVES This systematic review (SR) highlights principles for nutrient clinical trials and explore the diverse physiological functions of vitamin D beyond its traditional role in the musculoskeletal system related to clinical study designs. BACKGROUND Thousands of published research articles have investigated the benefits of vitamin D (a nutrient example taken in this SR) beyond the musculoskeletal system, including the immune, pulmonary, and cardiovascular systems; pregnancy; autoimmune disorders; and cancer. They illustrated vitamin D's molecular mechanisms, interactions, and genomic and nongenomic actions. METHODS This SR was designed to identify shortcomings in clinical study designs, statistical methods, and data interpretation that led to inconsistent findings in vitamin D-related publications. SR also highlights examples and insights into avoiding study design errors in future clinical studies, including randomized controlled clinical trials (RCTs). The SR adheres to the latest PRISMA statement, guidelines, and the PICOS process. RESULTS Inappropriate or flawed study designs were frequent in clinical trials. Major failures discussed here include too short clinical study duration, inadequate or infrequent doses, insufficient statistical power, failure to measure baseline and achieved levels, and recruiting vitamin D-sufficient participants. These design errors have led to misleading interpretations. Thus, conclusions from such studies should not be generalized or used in guidelines, recommendations, or policymaking. CONCLUSION Adequately powered epidemiological studies and RCTs with sufficient vitamin D and duration in individuals with vitamin D deficiency reported favorable clinical outcomes, enriching the literature, enabling to understand its physiology and mechanisms. Proper study designs with rigorous methodologies and cautious interpretation of outcomes are crucial in advancing the nutrient field. The principles discussed apply not only to vitamin D, but also other micro-nutrients and nutraceutical research. Adhering to them enhances the credibility and reliability of clinical trials, SRs, and meta-analysis outcomes. The study emphasizes the importance of focused, hypothesis-driven, well-designed, statistically powered RCTs to explore the diverse benefits of nutrients, conducted in index nutrient deficient participants, and avoidance of study design errors. Findings from such studies should be incorporated into clinical practice, policymaking, and public health guidelines, improving the health of the nation and reducing healthcare costs.
Collapse
Affiliation(s)
- Sunil J Wimalawansa
- Department of Medicine, Endocrinology & Human Nutrition, North Brunswick, NJ, United States
| |
Collapse
|
2
|
Mondkar S, Oza C, Dange N, Soren P, Kajale N, Kardile M, Yewale S, Gondhalekar K, Khadilkar V, Khadilkar A. Assessment of Vitamin D Status, its Determinants and Relationship with Bone Health in Indian Children and Young Adults with Type-1 Diabetes. Indian J Endocrinol Metab 2024; 28:405-412. [PMID: 39371655 PMCID: PMC11451962 DOI: 10.4103/ijem.ijem_141_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/08/2023] [Accepted: 07/29/2023] [Indexed: 10/08/2024] Open
Abstract
Introduction Recent evidence suggests that vitamin D deficiency and type-1 diabetes (T1D) have a bidirectional cause-effect relationship. The objective of this study is to estimate the prevalence and determinants of vitamin D deficiency in Indian children and young adults with T1D and assess the relationship between vitamin D status and their bone health. Methods It was a single-centre, cross-sectional study. Inclusion: Children, young adults aged 5-25 years with T1D duration >1 year. Exclusion: Already on vitamin D supplementation, conditions affecting bone health. Data collected: Demographic, clinical, anthropometry, biochemical, body composition, DXA, pQCT measurements. Results A total of 453 participants (251 girls) with T1D, mean age = 13.5 ± 4.0 years, disease duration = 5.7 ± 3.9 years. Mean 25-hydroxy vitamin D concentration of study group was 20.4 ± 11.3 ng/mL. One hundred and eleven (24.5%) were deficient in 25-hydroxy vitamin D, 141 (31.1%) were insufficient and 201 (44.4%) were sufficient. 25-Hydroxy vitamin D concentrations had significant negative correlation with BMI Z-score, diastolic blood pressure, fat percentage Z-score and positive correlation with physical activity, haemoglobin concentrations and trabecular density (P < 0.05). Risk of developing vitamin D deficiency and insufficiency was significantly lower in subjects with good/intermediate glycaemic control versus poor control (P = 0.008). Higher diastolic blood pressure and female gender were significant risk factors for development of vitamin D deficiency. Conclusion Vitamin D deficiency has high prevalence in children and youth with T1D and has detrimental effect on bone geometry of these subjects. Weight reduction increased outdoor physical activity, good glycemic control are some modifiable factors that may prove useful in preventing vitamin D deficiency.
Collapse
Affiliation(s)
- Shruti Mondkar
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Chirantap Oza
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Nimisha Dange
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Poonam Soren
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Neha Kajale
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Mayur Kardile
- Department of Orthopedics, Jehangir Hospital, Pune, Maharashtra, India
| | - Sushil Yewale
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Ketan Gondhalekar
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Department of Growth and Paediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| |
Collapse
|
3
|
Gazala MP, Mishra S, Gupta V, Rahman W, Khiraiya N, Dahiya S. Serum 25 hydroxycholecalciferol in periodontitis patients with type 2 diabetes mellitus - A socioeconomic and clinicobiochemical study in Chhattisgarh. J Indian Soc Periodontol 2024; 28:216-223. [PMID: 39411737 PMCID: PMC11472963 DOI: 10.4103/jisp.jisp_349_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/26/2024] [Accepted: 08/04/2024] [Indexed: 10/19/2024] Open
Abstract
Background Very few studies have examined the impact of the concurrent presence of periodontitis (PD) and type 2 diabetes mellitus (T2DM) on serum Vitamin D levels, particularly in developing nations like India, and needs further investigation. Aim This study aims to assess the relationship between serum Vitamin D values and PD in T2DM patients and to study the correlation between socioeconomic and demographic variables that influence the serum Vitamin D levels and the extent of PD in patients with T2DM. Materials and Methods This was a cross-sectional, hospital-based research. Medical, dental, and diet histories were obtained from the participants, and their socioeconomic status (SES) was determined. Clinical parameters - plaque index (PI), gingival index (GI), sites with gingival bleeding, probing pocket depth (PPD), and clinical attachment level (CAL) were compared among three groups -patients with generalized Stage III Grade B PD with T2DM (n=35), patients with generalized stage III Grade B PD (n=35) and healthy controls (n=35) and the clinical parameters - plaque index(PI), gingival index(GI), sites with gingival bleeding, probing pocket depth(PPD), and clinical attachment level(CAL) were measured. Biochemical tests included the evaluation of serum 25-hydroxyvitamin D (25[OH] D) and hemoglobin A1C (HbA1c) levels. Statistical Analysis Periodontal and biochemical parameters were compared using a one-way analysis of variance across the three groups. The association between clinical parameters, SES, and 25(OH)D was examined using Pearson's correlation coefficient test and linear regression analysis. Results The serum 25(OH)D levels were lowest in the subjects with generalized Stage III Grade B PD with T2DM (13.54 ± 3.31 ng/mL). Furthermore, there was a significant (P < 0.01) negative correlation between serum 25(OH)D and periodontal parameters, PI (-0.442), PPD (-0.474), CAL (-0.459), sites with gingival bleeding (-0.354), and GI (-0.346) among the groups. The regression analyses showed that an increase in periodontal parameters (PI, GI, PPD, and CAL) and a higher HbA1c was linked to a lower 25(OH)D. However, the periodontal parameters and 25(OH)D levels showed no correlation with socioeconomic and demographic parameters in the study. Conclusion Serum Vitamin D values are negatively influenced by the synergistic effect of PD and T2DM or by the presence of PD alone. However, the association of SES on serum Vitamin D values in individuals with PD and T2DM or PD alone could not be demonstrated.
Collapse
Affiliation(s)
- M. P. Gazala
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Supriya Mishra
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Vineeta Gupta
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Waheda Rahman
- Department of Periodontics, Government Dental College and Hospital, Chhattisgarh, India
| | - Nupoor Khiraiya
- Practitioner, Gayatri Dental Clinic, Dantewada, Chhattisgarh, India
| | - Sheetal Dahiya
- Vrinda Dental Clinic and Implant Centre, Raipur, Chhattisgarh, India
| |
Collapse
|
4
|
Fathi FEZM, Sadek KM, Khafaga AF, Al Senosy AW, Ghoniem HA, Fayez S, Zeweil MF. Vitamin D regulates insulin and ameliorates apoptosis and oxidative stress in pancreatic tissues of rats with streptozotocin-induced diabetes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:90219-90229. [PMID: 35864405 PMCID: PMC9722851 DOI: 10.1007/s11356-022-22064-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
This study was designed to evaluate the potential therapeutic efficacy of vitamin D (Vit D) in averting the harmful effects of type 2 diabetes mellitus (T2D). Forty male Wistar rats were allotted into four groups: (1) the control, (2) Vit D, (3) streptozotocin (STZ), and (4) STZ + Vit D groups. Rats co-treated with Vit D had significantly (p < 0.05) decreased levels of cortisol; proinflammatory cytokines, including interleukin-6 (IL-6); and malondialdehyde (MDA). Meanwhile, the levels of insulin significantly (p < 0.05) increased, whereas the activity of the antioxidant system, including glutathione (GSH), superoxide dismutase (SOD), catalase, and total antioxidant capacity (TAC), significantly (p < 0.05) decreased. Histopathological examination revealed the destruction of beta cells in the islets of Langerhans in rats with diabetes. Meanwhile, immunoexpression revealed an increase in the immunoreactivity of caspase-3 and endothelial nitric oxide synthase and a reduction in the immunoreactivity of insulin in rats with diabetes. In conclusion, Vit D ameliorated the harmful biochemical impact of diabetes mellitus, probably by increasing insulin secretion and sensitivity, ameliorating β-cell function, and decreasing cortisol levels; also, the anti-inflammatory effect of Vit D reduces the number of proinflammatory cytokines (e.g., IL-6) and increases the activity of the antioxidant system, such as GSH, SOD, TAC, and catalase while reducing lipid peroxidation enzymes (e.g., MDA).
