|
1
|
Chang Villacreses MM, Karnchanasorn R, Panjawatanan P, Ou HY, Chiu KC. Conundrum of vitamin D on glucose and fuel homeostasis. World J Diabetes 2021; 12:1363-1385. [PMID: 34630895 PMCID: PMC8472505 DOI: 10.4239/wjd.v12.i9.1363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/10/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023] Open
Abstract
As an endocrine hormone, vitamin D plays an important role in bone health and calcium homeostasis. Over the past two decades, the non-calcemic effects of vitamin D were extensively examined. Although the effect of vitamin D on beta cell function were known for some time, the effect of vitamin D on glucose and fuel homeostasis has attracted new interest among researchers. Yet, to date, studies remain inconclusive and controversial, in part, due to a lack of understanding of the threshold effects of vitamin D. In this review, a critical examination of interventional trials of vitamin D in prevention of diabetes is provided. Like use of vitamin D for bone loss, the benefits of vitamin D supplementation in diabetes prevention were observed in vitamin D-deficient subjects with serum 25-hydroxyvitamin D < 50 nmol/L (20 ng/mL). The beneficial effect from vitamin D supplementation was not apparent in subjects with serum 25-hydroxyvitamin D > 75 nmol/L (30 ng/mL). Furthermore, no benefit was noted in subjects that achieved serum 25-hydroxyvitamin D > 100 nmol/L (40 ng/mL). Further studies are required to confirm these observations.
Collapse
Affiliation(s)
- Maria Mercedes Chang Villacreses
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, United States
| | - Rudruidee Karnchanasorn
- Division of Endocrinology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Panadeekarn Panjawatanan
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, United States
| | - Horng-Yih Ou
- Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 700, Taiwan
| | - Ken C Chiu
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, United States
| |
Collapse
|
|
2
|
Zhang L, Quan M, Cao ZB. Effect of vitamin D supplementation on upper and lower limb muscle strength and muscle power in athletes: A meta-analysis. PLoS One 2019; 14:e0215826. [PMID: 31039170 PMCID: PMC6490896 DOI: 10.1371/journal.pone.0215826] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 04/09/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D may play a role in skeletal muscle because of the discovery of VDR in skeletal muscle. However, vitamin D deficiency is a global problem, including athletes. Studies examining the effect of vitamin D supplementation on muscle function in athletes have inconsistent results. Therefore, we aimed to quantitatively summarize the evidence for the effect of vitamin D supplementation on skeletal muscle strength and explosive power of athletes using a meta-analysis. METHODS PubMed, EMBASE, Cochrane Library, and Web of Science were searched for studies to identify randomized controlled trials or controlled trials meeting the inclusion criteria. By a meta-analysis, effect sizes (standardized mean differences, SMD) with 95% confidence intervals (CI) was calculated to compare reported outcomes across studies, I2 index was used to assessing heterogeneity, and heterogeneity factors were identified by regression analysis. The potential publication and sensitivity analyses were also assessed. RESULTS Eight RCTs involving 284 athletes were included. The protocols used to evaluate the muscle strength of athletes were inconsistent across the included studies, and muscle explosive power was assessed via vertical jump tests. The results indicated that vitamin D supplementation had no impact on overall muscle strength outcomes (SMD 0.05, 95% CI: -0.39 to 0.48, p = 0.84). In subgroup analysis, vitamin D supplementation had an effect on lower-limb muscle strength (SMD 0.55, 95% CI:0.12 to 0.98, p = 0.01) but not upper-limb muscle strength (SMD -0.19, 95% CI:-0.73 to 0.36, p = 0.50) or muscle explosive power (SMD 0.05, 95% CI:-0.24 to 0.34, p = 0.73). Vitamin D supplementation was more effective for athletes trained indoors (SMD 0.48, 95% CI:0.06 to 0.90, p = 0.02). CONCLUSIONS Vitamin D supplementation positively affected lower limb muscle strength in athletes, but not upper limb muscle strength or muscle power. Different muscle groups and functions may respond differently to vitamin D supplementation. Additional studies should focus on determining the appropriate vitamin D supplementation methods and optimal serum 25(OH)D levels for athletes. REGISTRATION The protocol for our study is registered in the international prospective register of systematic reviews (PROSPERO registration number CRD42016045872).
