Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2023; 14(10): 1514-1523
Published online Oct 15, 2023. doi: 10.4239/wjd.v14.i10.1514
Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance
Li-Jie Sun, Ji-Xuan Lu, Xin-Yu Li, Tian-Sheng Zheng, Xiao-Rong Zhan
Li-Jie Sun, Ji-Xuan Lu, Xin-Yu Li, Xiao-Rong Zhan, Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Tian-Sheng Zheng, Xiao-Rong Zhan, Department of Endocrinology, Southern University of Science and Technology Hospital, Shenzhen 518071, Guangdong Province, China
Author contributions: Zhan XR conceived and designed the study; Sun LJ, Lu JX, Li XY, and Zheng TS collected the data; Sun LJ and Zhan XR analyzed the findings; Sun LJ and Lu JX wrote the manuscript; and all authors revised and approved the final version.
Institutional review board statement: This study was reviewed and approved by the Ethical Committees of the First Affiliated Hospital of Harbin Medical University.
Informed consent statement: All patient data obtained, recorded, and managed only used for this study, and all patient information are strictly confidential, without any harm to the patient, so the informed consent was waived by the Ethics Committee of First Affiliated Hospital of Harbin Medical University.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Rong Zhan, MD, Chief Doctor, Professor, Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, No. 199 Dazhi Street, Nangang District, Harbin 150001, Heilongjiang Province, China. xiaorongzhandoctor@126.com
Received: June 20, 2023
Peer-review started: June 20, 2023
First decision: July 7, 2023
Revised: July 19, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: October 15, 2023
Processing time: 111 Days and 3.9 Hours
Abstract
BACKGROUND

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease featured by insulin resistance (IR) and decreased insulin secretion. Currently, vitamin D deficiency is found in most patients with T2DM, but the relationship between vitamin D and IR in T2DM patients requires further investigation.

AIM

To explore the risk factors of IR and the effects of vitamin D supplementation on glucose and lipid metabolism in patients with T2DM.

METHODS

Clinical data of 162 T2DM patients treated in First Affiliated Hospital of Harbin Medical University between January 2019 and February 2022 were retrospectively analyzed. Based on the diagnostic criteria of IR, the patients were divided into a resistance group (n = 100) and a non-resistance group (n = 62). Subsequently, patients in the resistance group were subdivided to a conventional group (n = 44) or a joint group (n = 56) according to the treatment regimens. Logistic regression was carried out to analyze the risk factors of IR in T2DM patients. The changes in glucose and lipid metabolism indexes in T2DM patients with vitamin D deficiency were evaluated after the treatment.

RESULTS

Notable differences were observed in age and body mass index (BMI) between the resistance group and the non-resistance group (both P < 0.05). The resistance group exhibited a lower 25-hydroxyvitamin D3 (25(OH)D3) level, as well as notably higher levels of 2-h postprandial blood glucose (2hPG), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) than the non-resistance group (all P < 0.0001). Additionally, the resistance group demonstrated a higher triglyceride (TG) level but a lower high-density lipoprotein-cholesterol (HDL-C) level than the non-resistance group (all P < 0.0001). The BMI, TG, HDL-C, 25(OH)D3, 2hPG, and HbA1c were found to be risk factors of IR. Moreover, the post-treatment changes in levels of 25(OH)D3, 2hPG, FBG and HbA1c, as well as TG, total cholesterol, and HDL-C in the joint group were more significant than those in the conventional group (all P < 0.05).

CONCLUSION

Patients with IR exhibit significant abnormalities in glucose and lipid metabolism parameters compared to the non-insulin resistant group. Logistic regression analysis revealed that 25(OH)D3 is an independent risk factor influencing IR. Supplementation of vitamin D has been shown to improve glucose and lipid metabolism in patients with IR and T2DM.

Keywords: Vitamin D; Type 2 diabetes mellitus; Glucose and lipid metabolism; Insulin resistance; Risk factors

Core Tip: A retrospective analysis was conducted on 162 type 2 diabetes mellitus (T2DM) patients to analyze the risk factor for insulin resistance (IR) and to investigate the effects of vitamin D supplementation on glucose and lipid metabolism in patients with T2DM and IR. It was found that 25-hydroxyvitamin D3 and body mass index were risk factors for IR in T2DM patients, and vitamin D supplementation improved the glucose and lipid metabolism in patients with IR. The treatment regimen with vitamin D supplementation led to more significant decreases in 2-h postprandial blood glucose, fasting blood glucose, glycosylated hemoglobin, triglyceride, and total cholesterol levels and more increase in high-density lipoprotein-cholesterol than the conventional regimen. It is suggested that vitamin D supplementation may be an effective intervention for T2DM patients with vitamin D deficiency and IR.