scholarly journals Vitamin D Status, Calcium Intake and Risk of Developing Type 2 Diabetes: An Unresolved Issue

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 642 ◽  
Author(s):  
Araceli Muñoz-Garach ◽  
Beatriz García-Fontana ◽  
Manuel Muñoz-Torres

The relationship between vitamin D status, calcium intake and the risk of developing type 2 diabetes (T2D) is a topic of growing interest. One of the most interesting non-skeletal functions of vitamin D is its potential role in glucose homeostasis. This possible association is related to the secretion of insulin by pancreatic beta cells, insulin resistance in different tissues and its influence on systemic inflammation. However, despite multiple observational studies and several meta-analyses that have shown a positive association between circulating 25-hydroxyvitamin D concentrations and the risk of T2D, no randomized clinical trials supplementing with different doses of vitamin D have confirmed this hypothesis definitively. An important question is the identification of what 25-hydroxyvitamin D levels are necessary to influence glycemic homeostasis and the risk of developing T2D. These values of vitamin D can be significantly higher than vitamin D levels required for bone health, but the currently available data do not allow us to answer this question adequately. Furthermore, a large number of observational studies show that dairy consumption is linked to a lower risk of T2D, but the components responsible for this relationship are not well established. Therefore, the importance of calcium intake in the risk of developing T2D has not yet been established. Although there is a biological plausibility linking the status of vitamin D and calcium intake with the risk of T2D, well-designed randomized clinical trials are necessary to answer this important question.

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Zhang ◽  
Jianhong Ye ◽  
Gang Guo ◽  
Zhenhao Lan ◽  
Xing Li ◽  
...  

Objectives. Vitamin D deficiency plays a role in insulin resistance and the pathogenesis of type 2 diabetes mellitus. Little information is available about the association between vitamin D status and insulin resistance in the Chinese population. Currently, vitamin D status is evaluated by the concentrations of serum 25-hydroxyvitamin D [25(OH)D]. This study explores the relationship between insulin resistance and serum 25-hydroxyvitamin D concentrations in Chinese patients with type 2 diabetes mellitus.Subjects and Methods. This study included 117 patients with type 2 diabetes. The following variables were measured: 25-hydroxyvitamin D [25(OH)D], glycosylated hemoglobin A1c (HbA1c), fasting blood glucose (FBS), fasting blood insulin (FINS), fasting blood C-peptide, serum creatinine (SCr), glomerular filtration rate (eGFR), body mass index (BMI), and homeostatic model estimates of insulin resistance (HOMA-IR).Results. The cases were divided into three groups: Group 1 (G1) with 25(OH)D ≤ 20 ng/mL [≤50 nmol/L], Group 2 (G2) with 25(OH)D values from 20 ng/mL [50 nmol/L] to 30 ng/mL [75 nmol/L], and Group 3 (G3) with 25(OH)D ≥ 30 ng/mL [≥75 nmol/L], with 52.6%, 26.3%, and 21.1% of subjects in Groups 1–3, respectively. There was a negative correlation between 25(OH)D and HOMA-IR (β= −0.314,p=0.001) adjusted by age, BMI, and eGFR.Conclusion. Better vitamin D status may be protective of glucose homeostasis since 25(OH)D was negatively associated with insulin resistance in Chinese patients with type 2 diabetes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Xiao ◽  
Jingyi Lv ◽  
Shiyu Wang ◽  
Yang Zhou ◽  
Lunwen Chen ◽  
...  

Abstract Background Vitamin D deficiency has been associated with type 2 diabetes (T2D) and metabolic syndrome (MS) and its components. However, it is unclear whether a low concentration of vitamin D is the cause or consequence of these health conditions. Thus, this study aimed to evaluate the association of vitamin D concentrations and its genetic risk scores (GRSs) with MS and its component diseases, such as T2D, in middle-aged and elderly participants from rural eastern China. Methods A subset of 2393 middle-aged and elderly individuals were selected from 70,458 participants of the Nantong Chronic Diseases Study of 2017–2018 in China. We used two 25-hydroxyvitamin D (25[OH]D) synthesis single-nucleotide polymorphisms (SNPs) (DHCR7-rs12785878 and CYP2R1-rs10741657) and two 25(OH) D metabolism SNPs (GC-rs2282679 and CYP24A1-rs6013897) for creating GRSs, which were used as instrumental variables to assess the effect of genetically lowered 25(OH) D concentrations on MS and T2D based on the Wald ratio. F statistics were used to validate that the four SNPs genetically determined 25(OH) D concentrations. Results Compared to vitamin D sufficient individuals, individuals with vitamin D insufficiency had an odds ratio (OR [95% confidence interval {CI}]) of MS of 1.30 (1.06–1.61) and of T2D of 1.32 (1.08–1.64), individuals with vitamin D deficiency had an ORs (95% CI) of MS of 1.50 (1.24–1.79) and of T2D of 1.47 (1.12–1.80), and those with vitamin D severe deficiency had an ORs (95% CI) of MS of 1.52 (1.29–1.85) and of T2D of 1.54 (1.27–1.85). Mendelian randomization analysis showed a 25-nmol/L decrease in genetically instrumented serum 25(OH) D concentrations using the two synthesis SNPs (DHCR7 and CYP2R1 genes) associated with the risk of T2D and abnormal diastolic blood pressure (DBP) with ORs of 1.10 (95%CI: 1.02–1.45) for T2D and 1.14 (95%CI: 1.03–1.43) for DBP. Conclusions This one sample Mendelian randomization analysis shows genetic evidence for a causal role of lower 25(OH) D concentrations in promoting of T2D and abnormal DBP in middle-aged and elderly participants from rural China.