Collapse
Affiliation(s)
- Lin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhen-Bo Cao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
- * E-mail:
| |
Collapse
|
|
3
|
Effect of vitamin D supplementation on inflammation and nuclear factor kappa-B activity in overweight/obese adults: a randomized placebo-controlled trial. Sci Rep 2017; 7:15154. [PMID: 29123173 PMCID: PMC5680306 DOI: 10.1038/s41598-017-15264-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/23/2017] [Indexed: 01/08/2023] Open
Abstract
In-vitro studies suggest that vitamin D reduces inflammation by inhibiting nuclear factor kappa-B (NFκB) activity. Yet, no trials have examined the effects of vitamin D supplementation on NFκB activity in-vivo in humans. We conducted a double-blind randomized trial (RCT) examining effects of vitamin D supplementation on inflammatory markers and NFκB activity in peripheral blood mononuclear cells (PBMCs). Sixty-five overweight/obese, vitamin D-deficient (25-hydroxyvitamin D [25(OH)D] ≤ 50 nmol/L) adults were randomized to a single 100,000 IU bolus followed by 4,000 IU daily cholecalciferol or matching placebo for 16 weeks. We measured BMI, % body fat, serum 25(OH)D, high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor (TNF), monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-γ), several interleukins, and NFκB activity in PBMCs. Fifty-four participants completed the study. Serum 25(OH)D concentrations increased with vitamin D supplementation compared to placebo (p < 0.001). Vitamin D and placebo groups did not differ in any inflammatory markers or NFκB activity (all p > 0.05). Results remained non-significant after adjustment for age, sex, and % body fat, and after further adjustment for sun exposure, physical activity, and dietary vitamin D intake. Although in-vitro studies report anti-inflammatory effects of vitamin D, our RCT data show no effect of vitamin D supplementation on inflammatory markers or NFκB activity in-vivo in humans.
Collapse
|
|
4
|
The Association of Serum 25-Hydroxyvitamin D Concentrations and Elevated Glycated Hemoglobin Values: A Longitudinal Study of Non-Diabetic Participants of a Preventive Health Program. Nutrients 2017. [PMID: 28640213 PMCID: PMC5537760 DOI: 10.3390/nu9070640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The prevalence of Type 2 Diabetes (T2D) is sharply on the rise, both in Canada and worldwide. As addressing its root causes, i.e., promotion of healthy lifestyles and weight management, has been largely unsuccessful, new clues for primary prevention seem essential to curbing the increasing public health burden of T2D. In the present study, we examined whether improvements in vitamin D status, i.e., serum 25-hydroxyvitamin D [25(OH)D] concentrations, are paralleled by a reduction in the risk for reaching adverse glycated hemoglobin (HbA1c) levels in a community sample of non-diabetic volunteers participating in a preventive health program that encourages the use of vitamin D. Repeated observations on 6565 participants revealed that serum 25(OH)D concentrations increased from 90.8 to 121.3 nmol/L, HbA1c values decreased from 5.6% to 5.5%, and the prevalence of having HbA1c values ≥ 5.8% decreased from 29.5% to 17.4% while in the program. Compared to participants who did not increase their 25(OH)D concentrations during follow-up, those who increased their 25(OH)D concentrations with 50 nmol/L or more were 0.74 times as likely to achieve elevated HbA1c values at follow-up (p = 0.03). These findings suggest that public health initiatives that promote vitamin D status along with healthy lifestyles in the population at large may alleviate the future public health burden associated with T2D.
Collapse
|
|
5
|
Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Rev Endocr Metab Disord 2017; 18:195-205. [PMID: 28176237 PMCID: PMC5486909 DOI: 10.1007/s11154-017-9411-6] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psoriasis is a chronic immune-mediated inflammatory skin disease. Psoriasis lesions are characterized by hyper-proliferation of epidermal keratinocytes associated with inflammatory cellular infiltrate in both dermis and epidermis. The epidermis is the natural source of vitamin D synthesis by sunlight action. Recently, a role for vitamin D in the pathogenesis of different skin diseases, including psoriasis, has been reported. Indeed, significant associations between low vitamin D status and psoriasis have been systematically observed. Due to its role in proliferation and maturation of keratinocytes, vitamin D has become an important local therapeutic option in the treatment of psoriasis. To date, the successful treatment based on adequate dietary intake of vitamin D or oral vitamin D supplementation in psoriasis represent an unmet clinical need and the evidence of its beneficial effects remains still controversial. This information is important either for Dermatologists and Nutritionists to increases the knowledge on the possible bi-directional relationships between low vitamin D status and psoriasis and on the potential usefulness of vitamin D in psoriasis with the aim not only to reduce its clinical severity, but also for delineating the risk profile for co-morbidities cardiac risk factors that may result from psoriasis. In the current review, we analyzed the possible bi-directional links between psoriatic disease and vitamin D.