Collapse
Affiliation(s)
- Fatima El Zahra M Fathi
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| | - Kadry M Sadek
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| | - Asmaa F Khafaga
- Department of Pathology, Faculty of Veterinary Medicine, Alexandria University, Edfina, 22758, Egypt.
| | - Abdel Wahab Al Senosy
- Department of Histology, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| | - Hanan A Ghoniem
- Department of Histology, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| | - Sahar Fayez
- Department of Histology, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| | - Mohamed F Zeweil
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhur University, Damanhour, 22516, Egypt
| |
Collapse
|
5
|
Lopes KG, Rodrigues EL, da Silva Lopes MR, do Nascimento VA, Pott A, Guimarães RDCA, Pegolo GE, Freitas KDC. Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:3260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant-juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
Collapse
Affiliation(s)
- Kátia Gianlupi Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Elisana Lima Rodrigues
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Mariana Rodrigues da Silva Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Valter Aragão do Nascimento
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Arnildo Pott
- Institute of Biosciences, Federal University of Mato Grosso do Sul-UFMS, Campo Grande 79079-900, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Giovana Eliza Pegolo
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Karine de Cássia Freitas
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| |
Collapse
|
6
|
He X, Luo Y, Hao J, Wang C, Gan K, Zhen Y, Ren L. Association Between Serum Vitamin D Levels and Ketosis Episodes in Hospitalized Patients with Newly Diagnosed Ketosis-Prone Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:3821-3829. [PMID: 36530585 PMCID: PMC9757126 DOI: 10.2147/dmso.s389609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between 25-hydroxyvitamin D (25OHD) and the onset of ketosis in newly diagnosed patients with ketosis-prone type 2 diabetes (KPT2D). PATIENTS AND METHODS A total of 162 patients with non-autoimmune newly diagnosed diabetes mellitus were included in this cross-sectional study. Patients were classified into KPT2D (n = 71) or non-ketotic type 2 diabetes (NKT2D, n = 91). Anthropometric parameters, islet functions, biochemical parameters, and body composition were determined in both KPT2D and NKT2D groups. Correlation analysis was performed to determine the associations between 25OHD and plasma ketones. The risk factors associated with ketosis episodes in patients with new-onset KPT2D were evaluated using binary logistic regression analysis. RESULTS Vitamin D deficiency was observed in both patients with KPT2D and NKT2D. Compared with the NKT2D group, serum 25OHD values were lower in the participants of the KPT2D group [14.20 (10.68, 19.52) vs 16.98 (13.54,2.96) ng/mL, P = 0.011]. Serum 25OHD was associated with plasma ketones (R = -0.387). Serum 25OHD is an independent protective factor for ketosis or ketoacidosis episodes in patients with new onset of KPT2D (P = 0.037, OR = 0.921). CONCLUSION Vitamin D levels are associated with ketosis episodes in patients with KPT2D. Serum 25OHD is an independent protective factor for ketosis episodes in patients with KPT2D.
Collapse
Affiliation(s)
- Xiaoyu He
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yu Luo
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, North China University of Science and Technology, Tangshan, Hebei, People’s Republic of China
| | - Jianan Hao
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Cuiyu Wang
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Kexin Gan
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yunfeng Zhen
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Luping Ren
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Correspondence: Luping Ren, Department of Endocrinology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, 050051, People’ s Republic of China, Tel +86 311 859 889 75, Email
| |
Collapse
|
7
|
Alemam HM, ElJilani MM, Bashein AM. Effect of Intramuscular Injection of Vitamin D on 25-Hydroxyvitamin D Levels, Glycaemic Control, and Liver Enzymes in Libyan Patients with Type 2 Diabetes Mellitus. LIBYAN INTERNATIONAL MEDICAL UNIVERSITY JOURNAL 2022. [DOI: 10.1055/s-0042-1749117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Background Vitamin D is a fat-soluble hormone that plays an important role in glycaemic control. In addition, it has a positive effect on improving liver enzyme function.
Aim This study was performed to examine the effect of intramuscular injection of vitamin D on serum 25-hydroxyvitamin D [25(OH)D] levels, glycemic control, and liver enzymes in Libyan patients suffering from type 2 diabetes mellitus (T2DM) with vitamin D deficiency.
Methods and Materials This cross-sectional study enrolled 100 T2DM (50 males and 50 females). Their serum 25(OH)D, fasting blood glucose (FBG), and liver enzymes were measured at the baseline and 12 weeks after treatment with vitamin D (200,000 IU) injection monthly for 3 months. Data analysis involved the estimation of mean ± standard error (SE) and comparison of means between pre and post-treatment values using paired t-test. Independent t-test was used to compare the means between males and females. The level of significance was set at p < 0.05.
Results Females had a lower 25(OH)D blood levels than males at baseline (7.03 ± 0.25 ng/mL versus 7.86 ± 0.26 ng/mL, respectively p < 0.02). 25(OH)D levels in both sexes was increased significantly from 7.45 ± 0.18 ng/mL to 26.69 ± 0.24 ng/mL after 12 weeks of vitamin D injections (p < 0.001), with no significant differences between male and females. FBG levels in both sexes was significantly decreased from 144.68 ± 1.84 mg/dL to 85.96 ± 0.34 mg/dL post treatment (p < 0.001). Alanine aminotransferase (ALT) was increased from 10.24 ± 0.17 U/L at baseline to 20.34 ± 1.15 U/L post treatment (p < 0.001). Similarly, aspartate aminotransferase (AST) was increased from 11.23 ± 0.21 to 20.57 ± 0.22 U/L (p < 0.001), and alkaline phosphatase (ALP) was decreased from 124.95 ± 1.15 U/L to 111.17 ± 1.27 U/L (p < 0.001). There were no significant differences between male and female liver enzymes either pre- or post-vitamin D injections
Conclusion Treatment with vitamin D injection showed a significant increase in 25(OH)D accompanied by decreased FBG and ALP levels and increased ALT and AST levels. Vitamin D levels should be monitored and adjusted in diabetic patients.
Collapse
Affiliation(s)
- Hafsa M. Alemam
- Department of Environment, Food, and Biological Applications, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Mouna M. ElJilani
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Abdulla M. Bashein
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| |
Collapse
|
8
|
He J, Du J, Yi B, Wang J, Zhang H, Li YC, Sun J. MicroRNA-122 contributes to lipopolysaccharide-induced acute kidney injury via down-regulating the vitamin D receptor in the kidney. Eur J Clin Invest 2021; 51:e13547. [PMID: 33782973 DOI: 10.1111/eci.13547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Our previous studies showed that vitamin D receptor (VDR) depletion promotes lipopolysaccharide (LPS)-induced acute kidney injury (AKI) in mice, and renal VDR is down-regulated in AKI, but the mechanism of VDR down-regulation is unclear. METHODS Nutritional vitamin D deficiency was induced by feeding mice a vitamin D-deficient (VD-D) diet. Mice were injected intraperitoneally with LPS (20 mg/kg) to establish LPS-induced AKI. Levels of VDR and miR-122 were measured both in vivo and in vitro. The associations between VDR and miR-122 were analysed by dual-luciferase reporter assays. RESULTS Compared with vitamin D-sufficient (VD-S) mice, VD-D mice developed more severe renal injury following LPS challenge. LPS induced a dramatic decrease in VDR expression and marked induction of miR-122 both in vivo and in vitro. Furthermore, miR-122 hairpin inhibitor alleviated LPS-induced VDR down-regulation whereas miR-122 mimic directly suppressed VDR expression in HK-2 cells. In luciferase reporter assays, miR-122 mimic was able to suppress luciferase activity in 293T cells co-transfected with a luciferase reporter that contains a putative miR-122 target site from 3'UTR of the VDR transcript, but not when this site was mutated. Moreover, miR-122 mimic significantly blocked paricalcitol-induced luciferase activity in 293T cells co-transfected with a VDRE-driven luciferase reporter, whereas miR-122 hairpin inhibitor enhanced paricalcitol's activity to suppress PUMA and caspase 3 activation induced by LPS in HK-2 cells. CONCLUSIONS Collectively, these studies provide evidence that miR-122 directly targets VDR in renal tubular cells, which strongly suggest that miR-122 up-regulation in the kidney under LPS challenge contributes to kidney injury by down-regulating VDR expression.
Collapse
Affiliation(s)
- Jinrong He
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jie Du
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL, USA
| | - Bin Yi
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianwen Wang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao Zhang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yan Chun Li
- Department of Medicine, Division of Biological Sciences, The University of Chicago, Chicago, IL, USA
| | - Jian Sun
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Rheumatology and Immunology, The Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
9
|
Lee SS, Subramaniam R, Tusimin M, Ling KH, Rahim KF, Loh SP. Inadequate vitamin D intake among pregnant women in Malaysia based on revised recommended nutrient intakes value and potential dietary strategies to tackle the inadequacy. Nutr Res Pract 2021; 15:492-503. [PMID: 34349882 PMCID: PMC8313385 DOI: 10.4162/nrp.2021.15.4.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/10/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Recently, the recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1-70 yrs has been revised from 5 µg/day to 15 µg/day. This study is aimed to assess the adequacy of vitamin D intake based on revised RNI and to recommend several dietary strategies to increase total vitamin D intake. SUBJECTS/METHODS Vitamin D intake from both food and supplement of 217 pregnant women was assessed using a validated food frequency questionnaire. Hypothetical effect of expanded supplementation and food fortifications strategies were modelled using the consumption data. RESULTS The results revealed that more than half (67.7%) of pregnant women had inadequate vitamin D intake (RNI < 15 µg/day). The modelling results demonstrated the potential of universal provision of 10 µg/day of multivitamins supplements in increasing vitamin D intake. Moreover, mandatory fortification of both milk and malted drink at single level of 5 µg/serving would lead to increase in vitamin D intake of Malaysians, particularly pregnant women. CONCLUSIONS The outcome of this study can be used as a reference for public health professionals to re-evaluate the existing Malaysian food fortification policies and supplementation recommendation for vitamin D for pregnant women.
Collapse
Affiliation(s)
- Siew Siew Lee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Raman Subramaniam
- Fetal Medicine and Gynaecology Centre (FMGC), 46200 Petaling Jaya, Malaysia
| | - Maiza Tusimin
- Prince Court Medical Centre, 50450 Kuala Lumpur, Malaysia
| | - King Hwa Ling
- Department of Biomedical Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | | | - Su Peng Loh
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| |
Collapse
|
10
|
Wang S, Shen T, Xi B, Shen Z, Zhang X. Vitamin D affects the neutrophil-to-lymphocyte ratio in patients with type 2 diabetes mellitus. J Diabetes Investig 2021; 12:254-265. [PMID: 32593190 PMCID: PMC7858138 DOI: 10.1111/jdi.13338] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/04/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS/INTRODUCTION Chronic inflammation is an underlying feature of type 2 diabetes mellitus. Hypovitaminosis D is associated with type 2 diabetes mellitus, but whether it contributes to chronic inflammation is unclear. We examined the effects of vitamin D on various immune markers to evaluate its contribution to systemic inflammation in type 2 diabetes mellitus. MATERIALS AND METHODS We retrospectively analyzed data from type 2 diabetes mellitus patients, people with prediabetes and control patients without diabetes (n = 9,746). Demographic and clinical variables were evaluated using descriptive statistics and generalized linear regression. A stratified analysis based on total serum vitamin D was also carried out. RESULTS Neutrophil count was a significant predictor of 1,5-anhydroglucitol and glycated hemoglobin (HbA1c) in patients with prediabetes (1,5-anhydroglucitol: β = -0.719, P < 0.001 and HbA1c: β = -0.006, P = 0.002) and patients with diabetes (1,5-anhydroglucitol: β = 0.207, P = 0.004 and HbA1c: β = -0.067, P = 0.010). Lymphocyte count was a significant predictor of HbA1c in patients without diabetes (β = 0.056, P < 0.001) and patients with prediabetes (β = 0.038, P < 0.001). The neutrophil-to-lymphocyte ratio (NLR) was a significant predictor of HbA1c in patients without diabetes (β = -0.001, P = 0.032). No immune markers differed significantly based on vitamin D level among patients without diabetes (P> 0.05 for all). Among patients with prediabetes, those who were vitamin D-deficient had the highest NLR (P = 0.040). Among patients with diabetes, those who were vitamin D-deficient had the highest neutrophil count (P = 0.001), lowest lymphocyte count (P = 0.016) and highest NLR (P < 0.001). CONCLUSIONS The NLR is strongly influenced by serum vitamin D level. Given the high prevalence of hypovitaminosis D and elevated NLR among chronic disease patients and the elderly, our results suggest that clinical interpretation of NLR as a predictive marker of type 2 diabetes mellitus-related inflammation should consider vitamin D level, age and pre-existing morbidity.