2019 ◽  
Vol 89 (5-6) ◽  
pp. 285-292
Author(s):  
Kaustubh Bora ◽  
Alice Abraham Ruram

Abstract. Background: Although inadequate vitamin D and altered parathyroid hormone (PTH) are implicated in deranged glucose metabolism and risk of future diabetes, their role in regulating glucose homeostasis in established cases of diabetes is unclear. We aimed to (i) evaluate vitamin D status, and (ii) determine if vitamin D and PTH were associated with parameters of glucose homeostasis in type 2 diabetes (T2D) patients from Meghalaya, India. Methods: We determined 25-hydroxyvitamin D (25-OH-D) and PTH concentrations in 251 T2D patients (not on insulin), and examined their associations with the following parameters of glucose homeostasis: fasting blood sugar (FBS), post-prandial blood sugar (PPBS), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Results: None of the patients had adequate vitamin D (mean 25-OH-D = 19.3 ng/mL); 47.8% patients were deficient (25-OH-D < 20 ng/mL), while 52.2% were insufficient (25-OH-D < 30 ng/mL) vitamin D. Significant ( P < 0.05) univariate associations were observed between: 25-OH-D and FI ( r = 0.14); 25-OH-D and HOMA-β ( r = 0.13); PTH and FI ( r = −0.18), and PTH and HOMA-β ( r = −0.11). However these associations disappeared after controlling for potential confounders. The 25-OH-D and PTH levels were not associated with any of the tested parameters of glucose homeostasis. Conclusion: There was widespread prevalence of vitamin D deficiency/insufficiency in our sample T2D patients. However, neither vitamin D nor PTH appeared to play a major role in influencing glucose homeostasis in this present selection of T2D cases.


2015 ◽  
Vol 100 (4) ◽  
pp. E591-E595 ◽  
Author(s):  
Mercedes Clemente-Postigo ◽  
Araceli Muñoz-Garach ◽  
Marta Serrano ◽  
Lourdes Garrido-Sánchez ◽  
M. Rosa Bernal-López ◽  
...  

Author(s):  
Medityas Winda Krissinta ◽  
M.I. Diah Pramudianti ◽  
Dian Ariningrum

Background: Type 2 diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Metabolic syndrome (MS) is a complex metabolic disorder like hyperglycemia, obesity, dyslipidemia, and hypertension. Vitamin D controls genes associated with regulation of insulin and renin production. The aim of this study was to analyze the relation between total levels of 25-hydroxyvitamin D [25(OH)D] and the incidence of MS in  type 2 DM patients.Methods: This case control study was conducted from October to November 2018 in Dr Moewardi Hospital Surakarta in 84 people with type 2 diabetes mellitus. All subjects were 34-75 years old. The research data were analyzed with a 2x2 test table to determine the odd ratio (OR) of each study variable, then multivariate analysis with logistic regression then continued.Results: The mean total level of 25(OH)D is 18.01 ± 6.10 ng/dl. Bivariate and multivariate OR analysis showed that poor glycemic control with the incidence of MS (OR: 11.154; 95% Cl: 3.933-31.631; p = 0.001); female sex (OR : 1.788; 95% Cl: 0.750-4.261; p = 0.188); age < 50 year (OR: 1.644; 95% Cl: 0.614-4.404; p = 0.321); and  total  25(OH)D deficiency (OR: 1.250; 95% Cl: 0.317-2.022; p = 0.637).Conclusion: total 25(OH)D level is not associated with the incidence of MS in the type 2 DM patients. Further study was needed using by healthy group control to explain the role of vitamin D in type 2 DMKeywords: type 2 DM, metabolic syndrome, 25(OH)D


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2889
Author(s):  
Adriana Florinela Cӑtoi ◽  
Mihaela Iancu ◽  
Alina Elena Pârvu ◽  
Andra Diana Cecan ◽  
Cristina Bidian ◽  
...  