Collapse
Affiliation(s)
- Luigi Barrea
- I.O.S. & COLEMAN Srl, Acerra, 80011 Naples, Italy
| | | | | | - Maddalena Napolitano
- Dipartimento di Medicina e Scienze della Salute “Vincenzo Tiberio”, Rheumatology Unit, University of Molise, Via Francesco De Sanctis 1, 86100 Campobasso, Italy
| | - Matteo Megna
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| |
Collapse
|
|
6
|
Penckofer S, Byrn M, Adams W, Emanuele MA, Mumby P, Kouba J, Wallis DE. Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes. J Diabetes Res 2017; 2017:8232863. [PMID: 29082262 PMCID: PMC5610883 DOI: 10.1155/2017/8232863] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/27/2017] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the effect of vitamin D supplementation on improving mood (depression and anxiety) and health status (mental and physical) in women with type 2 diabetes mellitus (T2DM). METHODS Fifty women with T2DM and significant depressive symptomology were enrolled into the "Sunshine Study," where weekly vitamin D supplementation (ergocalciferol, 50,000 IU) was given to all participants for six months. The main outcomes included (1) depression (Center for Epidemiologic Studies Depression, CES-D, and Patient Health Questionnaire, PHQ-9), (2) anxiety (State-Trait Anxiety), and (3) health status (Short Form, SF-12). RESULTS Forty-six women (92%) completed all visits. There was a significant decrease in depression (CES-D and PHQ-9, p < 0.001) and anxiety (state and trait, p < 0.001). An improvement in mental health status (SF-12, p < 0.001) was also found. After controlling for covariates (race, season of enrollment, baseline vitamin D, baseline depression (PHQ-9), and body mass index), the decline in depression remained significant (CES-D, p < 0.001). There was a trend for a better response to supplementation for women who were not taking medications for mood (antidepressants or anxiolytics) (p = 0.07). CONCLUSIONS Randomized trials to confirm that vitamin D supplementation can improve mood and health status in T2DM women are needed.
Collapse
Affiliation(s)
- Sue Penckofer
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - Mary Byrn
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - William Adams
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - Mary Ann Emanuele
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - Patricia Mumby
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - Joanne Kouba
- Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
| | - Diane E. Wallis
- Advocate Medical Group, 3825 Highland Avenue, Suite 400, Downers Grove, IL 60515, USA
| |
Collapse
|
|
7
|
Trummer C, Pandis M, Verheyen N, Grübler MR, Gaksch M, Obermayer-Pietsch B, Tomaschitz A, Pieber TR, Pilz S, Schwetz V. Beneficial Effects of UV-Radiation: Vitamin D and beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1028. [PMID: 27775585 PMCID: PMC5086767 DOI: 10.3390/ijerph13101028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 12/11/2022]
Abstract
Aside from its well-known effects on bone and mineral metabolism, vitamin D may also play an important role in extra-skeletal processes like immunologic diseases, cancer, or cardiovascular diseases. Even though meta-analyses showed that vitamin D supplementation reduces fractures, falls, and overall mortality, its potential benefits did not find universal acclaim. Several health care authorities published Recommended Dietary Allowances (RDAs) for vitamin D, most of them ranging from 600 to 800 international units (IU) per day, corresponding to a serum level of 25-hydroxyvitamin D of at least 20 ng/mL (50 nmol/L). However, studies conducted in the general population revealed a much lower overall intake of vitamin D than the proposed RDAs. Thus, strategies to increase the vitamin D intake in the general population, e.g., food fortification or vitamin D supplementation, are needed to match the existing evidence and recommendations. Therefore, several currently ongoing projects aim to investigate the effect of vitamin D supplementation in the general population and try to establish food-based solutions to improve vitamin D status.
Collapse
Affiliation(s)
- Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Marlene Pandis
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Nicolas Verheyen
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Martin R Grübler
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 8, Bern 3010, Switzerland.
| | - Martin Gaksch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Andreas Tomaschitz
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
- Bad Gleichenberg Clinic, Schweizereiweg 4, Bad Gleichenberg 8344, Austria.