Collapse
Affiliation(s)
- Si‐Yang Wang
- Department of GeriatricsShanghai Xuhui Central HospitalShanghaiChina
| | - Ting‐Ting Shen
- Department of GeriatricsZhongshan‐Xuhui Hospital Affiliated to Fudan UniversityShanghaiChina
| | - Bei‐Li Xi
- Department of GeriatricsShanghai Xuhui Central HospitalShanghaiChina
| | - Zhan Shen
- Department of GeriatricsShanghai Xuhui Central HospitalShanghaiChina
| | - Xian Zhang
- Department of GeriatricsShanghai Xuhui Central HospitalShanghaiChina
| |
Collapse
|
11
|
Aslam M, Jagtap N, Karyampudi A, Talukdar R, Reddy DN. Risk factors for development of endocrine insufficiency in chronic pancreatitis. Pancreatology 2021; 21:15-20. [PMID: 33257226 DOI: 10.1016/j.pan.2020.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
UNLABELLED Endocrine insufficiency is a common and frequent complication of chronic pancreatitis. Identifying the role of pancreatic damage in the development of diabetes is important for early identification and appropriate management. METHODS All consecutive CP patients between January 2019 and May 2020 were retrospectively studied. Relevant statistical tests were performed. A two sided p value < 0.05 was considered statistically significant. RESULTS Total 587 chronic pancreatitis patients were included of which 118 (20.1%) patients developed diabetes with duration of 12 (IQR 4-48) months. Older age (OR 1.079; 95% CI 1.045-1.113; p < 0.001), presence of pancreatic parenchymal (OR 2.284; 95% CI 1.036-5.038; p = 0.041) and ductal (OR 2.351; 95% CI 1.062-5.207; p = 0.035) calcifications, exocrine insufficiency (OR 6.287; 95% CI 2.258-17.504; p < 0.001), and pancreatic duct stricture (OR 3.358; 95% CI 1.138-9.912; p = 0.028) were independently associated with development of diabetes mellitus in chronic pancreatitis patients. On cox-regression analysis, smoking (HR 2.370; 95% CI 1.290-4.354; p = 0.005) and pancreatic ductal calcification (HR 2.033; 95% CI 1.286-3.212; p = 0.002) were independently associated with earlier onset of diabetes mellitus in patients with chronic pancreatitis. CONCLUSION Pancreatic calcification, pancreatic duct stricture and pancreatic exocrine insufficiency are associated with development of diabetes mellitus in chronic pancreatitis indicating disease progression. Smoking is the modifiable risk factors associated with early onset of diabetes mellitus in CP patients.
Collapse
Affiliation(s)
- Mohsin Aslam
- Asian Institute of Gastroenterology, Hyderabad, India.
| | - Nitin Jagtap
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | | | | |
Collapse
|
12
|
de la Guía-Galipienso F, Martínez-Ferran M, Vallecillo N, Lavie CJ, Sanchis-Gomar F, Pareja-Galeano H. Vitamin D and cardiovascular health. Clin Nutr 2020; 40:2946-2957. [PMID: 33397599 PMCID: PMC7770490 DOI: 10.1016/j.clnu.2020.12.025] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/18/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
The principal source of vitamin D in humans is its biosynthesis in the skin through a chemical reaction dependent on sun exposure. In lesser amounts, the vitamin can be obtained from the diet, mostly from fatty fish, fish liver oil and mushrooms. Individuals with vitamin D deficiency, defined as a serum level of 25 hydroxyvitamin D < 20 ng/dl, should be supplemented. Vitamin D deficiency is a prevalent global problem caused mainly by low exposure to sunlight. The main role of 1,25 dihydroxyvitamin D is the maintenance of calcium and phosphorus homeostasis. However, vitamin D receptors are found in most human cells and tissues, indicating many extra-skeletal effects of the vitamin, particularly in the immune and cardiovascular (CV) systems. Vitamin D regulates blood pressure by acting on endothelial cells and smooth muscle cells. Its deficiency has been associated with various CV risk factors and appears to be linked to a higher mortality and incidence of CV disease (CVD). Several mechanisms have been proposed relating vitamin D deficiency to CV risk factors such as renin-angiotensin-aldosterone system activation, abnormal nitric oxide regulation, oxidative stress or altered inflammatory pathways. However, in the latest randomized controlled trials no benefits of vitamin D supplementation for CVD have been confirmed. Although more work is needed to establish the protective role of vitamin D in this setting, according to current evidences vitamin D supplements should not be recommended for CVD prevention.
Collapse
Affiliation(s)
- Fernando de la Guía-Galipienso
- Cardiology Service, Hospital Clínica Benidorm, Alicante, Spain; Glorieta Policlinic, Denia, Alicante, Spain; REMA Sports Cardiology Clinic, Denia, Alicante, Spain
| | - María Martínez-Ferran
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Madrid, Spain
| | - Néstor Vallecillo
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Fabian Sanchis-Gomar
- Dept. of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.
| | | |
Collapse
|
13
|
Sharifan P, Khoshakhlagh M, Khorasanchi Z, Darroudi S, Rezaie M, Safarian M, Vatanparast H, Afshari A, Ferns G, Ghazizadeh H, Ghayour Mobarhan M. Efficacy of low-fat milk and yogurt fortified with encapsulated vitamin D 3 on improvement in symptoms of insomnia and quality of life: Evidence from the SUVINA trial. Food Sci Nutr 2020; 8:4484-4490. [PMID: 32884728 PMCID: PMC7455959 DOI: 10.1002/fsn3.1750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Sleep disorders are a common condition globally. Vitamin D receptors are present on cells in several regions of the brain. It is possible that vitamin D status may affect brain function, including sleep patterns. We aimed to evaluate the 1,500 IU of Nano-encapsulated vitamin D fortified in dairy products on the symptoms of insomnia and associated improvement of quality of life. METHODS A case series was undertaken as part of the Survey of ultraviolent intake by nutritional approach project. Subjects enrolled among adults with abdominal obesity. Twenty-nine subjects with insomnia were selected according to the results of Insomnia Severity Index questionnaire and quality of life using a Short Form Health Survey (SF-36) questionnaire. Subjects were allocated to four groups: low-fat milk fortified by 1,500 IU vitamin D3 (n = 8), simple milk (n = 8), low-fat yogurt fortified by 1,500 IU vitamin D3 (n = 7), and simple yogurt (n = 6) and were treated for 10 weeks. RESULTS The insomnia score improved after the intervention in the group receiving vitamin D fortified milk compared to group receiving unfortified milk (p < .001). There were no significant differences between the two groups taking yogurt (fortified vs. unfortified). Comparison of quality of life scores between baseline and after intervention indicated significant improvements in both fortified and simple milk groups (p = .002 and p = .03, respectively); but no differences were found in the groups taking yogurt. CONCLUSION Fortified low-fat milk containing 1,500 IU vitamin D3 can improve insomnia symptoms and subsequently quality of life.Trial registration number: IRCT20101130005280N27, www.IRCT.ir.
Collapse
Affiliation(s)
- Payam Sharifan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mahdieh Khoshakhlagh
- Department of Medical BiochemistryFaculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zahra Khorasanchi
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Susan Darroudi
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mitra Rezaie
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohammad Safarian
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Hassan Vatanparast
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSKCanada
| | - Asma Afshari
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Gordon Ferns
- Brighton and Sussex Medical SchoolDivision of Medical EducationBrightonUK
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Majid Ghayour Mobarhan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| |
Collapse
|
14
|
Shi C, Wang P, Airen S, Brown C, Liu Z, Townsend JH, Wang J, Jiang H. Nutritional and medical food therapies for diabetic retinopathy. EYE AND VISION (LONDON, ENGLAND) 2020; 7:33. [PMID: 32582807 PMCID: PMC7310218 DOI: 10.1186/s40662-020-00199-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Diabetic retinopathy (DR) is a form of microangiopathy. Reducing oxidative stress in the mitochondria and cell membranes decreases ischemic injury and end-organ damage to the retina. New approaches are needed, which reduce the risk and improve the outcomes of DR while complementing current therapeutic approaches. Homocysteine (Hcy) elevation and oxidative stress are potential therapeutic targets in DR. Common genetic polymorphisms such as those of methylenetetrahydrofolate reductase (MTHFR), increase Hcy and DR risk and severity. Patients with DR have high incidences of deficiencies of crucial vitamins, minerals, and related compounds, which also lead to elevation of Hcy and oxidative stress. Addressing the effects of the MTHFR polymorphism and addressing comorbid deficiencies and insufficiencies reduce the impact and severity of the disease. This approach provides safe and simple strategies that support conventional care and improve outcomes. Suboptimal vitamin co-factor availability also impairs the release of neurotrophic and neuroprotective growth factors. Collectively, this accounts for variability in presentation and response of DR to conventional therapy. Fortunately, there are straightforward recommendations for addressing these issues and supporting traditional treatment plans. We have reviewed the literature for nutritional interventions that support conventional therapies to reduce disease risk and severity. Optimal combinations of vitamins B1, B2, B6, L-methylfolate, methylcobalamin (B12), C, D, natural vitamin E complex, lutein, zeaxanthin, alpha-lipoic acid, and n-acetylcysteine are identified for protecting the retina and choroid. Certain medical foods have been successfully used as therapy for retinopathy. Recommendations based on this review and our clinical experience are developed for clinicians to use to support conventional therapy for DR. DR from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) have similar retinal findings and responses to nutritional therapies.
Collapse
Affiliation(s)
- Ce Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peng Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shriya Airen
- College of Arts and Sciences, University of Miami, Miami, FL USA
| | - Craig Brown
- Department of Ophthalmology, College of Medicine, the University of Arkansas for Medical Sciences, Fayetteville, AR USA
| | - Zhiping Liu
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong China
| | - Justin H. Townsend
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| |
Collapse
|
15
|
|
16
|
Cimini FA, Barchetta I, Carotti S, Morini S, Cavallo MG. Overview of studies of the vitamin D/vitamin D receptor system in the development of non-alcoholic fatty liver disease. World J Gastrointest Pathophysiol 2019; 10:11-16. [PMID: 31559105 PMCID: PMC6751507 DOI: 10.4291/wjgp.v10.i2.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/09/2019] [Accepted: 08/21/2019] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. NAFLD is known to be associated with obesity, type 2 diabetes, metabolic syndrome and increased cardiovascular events: for these reasons, it is becoming a global public health problem and represents an important challenge in terms of prevention and treatment. The mechanisms behind the pathogenesis of NAFLD are multiple and have not yet been completely unraveled; consequently, at moment there are not effective treatments. In the past few years a large body of evidence has been assembled that attributes an important role in hepatic aberrant fat accumulation, inflammation and fibrosis, to the vitamin D/vitamin D receptor (VD/VDR) axis, showing a strong association between hypovitaminosis D and the diagnosis of NAFLD. However, the data currently available, including clinical trials with VD supplementation, still provides a contrasting picture. The purpose of this editorial is to provide an overview of recent advances in the pathogenesis of NAFLD in relation to VD/VDR. Based on recent data from literature, we focused in particular on the hypothesis that VDR itself, independently from its traditional ligand VD, may have a crucial function in promoting hepatic fat accumulation. This might also offer new possibilities for future innovative therapeutic approaches in the management of NAFLD.