Vitamin D deficiency is highly prevalent in patients with overweight/obesity and type 2 diabetes (T2DM). Herein, we investigated the relationship between vitamin D status and overweight/obesity status, insulin resistance (IR), systemic inflammation as well as oxidative stress (OS). Anthropometric and laboratory assessments of 25-hydroxyvitamin D (25(OH)D) and glycemic, pro-inflammatory and OS biomarkers were performed in a sample of 47 patients with T2DM who were divided into categories based on overweight and degree of obesity. The main findings were: the overweight/obesity status correlated negatively with the degree of serum 25(OH)D deficiency (ρ = −0.27) with a trend towards statistical significance (p = 0.069); the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly different (p = 0.024) in patients with 25(OH)D deficiency, as was total oxidant status (TOS) and oxidative stress index (OSI) in patients with severe serum 25(OH)D deficiency as compared to those with 25(OH)D over 20 ng/mL (TOS: p = 0.007, OSI: p = 0.008); and 25(OH)D had a negative indirect effect on TOS by body mass index (BMI), but BMI was not a significant mediator of the studied relationship. In a setting of overweight and increasing degree of obesity, patients with T2DM did not display decreasing values of 25(OH)D. Subjects with the lowest values of 25(OH)D presented the highest values of BMI. Patients with 25(OH)D deficiency were more insulin resistant and showed increased OS but no elevated systemic inflammation. The negative effect of 25(OH)D on TOS did not seem to involve BMI as a mediator.


2011 ◽  
Vol 81 (5) ◽  
pp. 317-327 ◽  
Author(s):  
Moira S. Hutchinson ◽  
Yngve Figenschau ◽  
Bjørg Almås ◽  
Inger Njølstad ◽  
Rolf Jorde

The relationships between vitamin D concentrations, hyperglycemia, and insulin resistance remain uncertain. During 2008 - 2010, an oral glucose tolerance test was performed in 3520 subjects from Tromsø, Norway. Serum 25-hydroxyvitamin D [25(OH)D] was measured in 1193 subjects with normal glucose tolerance, in 304 with isolated impaired fasting glucose, in 254 with isolated impaired glucose tolerance, in 139 with a combination of the two, and in 194 subjects with type 2 diabetes. Serum 25(OH)D did not differ between subjects with isolated impaired fasting glucose or impaired glucose tolerance, but was lower in all groups of deranged glucose metabolism as compared with normal subjects. These differences could not be explained by differences in intakes of vitamin D from cod liver oil or other supplements and remained statistically significant after adjustment for gender, age, body mass index, physical activity score, and month of examination. When the cohort was divided according to serum 25(OH)D quartiles, there was an improvement in all measures of glucose metabolism (fasting and 2-hour plasma glucose, serum insulin, HbA1c) and estimates of insulin resistance (QUICKI , HOMA-IR, ISI0.120) with increasing serum 25(OH)D quartile. However, interventional studies are needed to prove a causal relationship between vitamin D and glucose metabolism.


2013 ◽  
Vol 35 ◽  
pp. 187-193 ◽  
Author(s):  
Shaum M. Kabadi ◽  
Longjian Liu ◽  
Amy H. Auchincloss ◽  
Issa F. Zakeri

Background and Aims.Despite growing interest in the protective role that vitamin D may have in health outcomes, little research has examined the mechanisms underlying this role. This study aimed to test two hypotheses: (1) serum 25-hydroxyvitamin D [25(OH)D] is inversely associated with type 2 diabetes mellitus (T2DM) and elevated hemoglobin A1c; (2) these associations are mediated by serum C-reactive protein (CRP).Methods.Participants aged 20 and older in 2001–2006 National Health and Nutrition Examination Surveys (n= 8,655) with measures of serum 25(OH)D, CRP, hemoglobin A1c, and other important covariates were included in the present study. Logistic regression and path analysis methods were applied to test the study hypotheses.Results.Decreased serum 25(OH)D concentration was significantly associated with increased odds of T2DM. In males, an estimated 14.9% of the association between 25(OH)D and hemoglobin A1c was mediated by serum CRP. However, this mediation effect was not observed in females.Conclusion.Using a nationally representative sample, the present study extends previous research and provides new evidence that the effect of decreased serum vitamin D concentration on T2DM may proceed through increased systemic inflammation in males. Longitudinal studies and randomized control trials are needed to confirm the present findings.


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