| | - Thomas R Pieber
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Verena Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| |
Collapse
|
|
8
|
Schwab S, Zierer A, Heier M, Fischer B, Huth C, Baumert J, Meisinger C, Peters A, Thorand B. Intake of Vitamin and Mineral Supplements and Longitudinal Association with HbA1c Levels in the General Non-Diabetic Population--Results from the MONICA/KORA S3/F3 Study. PLoS One 2015; 10:e0139244. [PMID: 26473975 PMCID: PMC4608810 DOI: 10.1371/journal.pone.0139244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 09/09/2015] [Indexed: 11/23/2022] Open
Abstract
Background Lower levels of hemoglobin A1c (HbA1c) are associated with a decreased risk of cardiovascular complications in diabetic and non-diabetic individuals. The aim of the study was to longitudinally investigate the association between the use of 11 vitamins and minerals (vitamins E, C, D, B1, folic acid, carotenoids, calcium, magnesium, zinc, iron, and selenium) and change in HbA1c levels over 10 years in non-diabetic individuals drawn from the general population. Methods Baseline data were available from 4447 subjects included in the population-based “Monitoring of Trends and Determinants in Cardiovascular Diseases” (MONICA) Augsburg S3 survey (1994/95). Follow-up data were derived from 2774 participants in the follow-up survey named “Cooperative Health Research in the Region of Augsburg” (KORA) F3 (2004/05). Vitamin/mineral intake from supplements and medications was assessed in a personal interview, where participants were asked to bring product packages of preparations that had been ingested during the last 7 days prior to the examination. Associations between regular vitamin/mineral intake amounts and HbA1c levels measured at baseline and follow-up were investigated using generalized estimating equation models. For carotenoids, analyses were stratified by smoking status. Results None of the investigated nutrients except for carotenoids was significantly associated with changes in HbA1c levels after 10 years. Regular intake of carotenoids from supplements and medications in amounts > 6.8mg/d (upper tertile) was associated with an absolute –0.26% (95% CI: –0.43 to –0.08) lower increase in HbA1c levels compared with no intake of carotenoids. An inverse association was observed in those who never smoked but not in (former) smokers. Conclusion Larger prospective and intervention studies in non-diabetic/non-smoking individuals are needed to confirm the results and to assess whether the observed associations between carotenoid intake and change in HbA1c levels are causal. If our results are confirmed, high carotenoid intake could be one strategy for the prevention of cardiovascular complications in non-diabetic people.
Collapse
Affiliation(s)
- Sigrid Schwab
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Astrid Zierer
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Cornelia Huth
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Jens Baumert
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
- * E-mail:
| |
Collapse
|
|
9
|
Effect of vitamin D supplementation on selected inflammatory biomarkers in older adults: a secondary analysis of data from a randomised, placebo-controlled trial. Br J Nutr 2015. [DOI: 10.1017/s0007114515002366] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractObservational studies have suggested that 25-hydroxyvitamin D (25(OH)D) levels are associated with inflammatory markers. Most trials reporting significant associations between vitamin D intake and inflammatory markers used specific patient groups. Thus, we aimed to determine the effect of supplementary vitamin D using secondary data from a population-based, randomised, placebo-controlled, double-blind trial (Pilot D-Health trial 2010/0423). Participants were 60- to 84-year-old residents of one of the four eastern states of Australia. They were randomly selected from the electoral roll and were randomised to one of three trial arms: placebo (n 214), 750 μg (n 215) or 1500 μg (n 215) vitamin D3, each taken once per month for 12 months. Post-intervention blood samples for the analysis of C-reactive protein (CRP), IL-6, IL-10, leptin and adiponectin levels were available for 613 participants. Associations between intervention group and biomarker levels were evaluated using quantile regression. There were no statistically significant differences in distributions of CRP, leptin, adiponectin, leptin:adiponectin ratio or IL-10 levels between the placebo group and either supplemented group. The 75th percentile IL-6 level was 2·8 pg/ml higher (95 % CI 0·4, 5·8 pg/ml) in the 1500 μg group than in the placebo group (75th percentiles:11·0 v. 8·2 pg/ml), with a somewhat smaller, non-significant difference in 75th percentiles between the 750 μg and placebo groups. Despite large differences in serum 25(OH)D levels between the three groups after 12 months of supplementation, we found little evidence of an effect of vitamin D supplementation on cytokine or adipokine levels, with the possible exception of IL-6.
Collapse
|
|
10
|
Groves NJ, McGrath JJ, Burne THJ. Vitamin D as a neurosteroid affecting the developing and adult brain. Annu Rev Nutr 2015; 34:117-41. [PMID: 25033060 DOI: 10.1146/annurev-nutr-071813-105557] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Vitamin D deficiency is prevalent throughout the world, and growing evidence supports a requirement for optimal vitamin D levels for the healthy developing and adult brain. Vitamin D has important roles in proliferation and differentiation, calcium signaling within the brain, and neurotrophic and neuroprotective actions; it may also alter neurotransmission and synaptic plasticity. Recent experimental studies highlight the impact that vitamin D deficiency has on brain function in health and disease. In addition, results from recent animal studies suggest that vitamin D deficiency during adulthood may exacerbate underlying brain disorders and/or worsen recovery from brain stressors. An increasing number of epidemiological studies indicate that vitamin D deficiency is associated with a wide range of neuropsychiatric disorders and neurodegenerative diseases. Vitamin D supplementation is readily available and affordable, and this review highlights the need for further research.