Collapse
Affiliation(s)
- Flavia Agata Cimini
- Department of Experimental Medicine, Sapienza University of Rome, Rome I-00161, Italy
| | - Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome I-00161, Italy
| | - Simone Carotti
- Department of Medicine and Surgery, Laboratory of Microscopic and Ultrastructural Anatomy, University Campus Bio-Medico of Rome, Rome I-00128, Italy
| | - Sergio Morini
- Department of Medicine and Surgery, Laboratory of Microscopic and Ultrastructural Anatomy, University Campus Bio-Medico of Rome, Rome I-00128, Italy
| | - Maria Gisella Cavallo
- Department of Experimental Medicine, Sapienza University of Rome, Rome I-00161, Italy
| |
Collapse
|
17
|
Liu Q, Zheng X, Liu Z, Qiu L. Vitamin D status is associated with 1,5-anhydro-d-glucitol status in patients with type 2 diabetes mellitus. Appl Physiol Nutr Metab 2019; 44:857-860. [PMID: 30633541 DOI: 10.1139/apnm-2018-0719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Serum 1,5-anhydro-d-glucitol (1,5-AG) concentrations are short-term hyperglycemia indicators and were used to estimate the effects of serum vitamin D concentrations on glycemic control in patients with type 2 diabetes mellitus (T2DM). Serum concentrations of 1,5-AG, 25-hydroxyvitamin D2 (25-OH-D2), and 25-hydroxyvitamin D3 (25-OH-D3) from 11 026 patients with T2DM, hospitalized in the Department of Endocrinology, Shanghai Central Hospital of Xuhui District, from January 2012 to June 2015, were retrospectively analyzed. Correlation analyses revealed correlations between 1,5-AG and 25-OH-D3 (r = 0.05, P < 0.001), age (r = 0.05, P < 0.001), and 25-OH-D2 + 25-OH-D3 (25-OH-D2/D3) (r = 0.05, P < 0.001). Linear regression analyses revealed associations between 1,5-AG and 25-OH-D2/D3 (adjusted R2 = 0.003) as well as 25-OH-D3 (adjusted R2 = 0.002). In males with 1,5-AG levels ≤11.55 mg/L, serum concentrations of 25-OH-D2 (P < 0.001) and 25-OH-D3 (P = 0.001) were significantly lower than those in diabetic males with 1,5-AG levels >11.55 mg/L. Serum concentrations of 25-OH-D2/D3 in patients with T2DM were associated with 1,5-AG retention, suggesting involvement in glycemic control.
Collapse
Affiliation(s)
- Qiaorui Liu
- Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China
| | - Xulei Zheng
- Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China
| | - Zhiwen Liu
- Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China.,Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China
| | - Ling Qiu
- Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China.,Department of Endocrinology, Shanghai Xuhui Central Hospital, No. 966 Huaihai Road, Shanghai 200031, China
| |
Collapse
|
18
|
Entezari V, Lazarus M. Surgical Considerations in Managing Osteoporosis, Osteopenia, and Vitamin D Deficiency During Arthroscopic Rotator Cuff Repair. Orthop Clin North Am 2019; 50:233-243. [PMID: 30850081 DOI: 10.1016/j.ocl.2018.10.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Osteopenia and osteoporosis are common in older adults and are associated with increased risk of fragility fractures. Vitamin D deficiency caused by chronic disease, poor nutrition, and inadequate sun exposure affects bone quality. Chronic rotator cuff tears can deteriorate the bone mineral density of the greater tuberosity and have been linked to reduced anchor pullout strength and high re-tear rate after repair especially in older patients with larger tear size. This article summarizes the current evidence on rotator cuff tear and bone quality and provides treatment strategies for rotator cuff repair in patients with poor bone quality.
Collapse
Affiliation(s)
- Vahid Entezari
- Department of Orthopaedic Surgery, Orthopaedic & Rheumatologic Institute, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195, USA.
| | - Mark Lazarus
- Department of Orthopaedic Surgery, The Rothman Institute-Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
19
|
Chen HM, Lee LC, Hu KY, Tsai WJ, Huang C, Tsay HJ, Liu HK. The application of post-translational modification oriented serum proteomics to assess experimental diabetes with complications. PLoS One 2018; 13:e0206509. [PMID: 30395577 PMCID: PMC6218044 DOI: 10.1371/journal.pone.0206509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/14/2018] [Indexed: 01/01/2023] Open
Abstract
Proteome analysis of serum from type 2 diabetics with complications may lead to the discovery of diagnostic or prognostic biomarkers. To circumvent the principal barrier of serum proteomics, our investigation aimed to evaluate whether a study of post-translational modification enriched serum proteins could be valuable for the discovery of biomarkers or metabolic pathways related to type 2 diabetes pathogenesis. Type 2 diabetes was induced from high-fat diet fed Sprague Dawley rats with streptozotocin injection. Once diabetic status was confirmed, serum samples from either fasted healthy or diabetic rats were pooled and profiled by two-dimensional difference gel electrophoresis or comparative 2D electrophoresis after protein enrichments using immobilized metal ion, concanavalin A, and lentil affinity chromatography, respectively. Differential expressed proteins were identified and the associated networks were established by an Ingenuity Pathway Analysis. As a result, induced rats became severe diabetic and accompanied by hyperlipidemia, fatty liver, and glomerular hypertrophy. There were 3 total, 14 phosphorylated and 23 glycosylated protein targets differentially expressed. Proteins could be linked to HNF4A, HNF1A, and NFκB transcriptional factors and antigen presentation, humoral immune response, and inflammatory response pathways. Predicted organ toxicity in kidney, heart, and liver matched with our histopathological results. In conclusion, post-translational modification based serum protein enrichment could be a valuable approach to enhance the resolution of serum proteomics without depleting potentially valuable abundant proteins. Our results also indicated the potential association of the hepatic secretome and hepatocyte nuclear factors in the pathogenesis of type 2 diabetes and its complications.
Collapse
Affiliation(s)
- Han-Min Chen
- Department of Life Science, Fu Jen Catholic University, New Taipei city, Taiwan, ROC
| | - Lin-Chien Lee
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Kuang-Yu Hu
- Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wei-Jern Tsai
- Division of Chinese Medicine Literature and Informatics, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Cheng Huang
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Earth and Life Sciences, University of Taipei, Taipei, Taiwan, ROC
| | - Hui-Jen Tsay
- Institute of Neuroscience, Brain Research Center, school of life science, National Yang-Ming University, Taipei, Taiwan, ROC
- * E-mail: (HKL); (THJ)
| | - Hui-Kang Liu
- Division of Basic Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan, ROC
- Ph.D. Program in Clinical Drug Development of Chinese Herbal Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- * E-mail: (HKL); (THJ)
| |
Collapse
|
20
|
Comparative study of antihypertensive and antioxidant effects of clove and metformin on renal dysfunction in streptozotocin-induced diabetic rats. PHARMANUTRITION 2018. [DOI: 10.1016/j.phanu.2018.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
21
|
Israelian N, Danska JS. Sex Effects at the Ramparts: Nutrient- and Microbe-Mediated Regulation of the Immune-Metabolic Interface. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1043:113-140. [PMID: 29224093 DOI: 10.1007/978-3-319-70178-3_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The relationships between dietary compounds, derivative metabolites, and host metabolism and immunity are controlled by diverse molecular mechanisms. Essential contributions to these dynamics come from the community of microbes (the microbiome) inhabiting the human digestive tract. The composition and function of the microbiome are shaped by available nutrients, and reciprocally, these organisms produce an as yet poorly defined repertoire of molecules that communicate with the epithelial barrier and the mucosal immune system. We present evidence that diet-derived vitamins and lipids regulate immunity and metabolic function and highlight the diverse mechanisms through which these effects are impacted by sex. We discuss exciting new data emerging from studies using high-throughput sequencing technology, specialized mouse models, and bio-specimens, and clinical data from human subjects that have begun to reveal the complexity of these interactions. Also profiled in this chapter are the striking sex differences in pathways by which dietary nutrients and gut microbes modify metabolism, immunity, and immune- and inflammation-mediated diseases. Although the incidence, severity, and therapeutic responses of many autoimmune diseases differ by sex, the molecular mechanisms of these effects remain poorly understood.
Collapse
Affiliation(s)
- Nyrie Israelian
- Department of Immunology, University of Toronto, Toronto, ON, Canada.,Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada
| | - Jayne S Danska
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada. .,Department of Immunology, and Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
22
|
Dziedzic EA, Gąsior JS, Pawłowski M, Dąbrowski M. Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:3929075. [PMID: 29230421 PMCID: PMC5688254 DOI: 10.1155/2017/3929075] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/27/2017] [Indexed: 12/21/2022] Open
Abstract
Several modifiable factors may influence cardiac function in diabetic patients. The aim of the study was to evaluate the influence of vitamin D level on the stage of coronary atherosclerosis in cardiac patients diagnosed with type 2 diabetes. The study was performed in 337 consecutive patients undergoing coronarography. The stage of atherosclerosis was evaluated using Coronary Artery Surgery Study Score. The plasma 25(OH)D concentration was determined by an electrochemiluminescence method. Patients without significant lesions in coronary arteries presented the highest 25(OH)D level, significantly higher than patients with one-, two-, and three-vessel coronary artery disease (CAD) (p < 0.01). Significantly lower level of the 25(OH)D was observed in patients hospitalized due to acute coronary syndrome (ACS) in comparison to patients hospitalized due to stable CAD (p < 0.001). Lower 25(OH)D levels were observed in patients with the history of myocardial infarction (MI) in comparison to patients without previous MI (p < 0.001). In cardiac patients with diabetes, the higher number of stenotic coronary arteries is associated with lower values of the 25(OH)D. A group of male cardiac patients with diabetes with significant stenosis in three coronary arteries, hospitalized due to acute coronary syndrome, with a history of previous MI and hyperlipidemia presented the lowest vitamin D level.
Collapse
Affiliation(s)
- Ewelina A. Dziedzic
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| | - Jakub S. Gąsior
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Mariusz Pawłowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Marek Dąbrowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| |
Collapse
|
23
|
Effect of paricalcitol on pancreatic oxidative stress, inflammatory markers, and glycemic status in diabetic rats. Ir J Med Sci 2017; 187:75-84. [PMID: 28551720 DOI: 10.1007/s11845-017-1635-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 05/18/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study is designed to explore the effect of paricalcitol (vitamin D receptor agonist) on pancreatic oxidative stress, inflammatory markers, and adiponectin and glycemic status in diabetic rats. MATERIALS AND METHODS Forty Sprague-Dawley male rats aged 10-12 weeks (150-250 g) were used in this study. Type 2 diabetes was developed by providing 4 weeks of high-fat-diet feeding before one shot of streptozotocin injection (40 mg/kg i.p.). Four study groups were designed as normal control rats, diabetic control vehicle-treated, diabetic paricalcitol-treated (0.8 μg/kg), and diabetic glibenclamide-treated (0.6 mg/kg) groups with 10 animals in each. After treatment of diabetic rats for 3 months, pancreatic inflammatory and oxidative stress markers, plasma adiponectin, glycemic status parameters, and histopathological pancreatic islet changes were evaluated. RESULTS Paricalcitol and glibenclamide treatment significantly (P < 0.05) decreased plasma glucose, insulin resistance, and pancreatic malondialdehyde and tumor necrosis factor-α levels. Moreover, they significantly (P < 0.05) increased plasma fasting insulin, C-peptide, adiponectin, pancreatic IL-2, catalase, superoxide dismutase, glutathione peroxidase, and reduced glutathione when contrasted with diabetic control rats. Furthermore, they prevented extensive histopathological damage in the pancreas of diabetic rats. CONCLUSIONS Paricalcitol reduced pancreatic oxidative stress and inflammatory markers, and improved glycemic status in diabetic rats.