Collapse
Affiliation(s)
- Natalie J Groves
- Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland 4072, Australia;
| | | | | |
Collapse
|
|
11
|
Nigil Haroon N, Anton A, John J, Mittal M. Effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes: a systematic review of interventional studies. J Diabetes Metab Disord 2015; 14:3. [PMID: 25722966 PMCID: PMC4340830 DOI: 10.1186/s40200-015-0130-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/25/2015] [Indexed: 01/23/2023]
Abstract
Background Diabetes and vitamin D deficiency are global epidemics. Researchers have long been exploring the role of potentially modifiable factors to manage type 2 diabetes. We conducted a systematic review of prospective studies and randomized controlled trials that involved vitamin D supplementation and specifically intended to study glycemic outcomes related to type 2 diabetes. Methods Two authors independently searched Medline and PubMed for longitudinal studies that had assessed the effect of vitamin D supplements on glycemic control, insulin resistance and beta-cell dysfunction in patients with diabetes. Results Seventeen randomized control trials and seven longitudinal studies with a minimum follow-up of one month were included. Results of the various short-term studies (follow up ≤ 3 months) suggested that vitamin D supplementation had a positive impact on glycemic control and metabolic parameters such as insulin resistance and beta cell dysfunction. However, the evidence was weak due to the low methodological quality of the studies. There was no significant effect on HbA1c, beta cell function and insulin resistance in the long-term studies (follow up > 3 months). There existed heterogeneity in the methodology of the studies, inclusion criteria, mode of supplementation of vitamin D and the duration of follow up. Conclusions Current evidence based on randomized controlled trials and longitudinal studies do not support the notion that vitamin D supplementation can improve hyperglycemia, beta cell secretion or insulin sensitivity in patients with type 2 diabetes. Large-scale trials with proper study design, optimal vitamin D supplementation and longer follow up need to be conducted.
Collapse
Affiliation(s)
- Nisha Nigil Haroon
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Ammepa Anton
- Toronto Western Hospital, University Health Network, Toronto, ON Canada
| | - Jisha John
- Department of Medicine, Wayne State University, Detroit, MI USA
| | - Madhukar Mittal
- Endocrinology Unit, Department of Medicine, King George Medical University, Lucknow, India
| |
Collapse
|
|
12
|
Zoppini G, Galletti A, Targher G, Brangani C, Pichiri I, Trombetta M, Negri C, De Santi F, Stoico V, Cacciatori V, Bonora E. Lower levels of 25-hydroxyvitamin D3 are associated with a higher prevalence of microvascular complications in patients with type 2 diabetes. BMJ Open Diabetes Res Care 2015; 3:e000058. [PMID: 25932330 PMCID: PMC4410134 DOI: 10.1136/bmjdrc-2014-000058] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 10/17/2014] [Accepted: 11/04/2014] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Low levels of serum 25-hydroxyvitamin D [25(OH)D] are commonly found in type 2 diabetes. We examined whether there is an association between circulating 25(OH)D concentrations and the presence of microvascular complications in people with type 2 diabetes. RESEARCH DESIGN AND METHODS We studied 715 outpatients with type 2 diabetes who regularly attended our clinic. Participants were evaluated for the presence of microvascular complications (namely retinopathy and/or nephropathy) by clinical evaluation, fundus examination, urine examination and biochemical tests. Serum 25(OH)D levels were also measured for each participant. RESULTS Hypovitaminosis D (ie, a serum 25(OH)D level <30 ng/mL) was found in 75.4%, while deficiency (ie, a 25(OH)D level <20 ng/mL) was found in 36.6% of these patients. Serum 25(OH)D levels decreased significantly in relation to the severity of either retinopathy or nephropathy or both. In multivariate logistic regression analysis, lower 25(OH)D levels were independently associated with the presence of microvascular complications (considered as a composite end point; OR 0.758; 95% CI 0.607 to 0.947, p=0.015). Notably, this association remained significant even after excluding those with an estimated glomerular filtration rate <60 mL/min/1.73 m(2). CONCLUSIONS We found an inverse and independent relationship between circulating 25(OH)D levels and the prevalence of microvascular complications in patients with type 2 diabetes. However, vitamin D may be simply a marker and causality cannot be implied from our cross-sectional study. Whether vitamin D supplementation in patients with type 2 diabetes may have beneficial effects on the risk of microvascular complications remains to be investigated.
Collapse
Affiliation(s)
- Giacomo Zoppini
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Anna Galletti
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Giovanni Targher
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Corinna Brangani
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Isabella Pichiri
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Maddalena Trombetta
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Carlo Negri
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Francesca De Santi
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Vincenzo Stoico
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Vittorio Cacciatori
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Enzo Bonora
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| |
Collapse
|
|
13
|
Weyland PG, Grant WB, Howie-Esquivel J. Does sufficient evidence exist to support a causal association between vitamin D status and cardiovascular disease risk? An assessment using Hill's criteria for causality. Nutrients 2014; 6:3403-30. [PMID: 25184368 PMCID: PMC4179168 DOI: 10.3390/nu6093403] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/31/2014] [Accepted: 08/18/2014] [Indexed: 12/18/2022] Open
Abstract
UNLABELLED Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill's criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. CONCLUSION all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor.
Collapse
Affiliation(s)
- Patricia G Weyland
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco (UCSF), #2 Koret Way Box 0610, San Francisco, CA 94143, USA.
| | - William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.
| | - Jill Howie-Esquivel
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco (UCSF), #2 Koret Way Box 0610, San Francisco, CA 94143, USA.
| |
Collapse
|
|
14
|
Durazo-Arvizu RA, Camacho P, Bovet P, Forrester T, Lambert EV, Plange-Rhule J, Hoofnagle AN, Aloia J, Tayo B, Dugas LR, Cooper RS, Luke A. 25-Hydroxyvitamin D in African-origin populations at varying latitudes challenges the construct of a physiologic norm. Am J Clin Nutr 2014; 100:908-14. [PMID: 25008852 PMCID: PMC4135499 DOI: 10.3945/ajcn.113.066605] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/10/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The vitamin D-endocrine system is thought to play a role in physiologic processes that range from mineral metabolism to immune function. Serum 25-hydroxyvitamin D [25(OH)D] is the accepted biomarker for vitamin D status. Skin color is a key determinant of circulating 25(OH)D concentrations, and genes responsible for melanin content have been shown to be under strong evolutionary selection in populations living in temperate zones. Little is known about the effect of latitude on mean concentrations of 25(OH)D in dark-skinned populations. OBJECTIVE The objective was to describe the distribution of 25(OH)D and its subcomponents in 5 population samples of African origin from the United States, Jamaica, Ghana, South Africa, and the Seychelles. DESIGN Participants were drawn from the Modeling of the Epidemiologic Transition Study, a cross-sectional observational study in 2500 adults, ages 25-45 y, enrolled between January 2010 and December 2011. Five hundred participants, ∼50% of whom were female, were enrolled in each of 5 study sites: Chicago, IL (latitude: 41°N); Kingston, Jamaica (17°N); Kumasi, Ghana (6°N); Victoria, Seychelles (4°S); and Cape Town, South Africa (34°S). All participants had an ancestry primarily of African origin; participants from the Seychelles trace their history to East Africa. RESULTS A negative correlation between 25(OH)D and distance from the equator was observed across population samples. The frequency distribution of 25(OH)D in Ghana was almost perfectly normal (Gaussian), with progressively lower means and increasing skewness observed at higher latitudes. CONCLUSIONS It is widely assumed that lighter skin color in populations outside the tropics resulted from positive selection, driven in part by the relation between sun exposure, skin melanin content, and 25(OH)D production. Our findings show that robust compensatory mechanisms exist that create tolerance for wide variation in circulating concentrations of 25(OH)D across populations, suggesting a more complex evolutionary relation between skin color and the vitamin D pathway.