Collapse
|
24
|
Pan GT, Guo JF, Mei SL, Zhang MX, Hu ZY, Zhong CK, Zeng CY, Liu XH, Ma QH, Li BY, Qin LQ, Zhang ZL. Vitamin D Deficiency in Relation to the Risk of Metabolic Syndrome in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus. J Nutr Sci Vitaminol (Tokyo) 2017; 62:213-219. [PMID: 27725405 DOI: 10.3177/jnsv.62.213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitamin D deficiency is highly prevalent all over the world and dietary intakes of vitamin D are very low in China. In this study we aimed to determine whether vitamin D deficiency is associated with increased risk of metabolic syndrome (MetS) among Chinese type 2 diabetes mellitus (T2DM) patients aged over 50 y. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured in a cross-sectional sample of 270 T2DM patients aged over 50 y from Zhejiang. Data on demographic characteristics, anthropometry and other variables were collected. The mean of serum 25(OH)D was 22.93 ng/mL, and percentages of vitamin D deficiency and insufficiency were 43.71% and 39.63%, respectively. Serum 25(OH)D concentrations were significantly lower in subjects with MetS than in those without MetS (21.74 vs 24.96 ng/mL, p=0.001), and the prevalence of MetS significantly increased according to tertiles of serum 25(OH)D concentrations. After adjusting for multivariate factors, the adverse effect of lower serum 25(OH)D concentrations was significant (OR: 3.26, 95% CI: 1.03-7.34; p=0.044) in the group with BMI≥24 kg/m2 while the change in OR of MetS for each 10 ng/mL decrease in the serum 25(OH)D concentrations was 2.03 (95% CI: 1.10-3.79). These results suggest that serum 25(OH)D deficiency may be a risk factor of MetS among Chinese type 2 diabetic patients, especially in the T2DM with BMI≥24 kg/m2. The challenge is determining the mechanisms of vitamin D action for recommendation of vitamin D supplementation that reduces the risks of MetS and progression to T2DM.
Collapse
|
25
|
Investigation of vitamin D status and its correlation with insulin resistance in a Chinese population. Public Health Nutr 2017; 20:1602-1608. [DOI: 10.1017/s1368980017000490] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AbstractObjectiveAlthough many studies worldwide have focused on the relationship between vitamin D and insulin resistance, results remain controversial. Furthermore, concentrations of serum 25-hydroxyvitamin D (25(OH)D) in the Chinese population are unclear. We aimed to investigate vitamin D status and its correlation with insulin resistance among a Chinese adult population.DesignSerum 25(OH)D, fasting blood glucose, fasting insulin, glycated Hb (HbA1c) and other metabolic parameters were assessed. Neck circumference, waist circumference, hip circumference, weight and height were also measured. Lifestyle factors including smoking and drinking status were obtained. Diabetes mellitus was diagnosed by HbA1c according to the 2010 American Diabetes Association criteria.SettingEastern China.SubjectsOf 7200 residents included, 6597 individuals were ultimately analysed.ResultsWe enrolled 2813 males (mean age 52·7 (sd 13·5) years) and 3784 females (52·3 (sd 13·5) years); mean serum 25(OH)D concentration was 43·1 (sd 11·6) and 39·6 (sd 9·8) nmol/l, respectively. Additionally, 83·3 % of participants were 25(OH)D deficient. A significant difference in 25(OH)D was observed between males and females in winter and spring (P<0·001). Furthermore, 25(OH)D concentrations were inversely associated with the homeostasis model assessment of insulin resistance (HOMA-IR) in the overweight and pre-diabetic populations. After adjusting for several variables, 25(OH)D was significantly associated with HOMA-IR in winter. When 25(OH)D values were categorized into quartiles, HOMA-IR was significantly associated with decreasing 25(OH)D.ConclusionsThe majority of the Chinese population was vitamin D deficient and this deficiency was negatively associated with insulin resistance, particularly in the overweight and pre-diabetic populations. Moreover, these associations might be more evident in the winter.
Collapse
|
26
|
Vasile M, Corinaldesi C, Antinozzi C, Crescioli C. Vitamin D in autoimmune rheumatic diseases: A view inside gender differences. Pharmacol Res 2017; 117:228-241. [DOI: 10.1016/j.phrs.2016.12.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/26/2016] [Accepted: 12/29/2016] [Indexed: 12/14/2022]
|
27
|
Antinozzi C, Corinaldesi C, Giordano C, Pisano A, Cerbelli B, Migliaccio S, Di Luigi L, Stefanantoni K, Vannelli GB, Minisola S, Valesini G, Riccieri V, Lenzi A, Crescioli C. Potential role for the VDR agonist elocalcitol in metabolic control: Evidences in human skeletal muscle cells. J Steroid Biochem Mol Biol 2017; 167:169-181. [PMID: 28042053 DOI: 10.1016/j.jsbmb.2016.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/20/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022]
Abstract
Vitamin D plays a pivotal role to maintain skeletal muscle integrity and health. Vitamin D deficiency characterizes inflammatory myopathy (IM) and diabetes, often overlapping diseases involving skeletal muscle damage. Vitamin D receptor (VDR) agonists likely exert beneficial effects in both IM and metabolic disturbances. We aim to evaluate in vitro the effect of elocalcitol, a non-hypercalcemic VDR agonist, on the biomolecular metabolic machinery of human skeletal muscle cells (Hfsmc), vs. insulin (I). We analyzed GLUT4, Flotillin-1, Caveolin-3 and Caveolin-1 cell expression/localization; mTOR, AKT, ERK and 4E-BP1 phosphorylation; IL-6 myokine release; VDR expression. We investigated in vivo vitamin D status in IM subjects, evaluating VDR muscular expression and serum vitamin D with metabolism-related parameters, as glycemia, triglycerides, cholesterol, resistin and adiponectin. In Hfsmc, elocalcitol exerted an I-like effect, promoting GLUT4 re-localization in Flotillin-1, Caveolin-3 and Caveolin-1 positive sites and mTOR, AKT, ERK, 4E-BP1 activation; it enhanced IL-6 myokine release. IM subjects, all normoglycemic, showed VDR/vitamin D deficiency that, together with high lipidemic and resistin profile, possibly increases the risk to develop metabolic diseases. VDR agonists as elocalcitol may be therapeutic tools for skeletal muscle integrity/function maintenance, an indispensable condition for health homeostasis.
Collapse
Affiliation(s)
- Cristina Antinozzi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Clarissa Corinaldesi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Annalinda Pisano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Bruna Cerbelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Luigi Di Luigi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Katia Stefanantoni
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, 00161 Rome, Italy
| | - Guido Valesini
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy
| | - Valeria Riccieri
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Clara Crescioli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy.
| |
Collapse
|
28
|
Grant WB, Karras SN, Bischoff-Ferrari HA, Annweiler C, Boucher BJ, Juzeniene A, Garland CF, Holick MF. Do studies reporting 'U'-shaped serum 25-hydroxyvitamin D-health outcome relationships reflect adverse effects? DERMATO-ENDOCRINOLOGY 2016; 8:e1187349. [PMID: 27489574 PMCID: PMC4951179 DOI: 10.1080/19381980.2016.1187349] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 12/14/2022]
Abstract
Several reports describe U-shaped 25-hydroxyvitamin D [25(OH)D] concentration-health outcomes, including musculo-skeletal disorders such as falls and fractures, several cancers, cardiovascular disease (CVD), cognitive function, all-cause mortality rates, birth outcomes, allergic reactions, frailty, and some other disorders. This paper reviews reports of U-shaped outcome associations with vitamin D status for evidence of underlying pathophysiological processes, or of confounding, finding that some U-shaped associations appear to be biologically meaningful, but that many could well reflect confounding by factors such as lifestyle, or hypovitaminosis D-related disease onset being masked by self-supplementation that was begun too late to correct developing health problems but before baseline vitamin D status assessment. However, the various U-shaped associations for allergic reactions may be due to vitamin D modulation of the phenotype of the immune response, shifting the Th1-Th2 balance toward Th2 formation. For prostate cancer, there seems to be little effect of 25(OH)D concentration on incidence; however, there is an inverse correlation between 25(OH)D concentration and mortality rates. Future observational studies, and randomized controlled trial data analyses, should include adjustment for data collected on prior long-term vitamin D supplementation and solar UVB exposure, as well as other potential confounders.
Collapse
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center San Francisco , CA, USA
| | - Spyridon N Karras
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics, University Hospital Zurich, Switzerland Centre on Aging and Mobility, University of Zurich , Switzerland
| | - Cedric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, University Memory Clinic of Angers, UPRES EA 4638, University of Angers , France
| | - Barbara J Boucher
- Honorary Professor, Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London , London UK
| | - Asta Juzeniene
- Oslo University Hospital, The Norwegian Radium Hospital, Institute for Cancer Research, Department of Radiation Biology , Montebello, Oslo, Norway
| | - Cedric F Garland
- Department of Family Medicine and Public Health, University of California San Diego , La Jolla, CA USA
| | - Michael F Holick
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center , Boston, MA, USA
| |
Collapse
|
29
|
Pan J, Xin L, Wang D, Liao Z, Lin JH, Li BR, Du TT, Ye B, Zou WB, Chen H, Ji JT, Zheng ZH, Hu LH, Li ZS. Risk Factors for Diabetes Mellitus in Chronic Pancreatitis: A Cohort of 2,011 Patients. Medicine (Baltimore) 2016; 95:e3251. [PMID: 27057870 PMCID: PMC4998786 DOI: 10.1097/md.0000000000003251] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/17/2016] [Accepted: 03/10/2016] [Indexed: 01/15/2023] Open
Abstract
Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP) and increases the mortality. The identification of risk factors for DM development may contribute to the early detection and potential risk reduction of DM in patients with CP.Patients with CP admitted to Changhai Hospital (Shanghai, China) from January 2000 to December 2013 were enrolled. Cumulative rates of DM after the onset of CP were calculated by Kaplan-Meier method. Risk factors for DM development after the diagnosis of CP were identified by Cox proportional hazards regression model.A total of 2011 patients with CP were enrolled. During follow-up (median duration, 22.0 years), 564 patients developed DM. Cumulative rates of DM 20 and 50 years after the onset of CP were 45.8% (95% confidence interval [CI], 41.8%-50.0%) and 90.0% (95% CI, 75.4%-97.7%), respectively. Five risk factors for DM development after the diagnosis of CP were identified: male sex (hazard ratio [HR], 1.51; 95% CI, 1.08-2.11), alcohol abuse (HR, 2.00; 95% CI, 1.43-2.79), steatorrhea (HR, 1.46; 95% CI, 1.01-2.11), biliary stricture (HR, 2.25; 95% CI, 1.43-3.52), and distal pancreatectomy (HR, 3.41; 95% CI, 1.80-6.44).In conclusion, the risk of developing DM in patients with CP is not only influenced by the development of biliary stricture and steatorrhea indicating disease progression, and inherent nature of study subjects such as male sex, but also by modifiable factors including alcohol abuse and distal pancreatectomy.