Collapse
Affiliation(s)
- Ramon A Durazo-Arvizu
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Pauline Camacho
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Pascal Bovet
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Terrence Forrester
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Estelle V Lambert
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Jacob Plange-Rhule
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Andrew N Hoofnagle
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - John Aloia
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Bamidele Tayo
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Lara R Dugas
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Richard S Cooper
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| | - Amy Luke
- From the Departments of Public Health Sciences (RAD-A, BT, LRD, RSC, and AL) and Endocrinology (PC), Stritch School of Medicine, Loyola University Chicago, Maywood, IL; the Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (PB); the Ministry of Health, Victoria, Republic of Seychelles (PB); the Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica (TF); the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa (EVL); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (JP-R); the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA (ANH); and Winthrop University Hospital, Mineola, NY (JA)
| |
Collapse
|
|
15
|
Mellenthin L, Wallaschofski H, Grotevendt A, Völzke H, Nauck M, Hannemann A. Association between serum vitamin D concentrations and inflammatory markers in the general adult population. Metabolism 2014; 63:1056-62. [PMID: 24928661 DOI: 10.1016/j.metabol.2014.05.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 04/09/2014] [Accepted: 05/04/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In recent years links among vitamin D deficiency, inflammation and cardio-metabolic disease were proposed. As information regarding the associations between vitamin D and inflammatory markers in the general population is sparse, we investigated the associations of 25-hydroxy vitamin D [25(OH)D] with high-sensitivity C-reactive protein (hs-CRP), fibrinogen and white blood cell count (WBC). MATERIALS/METHODS The study population comprised 2723 men and women aged 25-88 years from the first follow-up of the Study of Health in Pomerania. Analyses of variance, linear and logistic regressions were performed to assess the associations between 25(OH)D and the three inflammatory markers. The models were adjusted for age, sex, waist circumference, diabetes mellitus, dyslipidemia, anti-inflammatory medication and month of blood sampling. The association between 25(OH)D and WBC was assessed separately in smokers (n = 718) and non-smokers (n = 2005) as effect modification was observed. RESULTS We detected a U-shaped association between 25(OH)D and hs-CRP with a nadir of 21-25 ng/ml in fully-adjusted linear regression models with restricted cubic splines (p < 0.01; p' < 0.01). We further detected an inverse association between 25(OH)D and fibrinogen (p < 0.01). In addition, there was an inverse association between 25(OH)D and WBC in smokers (p = 0.02) but no association in non-smokers (p = 0.73). CONCLUSION Our study confirms a potential role of 25(OH)D in chronic inflammation. Yet, different inflammatory biomarkers are differently associated with 25(OH)D. Beneficial effects of increasing 25(OH)D were observed for fibrinogen and WBC (in smokers only). In contrast, the U-shaped association between 25(OH)D and hs-CRP indicates that ever-increasing 25(OH)D concentrations may also be related to proinflammatory states.
Collapse
Affiliation(s)
- Liesa Mellenthin
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anne Grotevendt
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
| |
Collapse
|
|
16
|
Al-Daghri NM, Alfawaz H, Aljohani NJ, Al-Saleh Y, Wani K, Alnaami AM, Alharbi M, Kumar S. A 6-month "self-monitoring" lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels. Lipids Health Dis 2014; 13:87. [PMID: 24884616 PMCID: PMC4041045 DOI: 10.1186/1476-511x-13-87] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/15/2014] [Indexed: 01/08/2023] Open
Abstract
Background The over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status. Methods A total of 150 overweight and obese Saudi adults with varying glycemic status aged 30–60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure. Results In all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension. Conclusion Improving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.
Collapse
Affiliation(s)
- Nasser M Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, PO Box, 2455, Riyadh 11451, Saudi Arabia.
| | | | | | | | | | | | | | | |
Collapse
|
|
17
|
Madar AA, Knutsen KV, Stene LC, Brekke M, Meyer HE, Lagerløv P. Effect of vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, serum lipids, and body mass index: a randomized, double-blinded, placebo-controlled trial among healthy immigrants living in Norway. BMJ Open Diabetes Res Care 2014; 2:e000026. [PMID: 25452867 PMCID: PMC4212570 DOI: 10.1136/bmjdrc-2014-000026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/26/2014] [Accepted: 08/04/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Despite the suggested role of vitamin D in the prevention of diabetes and cardiovascular disease or its risk factors, the evidence is not consistent and there is a paucity of randomized controlled trials in this field. We aimed to investigate the effect of 16-week daily vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, body mass index (BMI), and serum lipids. DESIGN Double-blind, randomized, placebo-controlled trial. SETTING Immigrant community centers in Oslo, Norway. PARTICIPANTS 251 healthy adults aged 18-50 years with a non-Western immigrant background. All participants performed the baseline test and 215 (86%) returned to the follow-up test. INTERVENTION 16 weeks of daily oral supplementation with either 10 μg vitamin D3, 25 μg vitamin D3, or placebo. MAIN OUTCOME MEASURES Difference in absolute change during the 16-week intervention between the intervention groups combined (10 or 25 μg of vitamin D3/day) and placebo, in HbA1c, fructosamine, serum lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), and BMI. RESULTS A total of 215 (86%) participants completed the study. Serum 25-hydroxyvitamin D increased from 29 nmol/L at baseline to 49 nmol/L after intervention, with little change in the placebo group. However, there was no difference in change of HbA1c between those receiving vitamin D3 compared with placebo (mean difference: 0.01% (95% CI -0.04 to 0.06, p=0.7)). Neither did the vitamin D3 supplementation have any effect on the other end points: fructosamine, serum lipids, and BMI. CONCLUSIONS 16-week vitamin D3 supplementation to healthy immigrants from South Asia, the Middle East, or Africa and now living in Norway with low vitamin D status did not improve HbA1c, fructosamine, lipid profiles, or BMI. An updated meta-analysis of similar published trials showed that our results were generally consistent with those of other studies. TRIAL REGISTRATION NUMBER NCT01263288.