Collapse
Affiliation(s)
- Jun Pan
- From the Department of Gastroenterology and Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai (JP, LX, DW, ZL, J-HL, B-RL, T-TD, BY, W-BZ, HC, J-TJ, Z-HZ, L-HH, Z-SL); Department of Gastroenterology, Air Force General Hospital, Beijing (B-RL); and Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, China (BY)
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Kumar A, Wong R, Ottenbacher KJ, Al Snih S. Prediabetes, undiagnosed diabetes, and diabetes among Mexican adults: findings from the Mexican Health and Aging Study. Ann Epidemiol 2016; 26:163-70. [PMID: 26872919 PMCID: PMC4863452 DOI: 10.1016/j.annepidem.2015.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 12/15/2015] [Accepted: 12/24/2015] [Indexed: 01/06/2023]
Abstract
PURPOSE The purpose of the study was to examine the prevalence and determinants of prediabetes, undiagnosed diabetes, and diabetes among Mexican adults from a subsample of the Mexican Health and Aging Study. METHODS We examined 2012 participants from a subsample of the Mexican Health and Aging Study. Measures included sociodemographic characteristics, body mass index, central obesity, medical conditions, cholesterol, high-density lipoprotein cholesterol, hemoglobin A1c, and vitamin D. Logistic regression was performed to identify factors associated with prediabetes, undiagnosed diabetes, and self-reported diabetes. RESULTS Prevalence of prediabetes, undiagnosed, and self-reported diabetes in this cohort was 44.2%, 18.0%, and 21.4%, respectively. Participants with high waist-hip ratio (1.61, 95% confidence interval [CI] = 1.05-2.45) and high cholesterol (1.85, 95% CI = 1.36-2.51) had higher odds of prediabetes. Overweight (1.68, 95% CI = 1.07-2.64), obesity (2.38, 95% CI = 1.41-4.02), and high waist circumference (1.60, 95% CI = 1.06-2.40) were significantly associated with higher odds of having undiagnosed diabetes. Those residing in a Mexican state with high U.S. migration had lower odds of prediabetes (0.61, 95% CI = 0.45-0.82) and undiagnosed diabetes (0.53, 95% CI = 0.41-0.70). Those engaged in regular physical activity had lower odds of undiagnosed diabetes (0.74, 95% CI = 0.57-0.97). CONCLUSIONS There is a high prevalence of prediabetes and undiagnosed diabetes among Mexican adults in this subsample. Findings suggest the need for resources to prevent, identify, and treat persons with prediabetes and undiagnosed diabetes.
Collapse
Affiliation(s)
- Amit Kumar
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston; Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston.
| | - Rebeca Wong
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston; Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston; Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston; Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Soham Al Snih
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston; Sealy Center on Aging, University of Texas Medical Branch, Galveston; Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston
| |
Collapse
|
31
|
Gillie OI. Controlled trials of vitamin D, causality and type 2 statistical error. Public Health Nutr 2016; 19:409-14. [PMID: 25370294 PMCID: PMC10271102 DOI: 10.1017/s1368980014002304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/14/2014] [Accepted: 09/16/2014] [Indexed: 12/29/2022]
Abstract
Two recent studies published in The Lancet (Autier et al. (2013) Lancet Diabetes Endocrinol 2, 76-89 and Bolland et al. (2014) Lancet Diabetes Endocrinol 2, 307-320) have concluded that low levels of vitamin D are not a cause but a consequence of ill health brought about by reduced exposure to the sun, an association known as 'reverse causality'. The scientific evidence and reasoning for these conclusions are examined here and found to be faulty. A null result in a clinical trial of vitamin D in adults need not lead to a conclusion of reverse causation when low vitamin D is found in observational studies of the same disease earlier in life. To assume an explanation of reverse causality has close similarities with type 2 statistical error. For example, a null result in providing vitamin D for treatment of adult bones that are deformed in the pattern of the rachitic rosary would not alter the observation that lack of vitamin D can cause rickets in childhood and may have lasting consequences if not cured with vitamin D. Other examples of diseases considered on a lifetime basis from conception to adulthood are used to further illustrate the issue, which is evidently not obvious and is far from trivial. It is concluded that deficiency of vitamin D in cohort studies, especially at critical times such as pregnancy and early life, can be the cause of a number of important diseases. Denial of the possible benefits of vitamin D, as suggested by insistent interpretation of studies with reverse causation, may lead to serious harms, some of which are listed.
Collapse
Affiliation(s)
- OIiver Gillie
- Health Research Forum, 68 Whitehall Park, London N19 3TN, UK
| |
Collapse
|
32
|
Mao X, Xing X, Xu R, Gong Q, He Y, Li S, Wang H, Liu C, Ding X, Na R, Liu Z, Qu Y. Folic Acid and Vitamins D and B12 Correlate With Homocysteine in Chinese Patients With Type-2 Diabetes Mellitus, Hypertension, or Cardiovascular Disease. Medicine (Baltimore) 2016; 95:e2652. [PMID: 26871790 PMCID: PMC4753885 DOI: 10.1097/md.0000000000002652] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Elevated serum homocysteine has been shown to be a risk factor for hypertension, cardiovascular disease (CVD), and type-2 diabetes mellitus (T2DM).We characterized the relationships between the serum levels of homocysteine, folic acid, and vitamins D2, D3, and B12 in patients with T2DM, CVD, and hypertension in Shanghai, China. The levels of these serum biochemical markers were determined for 9311 Chinese patients (mean age: 79.50 ± 13.26 years) with T2DM (N = 839), hypertension (N = 490), or CVD (N = 7925). The demographic and serum biochemical data were compared using an analysis of variance. We performed stratified analyses using Pearson linear regression to investigate correlations between the different variables in the T2DM, CVD, and hypertension groups and in patients aged < 50, 50 to 64, 65 to 80, and ≥80 years. A subgroup analysis was also performed to identify correlations between the serum biochemical markers. Stratified chi-squared analyses were performed based on the levels of folic acid and total vitamin D.In all 3 patient groups, elevated levels of vitamin D2 and homocysteine were observed, whereas the levels of folic acid and vitamins D3 and B12 were lower than the reference range for each serum marker (P < 0.05 for all). The linear regression and stratified analyses showed that the highest levels of folic acid and vitamins D2 and D3 correlated with the lowest level of homocysteine in T2DM, CVD, and hypertension patients (P < 0.05 for all), whereas the highest level of vitamin B12 correlated with a lowest level of homocysteine in CVD patients only (P < 0.05).Our results indicate that the contributions of both vitamin D2 and vitamin D3 should be considered in investigations of the effects of vitamin D supplements in T2DM, CVD, and hypertension patients. Our findings warrant future studies of the benefits of vitamin D and folic acid supplements for reducing the risk of T2DM, CVD, and hypertension in elderly Chinese people, as well as the benefits of vitamin B12 supplements for reducing the risk of CVD alone.
Collapse
Affiliation(s)
- Xudong Mao
- From the Department of Geriatrics (XM, YQ, RX, QG, YH); Central Laboratory (SL); Department of Endocrinology, Shanghai Xuhui Central Hospital, Shanghai Clinical Center, Chinese Academy of Sciences (CL, XD, ZL, RN); Department of Cardiology, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, (XX); and Institute of Radiation Medicine, Shanghai Medical College, Fudan University, Shanghai, China (HW)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Esteghamati A, Fotouhi A, Faghihi-Kashani S, Hafezi-Nejad N, Heidari B, Sheikhbahaei S, Zandieh A, Nakhjavani M. Non-linear contribution of serum vitamin D to symptomatic diabetic neuropathy: A case-control study. Diabetes Res Clin Pract 2016; 111:44-50. [PMID: 26548603 DOI: 10.1016/j.diabres.2015.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/23/2015] [Accepted: 10/12/2015] [Indexed: 12/12/2022]
Abstract
AIMS Vitamin D deficiency has recently been speculated to be associated with increased risk of diabetes neuropathy (DN). The aim of this study was to evaluate the odds of symptomatic DN across serum vitamin D levels. METHODS All patients with DM were assessed using diabetic neuropathy symptoms and diabetic neuropathy examination score. Overall, 150 cases with DN and 600 controls were included. Serum 25-hydroxyvitamin D (25-OH-D) was measured to determine vitamin D status. RESULTS A non-linear association between 25-OH-D and suffering from symptomatic DN was observed which was extracted after stratifying the ORs across different serum 25-OH-D levels. When compared to individuals with 25-OH-D of 30-40 ng/mL, patients with deficient (<20 ng/mL) vitamin D levels had higher odds of having symptomatic DN (OR: 2.04, 95%CI: 0.99-4.02, P=0.054). Participants with vitamin D values of greater than 40 ng/mL were also more likely to exhibit symptomatic DN (fully adjusted OR: 4.29, 95%CI: 1.59-11.55). CONCLUSIONS We hypothesize a non-linear contribution of serum vitamin D to symptomatic DN occurrence, which emphasizes that administration of vitamin D should be monitored and evaluated more carefully, especially in patients with diabetes.
Collapse
Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Sara Faghihi-Kashani
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Behnam Heidari
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Sara Sheikhbahaei
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Ali Zandieh
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| |
Collapse
|
34
|
Joseph R, Nagrale AV, Joseraj MG, Pradeep Kumar KM, Kaziyarakath JA, Chandini R. Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study. J Indian Soc Periodontol 2015; 19:501-6. [PMID: 26644714 PMCID: PMC4645534 DOI: 10.4103/0972-124x.167162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: Vitamin D is associated with inflammatory diseases such as periodontal disease and diabetes mellitus (DM). The aim of our study was to find out the level of serum Vitamin D in chronic periodontitis patients (CHP) with and without type 2 DM. Materials and Methods: This study consists of 141 subjects, including 48 controls. Case groups consisted of 43 chronic periodontitis patients with type 2 DM (CHPDM) and 50 CHP. pocket depth (PD), clinical attachment loss (CAL), modified gingival index (MGI), plaque index (PI), and calculus index (CI) were taken. Serum 25-hydroxyvitamin D (25[OH] D) level in ηg/ml was estimated by electrochemiluminescence immunoassay with Elecsys and cobase e immunoassay analysers(cobase e 411). Other laboratory investigations including fasting blood sugar (FBS) and serum calcium were measured in all subjects. Results: The mean serum 25(OH) D level was 22.32 ± 5.76 ηg/ml, 14.06 ± 4.57 ηg/ml and 16.94 ± 5.58 ηg/ml for control, CHPDM and CHP groups respectively. The difference was statistically significant (P < 0.05). The mean value of FBS was significantly high in CHPDM group as compared to CHP group. Periodontal parameters like MGI, PI, PD, and CI showed significant difference between groups (P < 0.05) and higher score was found in CHP group, while CAL and PI showed no statistically significant difference between CHP and CHPDM group (P > 0.05). Conclusions: This study observed a low level of serum Vitamin D level in patients with CHP and CHPDM. Low Vitamin D level was observed in case groups may be due to the diseases process rather than low Vitamin D acting as a cause for the disease.
Collapse
Affiliation(s)
- Rosamma Joseph
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
| | - Amol Vijay Nagrale
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
| | | | | | | | | |
Collapse
|
35
|
Bizzaro G, Shoenfeld Y. Vitamin D and autoimmune thyroid diseases: facts and unresolved questions. Immunol Res 2015; 61:46-52. [PMID: 25407646 DOI: 10.1007/s12026-014-8579-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (levels lower than 20 ng/ml) is becoming a global health problem, since it is increasingly represented even among healthy subjects. Vitamin D, as an environmental factor, is involved in many biological processes, like perception of chronic pain and response to infections. In recent years, evidence has emerged pointing to an involvement of vitamin D in the development of many autoimmune diseases, and a severe vitamin D deficiency has been especially demonstrated in patients affected with autoimmune thyroid disease (AITD). Low levels of vitamin D were found associated with antithyroid antibody presence, abnormal thyroid function, increased thyroid volume, increased TSH levels, and adverse pregnancy outcome in women with AITD. Vitamin D mediates its effect through binding to vitamin D receptor (VDR), which is harbored on many human immune cells, and in this way is able to modulate immune cells activity, triggering both innate and adaptive immune responses. As VDR gene polymorphisms were found to associate with AITD, the evidence links vitamin D deficiency to AITD either through gene polymorphism or by environmental factors (lack of dietary uptake and sun exposure). Vitamin D supplementation may be offered to AITD patients, but further research is needed to define whether it should be introduced in clinical practice.
Collapse
Affiliation(s)
- Giorgia Bizzaro
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 52621, Tel-Hashomer, Tel Aviv, Israel
| | | |
Collapse
|
36
|
|
37
|
Vitamin D Levels Decline with Rising Number of Cardiometabolic Risk Factors in Healthy Adults: Association with Adipokines, Inflammation, Oxidative Stress and Advanced Glycation Markers. PLoS One 2015; 10:e0131753. [PMID: 26120828 PMCID: PMC4487995 DOI: 10.1371/journal.pone.0131753] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/05/2015] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Hypovitaminosis D associates with obesity, insulin resistance, hypertension, and dyslipoproteinemia. We asked whether the presence of multiple cardiometabolic risk factors, and which particular combination, exerts additive negative effects on 25(OH)D3 levels; and whether 25(OH)D3 levels associate with markers of inflammation and oxidative stress. SUBJECTS AND METHODS In non-diabetic medication-free adults central obesity (waist-to-height ratio > 0.5); elevated blood pressure (systolic BP≥130 mm Hg and/or diastolic BP ≥85 mm Hg); increased atherogenic risk (log(TAG/HDL) ≥ 0.11); and insulin resistance (QUICKI < 0.322) were considered as cardiometabolic risk factors. 25(OH)D3 status was classified as deficiency (25(OH)D3 ≤20 ng/ml); insufficiency (levels between 20-to-30 ng/ml), or as satisfactory (>30 ng/ml). Plasma adipokines, inflammatory and oxidative stress markers, advanced glycation end-products, and their soluble receptor were determined. RESULTS 162 subjects were cardiometabolic risk factors-free, 162 presented increased (i.e. 1 or 2), and 87 high number (i.e. 3 or 4) of cardiometabolic risk factors. Mean 25(OH)D3 decreased with rising number of manifested risk factors (36 ± 14 ng/ml, 33 ± 14 ng/ml, and 31 ± 15 ng/ml, respectively; pANOVA: 0.010), while prevalence of hypovitaminosis D did not differ significantly. Elevated blood pressure and insulin resistance appeared as significant determinants of hypovitaminosis D. Subjects presenting these risk factors concurrently displayed the lowest 25(OH)D3 levels (29 ± 15 ng/ml). Plasma adipokines, inflammatory and oxidative stress markers, advanced glycation end-products, and their soluble receptor generally differed significantly between the groups, but only advanced oxidation protein products and advanced glycation end-products associated fluorescence of plasma showed significant independent association with 25(OH)D3 levels. CONCLUSION In apparently healthy adults increasing number of cardiometabolic risk factors associates with poorer 25(OH)D3 status, while the association between 25(OH)D3 status and inflammatory or oxidative stress markers remains equivocal.
Collapse
|
38
|
Boucher BJ. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus. Paediatr Perinat Epidemiol 2015; 29:196-9. [PMID: 25873289 DOI: 10.1111/ppe.12187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Barbara J Boucher
- Centre for Diabetes, Bart's and The London School of Medicine, Queen Mary University of London, London, UK
| |
Collapse
|
39
|
Chou CL, Pang CY, Lee TJF, Fang TC. Beneficial effects of calcitriol on hypertension, glucose intolerance, impairment of endothelium-dependent vascular relaxation, and visceral adiposity in fructose-fed hypertensive rats. PLoS One 2015; 10:e0119843. [PMID: 25774877 PMCID: PMC4361671 DOI: 10.1371/journal.pone.0119843] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 02/03/2015] [Indexed: 01/23/2023] Open
Abstract
Besides regulating calcium homeostasis, the effects of vitamin D on vascular tone and metabolic disturbances remain scarce in the literature despite an increase intake with high-fructose corn syrup worldwide. We investigated the effects of calcitriol, an active form of vitamin D, on vascular relaxation, glucose tolerance, and visceral fat pads in fructose-fed rats. Male Wistar-Kyoto rats were divided into 4 groups (n = 6 per group). Group Con: standard chow diet for 8 weeks; Group Fru: high-fructose diet (60% fructose) for 8 weeks; Group Fru-HVD: high-fructose diet as Group Fru, high-dose calcitriol treatment (20 ng / 100 g body weight per day) 4 weeks after the beginning of fructose feeding; and Group Fru-LVD: high-fructose diet as Group Fru, low-dose calcitriol treatment (10 ng / 100 g body weight per day) 4 weeks after the beginning of fructose feeding. Systolic blood pressure was measured twice a week by the tail-cuff method. Blood was examined for serum ionized calcium, phosphate, creatinine, glucose, triglycerides, and total cholesterol. Intra-peritoneal glucose intolerance test, aortic vascular reactivity, the weight of visceral fat pads, adipose size, and adipose angiotensin II levels were analyzed at the end of the study. The results showed that the fructose-fed rats significantly developed hypertension, impaired glucose tolerance, heavier weight and larger adipose size of visceral fat pads, and raised adipose angiotensin II expressions compared with the control rats. High- and low-dose calcitriol reduced modestly systolic blood pressure, increased endothelium-dependent aortic relaxation, ameliorated glucose intolerance, reduced the weight and adipose size of visceral fat pads, and lowered adipose angiotensin II expressions in the fructose-fed rats. However, high-dose calcitriol treatment mildly increased serum ionized calcium levels (1.44 ± 0.05 mmol/L). These results suggest a protective role of calcitriol treatment on endothelial function, glucose tolerance, and visceral adiposity in fructose-fed rats.
Collapse
Affiliation(s)
- Chu-Lin Chou
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Yoong Pang
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Tony J. F. Lee
- Institutes of Life Sciences, Pharmacology & Toxicology, and Medical Sciences, Tzu Chi University, Hualien, Taiwan
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois, United States of America
| | - Te-Chao Fang
- Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
40
|
Celikbilek A, Gocmen AY, Tanik N, Borekci E, Adam M, Celikbilek M, Suher M, Delibas N. Decreased serum vitamin D levels are associated with diabetic peripheral neuropathy in a rural area of Turkey. Acta Neurol Belg 2015; 115:47-52. [PMID: 24841640 DOI: 10.1007/s13760-014-0304-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 04/25/2014] [Indexed: 01/04/2023]
Abstract
Data examining the association between vitamin D and diabetic peripheral neuropathy are limited. This study investigated the serum levels of vitamin D, vitamin D-binding protein (VDBP), and vitamin D receptor (VDR) in diabetics in the Yozgat region of Turkey, and assessed their relationships with diabetic peripheral neuropathy. 69 diabetic patients and 49 age- and sex-matched control subjects were enrolled in this clinical prospective study. All the diabetics underwent conventional sensory and motor nerve conduction studies, and diabetic peripheral neuropathy was confirmed or ruled out according to the electromyography findings and Douleur Neuropathique 4 questions. Serum vitamin D, VDBP and VDR levels were measured using commercial enzyme-linked immunosorbent assay kits. The serum vitamin D levels (p = 0.001) were significantly lower, while the VDR levels (p = 0.003) were higher, in diabetics than in controls. The serum VDBP levels were similar in both groups (p > 0.05). The serum vitamin D levels were significantly lower in diabetics with diabetic peripheral neuropathy than in those without (p = 0.032), whereas the serum VDBP and VDR levels were similar in these two groups (p > 0.05). The lower serum vitamin D levels in diabetics, especially in those with peripheral neuropathy, may suggest a neurotrophic effect of vitamin D.
Collapse
|
41
|
Hoffmann MR, Senior PA, Mager DR. Vitamin D supplementation and health-related quality of life: a systematic review of the literature. J Acad Nutr Diet 2015; 115:406-418. [PMID: 25573654 DOI: 10.1016/j.jand.2014.10.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/16/2014] [Indexed: 01/10/2023]
Abstract
Vitamin D deficiency and insufficiency are highly prevalent worldwide and thought to potentiate a variety of chronic disease states, including diabetes, cancer, and depression. Routine vitamin D supplementation is often needed to meet vitamin D requirements. Little is known regarding the effect of vitamin D supplementation on quality of life. The purpose of this article was to systematically review the literature regarding quality-of-life outcomes from vitamin D supplementation in healthy and clinical populations. Clinical trials of vitamin D supplementation, where quality-of-life outcomes were reported, were selected from Medline and Web of Science databases. Inclusion criteria were English language articles available online (published between 1950 and May 2014), primary research articles, studies conducted on human beings, and treatment/supplementation with vitamin D. Articles were excluded if they involved topical vitamin D application or implicit cotreatment with other vitamins (eg, multivitamins). Articles selected for review were examined for process and methodologic quality using validated methodologies. A total of 15 articles met the inclusion criteria for review. Interventions were highly variable in terms of study population (eg, healthy/diseased, children/elderly, and baseline vitamin D status) vitamin D dose, and duration of follow-up. Vitamin D supplementation ranged from 400 IU/day for an average of 7.1 years, to a single 300, 000 IU dose. The main tools used to capture quality of life were adaptations of validated, questionnaires (Medical Outcomes Study Short Form 36-item questionnaire and EuroQOL five dimension questionnaire). Vitamin D supplementation was not associated with significant changes in quality of life. Studies that reported changes in quality of life as a result of vitamin D supplementation were in clinical populations on short-term vitamin D. Most articles reviewed displayed poor methodologic quality (eg, no randomization/blinding, dropout description, or vitamin D assessment). Current evidence indicates that vitamin D supplementation may have a small to moderate effect on quality of life when used on a short-term basis in diseased populations. However, the evidence for a beneficial effect of long-term vitamin D supplementation on health-related quality of life is lacking.
Collapse
|
42
|
Hirani V, Cumming RG, Le Couteur DG, Naganathan V, Blyth F, Handelsman DJ, Waite LM, Seibel MJ. Low levels of 25-hydroxy vitamin D and active 1,25-dihydroxyvitamin D independently associated with type 2 diabetes mellitus in older Australian men: the Concord Health and Ageing in Men Project. J Am Geriatr Soc 2014; 62:1741-7. [PMID: 25112415 DOI: 10.1111/jgs.12975] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the associations between serum 25-hydroxyvitamin D (25OHD) levels and the active vitamin D metabolite, 1,25-hydroxyvitamin D (1,25OHD), with type 2 diabetes mellitus (DM) in community-living men aged 70 and older. DESIGN Cross-sectional. SETTING A population-based, cross-sectional analysis of the baseline phase of the Concord Health and Ageing in Men Project (CHAMP), a large epidemiological study conducted in Sydney between January 2005 and May 2007. PARTICIPANTS Community dwelling men aged 70 and older taking part in CHAMP (N = 1,659). MEASUREMENTS Serum 25OHD and 1,25OHD levels, presence of DM, age, country of birth, season of blood collection, sun exposure, body mass index, vitamin D supplement use, statin use, income, measures of health, depression, activity of daily living disabilities, parathyroid hormone, estimated glomerular filtration rate, phosphate, and calcium. RESULTS The prevalence of DM was 20.0%. There was a significant association between low 25OHD and 1,25OHD levels and DM that remained after adjustment for a wide range of confounders and covariates of clinical significance such as comorbidity, renal function, calciotropic hormones, and medications. CONCLUSION 25OHD and 1,25OHD levels were associated with DM. The independent association between serum 25OHD and 1,25OHD concentrations and DM raises the question of whether each of the two vitamin D metabolites may influence DM through different biological mechanisms and pathways.