Collapse
Affiliation(s)
- Ahmed A Madar
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kirsten V Knutsen
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lars C Stene
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Haakon E Meyer
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Lagerløv
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
|
18
|
Asemi Z, Hashemi T, Karamali M, Samimi M, Esmaillzadeh A. Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind randomized controlled clinical trial. Am J Clin Nutr 2013; 98:1425-32. [PMID: 24132976 DOI: 10.3945/ajcn.113.072785] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To our knowledge, there is no study that has examined the effects of vitamin D supplementation on metabolic status in gestational diabetes mellitus (GDM). OBJECTIVE This study was designed to assess the effects of vitamin D supplementation on metabolic profiles, high-sensitivity C-reactive protein, and biomarkers of oxidative stress in pregnant women with GDM. DESIGN This randomized, double-blind, placebo-controlled clinical trial was conducted in 54 women with GDM. Subjects were randomly assigned to receive either vitamin D supplements or placebo. Individuals in the vitamin D group (n = 27) received capsules containing 50,000 IU vitamin D₃ 2 times during the study (at baseline and at day 21 of the intervention) and those in the placebo group (n = 27) received 2 placebos at the same times. Fasting blood samples were collected at baseline and after 6 wk of the intervention to quantify relevant variables. RESULTS Cholecalciferol supplementation resulted in increased serum 25-hydroxyvitamin D concentrations compared with placebo (+18.5 ± 20.4 compared with +0.5 ± 6.1 ng/mL; P < 0.001). Furthermore, intake of vitamin D supplements led to a significant decrease in concentrations of fasting plasma glucose (-17.1 ± 14.8 compared with -0.9 ± 16.6 mg/dL; P < 0.001) and serum insulin (-3.08 ± 6.62 compared with +1.34 ± 6.51 μIU/mL; P = 0.01) and homeostasis model of assessment-insulin resistance (-1.28 ± 1.41 compared with +0.34 ± 1.79; P < 0.001) and a significant increase in the Quantitative Insulin Sensitivity Check Index (+0.03 ± 0.03 compared with -0.001 ± 0.02; P = 0.003) compared with placebo. A significant reduction in concentrations of total (-11.0 ± 23.5 compared with +9.5 ± 36.5 mg/dL; P = 0.01) and low-density lipoprotein (LDL) (-10.8 ± 22.4 compared with +10.4 ± 28.0 mg/dL; P = 0.003) cholesterol was also seen after vitamin D supplementation. CONCLUSIONS Vitamin D supplementation in pregnant women with GDM had beneficial effects on glycemia and total and LDL-cholesterol concentrations but did not affect inflammation and oxidative stress. This trial was registered at www.irct.ir as IRCT201305115623N7.
Collapse
Affiliation(s)
- Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases (ZA) and the Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran (TH and MS); the Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran (MK); and the Food Security Research Center, and the Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran (AE)
| | | | | | | | | |
Collapse
|
|
19
|
Pilz S, Gaksch M, O'Hartaigh B, Tomaschitz A, März W. The role of vitamin D deficiency in cardiovascular disease: where do we stand in 2013? Arch Toxicol 2013; 87:2083-103. [PMID: 24173581 DOI: 10.1007/s00204-013-1152-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/22/2013] [Indexed: 12/14/2022]
Abstract
The high worldwide prevalence of vitamin D deficiency is largely the result of low sunlight exposure with subsequently limited cutaneous vitamin D production. Classic manifestations of vitamin D deficiency are linked to disturbances in bone and mineral metabolism, but the identification of the vitamin D receptor in almost every human cell suggests a broader role of vitamin D for overall and cardiovascular health. The various cardiovascular protective actions of vitamin D such as anti-diabetic and anti-hypertensive effects including renin suppression as well as protection against atherosclerosis and heart diseases are well defined in previous experimental studies. In line with this, large epidemiological studies have highlighted vitamin D deficiency as a marker of cardiovascular risk. However, randomized controlled trials (RCTs) on vitamin D have largely failed to show its beneficial effects on cardiovascular diseases and its conventional risk factors. While most prior vitamin D RCTs were not designed to assess cardiovascular outcomes, some large RCTs have been initiated to evaluate the efficacy of vitamin D supplementation on cardiovascular events in the general population. When considering the history of previous disappointing vitamin RCTs in general populations, more emphasis should be placed on RCTs among severely vitamin D-deficient populations who would most likely benefit from vitamin D treatment. At present, vitamin D deficiency can only be considered a cardiovascular risk marker, as vitamin D supplementation with doses recommended for osteoporosis treatment is neither proven to be beneficial nor harmful in cardiovascular diseases.
Collapse
Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria,
| | | | | | | | | |
Collapse
|