Collapse
Affiliation(s)
- Vasant Hirani
- Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia; School of Public Health, University of Sydney, Sydney, New South Wales, Australia; ARC Centre of Excellence in Population Ageing Research, University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Affiliation(s)
- Barbara Boucher
- Barts and The London School of Medicine and Dentistry, The Blizard Institute, London E1 2AD, UK.
| |
Collapse
|
44
|
Sadek KM, Shaheen H. Biochemical efficacy of vitamin D in ameliorating endocrine and metabolic disorders in diabetic rats. PHARMACEUTICAL BIOLOGY 2014; 52:591-596. [PMID: 24251869 DOI: 10.3109/13880209.2013.854812] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 10/08/2013] [Indexed: 06/02/2023]
Abstract
CONTEXT Due to the biochemical role of vitamin D (Vit D) in the endocrine system, especially its potential anti-inflammatory and immune-modulating properties, there is an increased interest in its potential role in the prevention and control of diabetes mellitus. OBJECTIVE This study evaluated the potential therapeutic efficacy of Vit D in averting the detrimental effects of both types of diabetes mellitus. MATERIALS AND METHODS A total of 50 male Wistar rats were allotted into five groups: a placebo group; a nongenetic model of type 1 diabetes in rats (T1D), injected with a single dose of streptozotocin (STZ; 65 mg/kg, ip); a nongenetic model of type 2 diabetes in rats (T2D), given a short-term high-fat diet followed by a single low dose of STZ (35 mg/kg, ip); fourth and fifth groups that were gastrogavaged with Vit D (10 IU/kg) three days after the induction of T1D and T2D, respectively, which was continued daily throughout the experiment. RESULTS Vit D (10 IU/kg/60 days) significantly (p < 0.05) decreased fasting plasma glucose, ketoacidosis (decreased non-esterified fatty acid and β-hydroxyl butyric acid), pro-inflammatory interleukin-6, HbA1c in T1D and T2D and insulin resistance index by 33% in T2D. Interestingly, Vit D significantly (p < 0.05) increased fasting plasma insulin by 144% in T1D, plasma Ca level, insulin sensitivity index, and β-cell function index in T1D and T2D. DISCUSSION AND CONCLUSION Vit D ameliorated the deleterious biochemical impact of diabetes mellitus, likely by increasing insulin secretion and sensitivity, ameliorating the β-cell function, and decreasing the number of pro-inflammatory cytokines and insulin resistance.
Collapse
MESH Headings
- 3-Hydroxybutyric Acid/blood
- Animals
- Blood Glucose/metabolism
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/immunology
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/immunology
- Diabetes Mellitus, Type 2/metabolism
- Endocrine System/drug effects
- Endocrine System/immunology
- Endocrine System/metabolism
- Fatty Acids, Nonesterified/blood
- Glycated Hemoglobin/analysis
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/therapeutic use
- Insulin/blood
- Insulin/metabolism
- Insulin Resistance/immunology
- Insulin Secretion
- Insulin-Secreting Cells/drug effects
- Insulin-Secreting Cells/metabolism
- Interleukin-6/immunology
- Male
- Rats, Wistar
- Streptozocin/pharmacology
- Vitamin D/administration & dosage
- Vitamin D/therapeutic use
Collapse
|
45
|
Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y. Vitamin D in systemic and organ-specific autoimmune diseases. Clin Rev Allergy Immunol 2014; 45:256-66. [PMID: 23238772 DOI: 10.1007/s12016-012-8342-y] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Lately, vitamin D has been linked with metabolic and immunological processes, which established its role as an essential component of human health preservation. Vitamin D has been defined as natural immune modulators, and upon activation of its receptors (VDRs), it regulates calcium metabolism, cellular growth, proliferation and apoptosis, and other immunological functions. Epidemiological data underline a strong correlation between poor vitamin D status and higher risk for chronic inflammatory illnesses of various etiologies, including autoimmune diseases. Epidemiological, genetic, and basic studies indicated a potential role of vitamin D in the pathogenesis of certain systemic and organ-specific autoimmune diseases. These studies demonstrate correlation between low vitamin D and prevalence of diseases. In addition, VDRs' polymorphisms observed in some of these autoimmune diseases may further support a plausible pathogenic link. Notably, for some autoimmune disease, no correlation with vitamin D levels could be confirmed. Thus, in the current review we present the body of evidence regarding the plausible roles of vitamin D and VDR's polymorphism in the pathogenesis of autoimmunity. We summarize the data regarding systemic (i.e., systemic lupus erythematosus, rheumatoid arthritis, etc.) and organ-specific (i.e., multiple sclerosis, diabetes mellitus, primary biliary cirrhosis, etc.) autoimmune diseases, in which low level of vitamin D was found comparing to healthy subjects. In addition, we discuss the correlations between vitamin D levels and clinical manifestations and/or activity of diseases. In this context, we address the rational for vitamin D supplementation in patients suffering from autoimmune diseases. Further studies addressing the mechanisms by which vitamin D affects autoimmunity and the proper supplementation required are needed.
Collapse
Affiliation(s)
- Nancy Agmon-Levin
- The Zabludowics Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel
| | | | | | | |
Collapse
|
46
|
Chen RH, Zhao XH, Gu Z, Gu PL, Zhou B, Zhu ZH, Xu LY, Zou YF, Jiang XZ. Serum levels of 25-hydroxyvitamin D are associated with cognitive impairment in type 2 diabetic adults. Endocrine 2014; 45:319-24. [PMID: 23982512 DOI: 10.1007/s12020-013-0041-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/14/2013] [Indexed: 12/27/2022]
Abstract
Hypovitaminosis D is highly prevalent in type 2 diabetes. The aim of this study is to determine the serum levels of 25-hydroxyvitamin D [25(OH)D] in type 2 diabetic patients with and without mild cognitive impairment (MCI), and examine the relationship of 25(OH)D and MCI with other clinical factors. One hundred and sixty-five diabetic patients were enrolled in this study. Among whom, 95 patients were considered as MCI [Montreal Cognitive Assessment score (MoCA) < 26] and the other 70 as no MCI (MoCA ≥ 26). Subjects were assessed clinically. Diabetic patients with MCI had a longer duration of DM, fewer years of education, elevated fasting blood glucose (FBG), resistant index (RI) of carotid, and lower levels of 25(OH)D {[17.35 (13.02-25.92) vs 28.00 (19.67-34.30)] ng/ml, P < 0.001}. The MoCA score was positively correlated with log10[25(OH)D], education year, and inversely correlated with duration of DM, history of hypertension, intima-media thickness (IMT), FBG, max-RI, and min-RI. Log10[25(OH)D] was positively correlated with MoCA score, and inversely correlated with IMT, in multivariate regression analysis adjusted for age, sex, and education year, 25(OH)D (β = 0.210, P = 0.003), history of hypertension (β = -0.191, P = 0.007), IMT (β = -0.194, P = 0.007), and FBG (β = -0.157, P = 0.026) independently predicted MoCA score. In conclusion, our results suggest that levels of serum 25(OH)D are inversely associated with the cognitive impairment in diabetic patients. Vitamin D may be a potential protective factor for cognitive impairment in patients with type 2 diabetes.
Collapse
Affiliation(s)
- Rui-hua Chen
- Department of Endocrinology, Shanghai Pudong New Area People's Hospital, No.490, South Chuanhuan Road, Shanghai, China
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2013.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
48
|
Vujosevic S, Borozan S, Radojevic N, Aligrudic S, Bozovic D. Relationship between 25-hydroxyvitamin D and newly diagnosed type 2 diabetes mellitus in postmenopausal women with osteoporosis. Med Princ Pract 2014; 23:229-33. [PMID: 24662713 PMCID: PMC5586874 DOI: 10.1159/000360540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 02/11/2014] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE The aim of the study was to determine a correlation between the level of 25-hydroxivitamin D (25-OHD) and the incidence of diabetes. SUBJECTS AND METHODS In this prospective observational study, 97 (out of an initial 100) Caucasian women with osteoporosis (OS) were monitored for 2 years for the incidence of diabetes. Logistic regression analysis was used to establish an association with and prognostic value of vitamin D for the onset of type 2 diabetes mellitus, as well as insulin resistance, body mass index (BMI), total cholesterol and triglyceride levels in the development of diabetes. The serum level of 25-OHD was measured using immunochemiluminescence in March and April 2011. RESULTS Of the 97 patients (mean age 51.64 ± 5.86 years, range 36.0-73.0), 21 (21.65%) were diagnosed with diabetes during the observational period. The study showed that the 22 patients with low levels of vitamin D were more susceptible to diabetes (odds ratio = 0.958). The cut-off value of vitamin D using a receiver operating characteristic curve was 62.36 nmol/l with a sensitivity of 39.5% and a specificity of 90.5%. With an increase in BMI and triglyceride levels, women were, respectively, 1,591 and 2,821 times more likely to get diabetes than those without an increase. CONCLUSION This study showed that the patients with postmenopausal OS and hypovitaminosis D, besides a high BMI, elevated triglyceride levels and insulin resistance, had an increased risk of developing type 2 diabetes.
Collapse
Affiliation(s)
| | | | - Nemanja Radojevic
- *Nemanja Radojevic, MD, Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Ljubljanska 1, ME–20000 Podgorica (Montenegro), E-Mail
| | | | | |
Collapse
|
49
|
Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr (Rio J) 2014; 90:28-34. [PMID: 24140383 DOI: 10.1016/j.jped.2013.06.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 06/19/2013] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This triple-masked controlled trial aimed to assess the effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in obese children and adolescents. METHODS The study comprised 50 participants, aged 10 to 16 years, who were randomly assigned into two groups of equal number. In this 12-week trial, one group received oral vitamin D (300,000 IU) and the other group received placebo. Cardiometabolic risk factors, insulin resistance, and a continuous value of metabolic syndrome (cMetS) were determined. Statistical analysis was conducted after adjustment for covariate interactions. RESULTS Overall, 21 patients in the vitamin D group and 22 in the placebo group completed the trial. No significant difference was observed in the baseline characteristics of the two groups. After the trial, in the vitamin D group, serum insulin and triglyceride concentrations, as well as HOM -IR and C-MetS decreased significantly, both when compared with the baseline and with the placebo group. No significant difference was observed when comparing total cholesterol, LDL-C, HDL-C, fasting blood glucose, and blood pressure. CONCLUSION The present findings support the favorable effects of vitamin D supplementation on reducing insulin resistance and cardiometabolic risk factors in obese children.
Collapse
Affiliation(s)
- Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shadi Salek
- Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Salek
- Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Hashemipour
- Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Movahedian
- Department of English Linguistics, University of Isfahan, Isfahan, Iran
| |
Collapse
|
50
|
Dawson DR, Branch-Mays G, Gonzalez OA, Ebersole JL. Dietary modulation of the inflammatory cascade. Periodontol 2000 2013; 64:161-97. [DOI: 10.1111/j.1600-0757.2012.00458.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|