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Shoier NO, Ghareib SA, Kothayer H, Alsemeh AE, El-Sayed SS. Vitamin D3 mitigates myopathy and metabolic dysfunction in rats with metabolic syndrome: the potential role of dipeptidyl peptidase-4. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025; 398:3697-3715. [PMID: 39356321 PMCID: PMC11978688 DOI: 10.1007/s00210-024-03439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024]
Abstract
Metabolic syndrome is associated with vitamin D3 deficiency. This work aims to examine the efficacy of vitamin D3 in inhibiting MetS-induced myopathy and to determine whether the beneficial effects of vitamin D3 are mediated by the inhibition of dipeptidyl peptidase-4 (DPP-4). An in silico study investigated the potential effectiveness of vitamin D3 on the inhibition of the DPP-4 enzyme. An in vitro assay of the DPP-4 inhibitory effect of vitamin D3 was performed. In vivo and over 12 weeks, both diet (with 3% salt) and drinking water (with 10% fructose) were utilized to induce MetS. In the seventh week, rats received either vitamin D3, vildagliptin, a combination of both, or vehicles. Serum lipids, adipokines, glycemic indices, and glucagon-like peptide-1 (GLP-1), muscular glucose transporter type-4 (GLUT-4) content, DPP-4, adenosine monophosphate kinase (AMPK) activities, and Sudan Black B-stained lipids were assessed. Muscular reactive oxygen species (ROS), caspase-3, and desmin immunostaining were used to determine myopathy. MetS-induced metabolic dysfunction was ameliorated by vitamin D3, which also reduced intramuscular glycogen and lipid accumulation. This is demonstrated by the attenuation of MetS-induced myopathy by vitamin D3, decreased oxidative stress, increased desmin immuno-expression, and caspase-3 activity. Our in silico data demonstrated that vitamin D3 is capable of inhibiting DPP-4, which is further supported by biochemical findings. Vitamin D3 increased serum GLP-1, muscular AMPK activity, and GLUT-4 content, whereas the levels of muscular ROS were decreased in MetS. Vildagliptin and its combination with vitamin D3 yielded comparable results. It is suggested that the DPP-4 inhibitory potential of vitamin D3 is responsible for the amelioration of MetS-induced metabolic changes and myopathy.
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Affiliation(s)
- Nourhan O Shoier
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Salah A Ghareib
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Hend Kothayer
- Medicinal Chemistry Department, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Amira Ebrahim Alsemeh
- Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shaimaa S El-Sayed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
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Grant WB, Wimalawansa SJ, Pludowski P, Cheng RZ. Vitamin D: Evidence-Based Health Benefits and Recommendations for Population Guidelines. Nutrients 2025; 17:277. [PMID: 39861407 PMCID: PMC11767646 DOI: 10.3390/nu17020277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/08/2025] [Accepted: 01/08/2025] [Indexed: 01/27/2025] Open
Abstract
Vitamin D offers numerous under-recognized health benefits beyond its well-known role in musculoskeletal health. It is vital for extra-renal tissues, prenatal health, brain function, immunity, pregnancy, cancer prevention, and cardiovascular health. Existing guidelines issued by governmental and health organizations are bone-centric and largely overlook the abovementioned extra-skeletal benefits and optimal thresholds for vitamin D. In addition, they rely on randomized controlled trials (RCTs), which seldom show benefits due to high baseline 25-hydroxyvitamin D [25(OH)D] concentrations, moderate supplementation doses, and flawed study designs. This review emphasizes the findings from prospective cohort studies showing that higher 25(OH)D concentrations reduce the risks of major diseases and mortality, including pregnancy and birth outcomes. Serum concentrations > 30 ng/mL (75 nmol/L) significantly lower disease and mortality risks compared to <20 ng/mL. With 25% of the U.S. population and 60% of Central Europeans having levels <20 ng/mL, concentrations should be raised above 30 ng/mL. This is achievable through daily supplementation with 2000 IU/day (50 mcg/day) of vitamin D3, which prevent diseases and deaths. Furthermore, a daily dose between 4000 and 6000 IU of vitamin D3 to achieve serum 25(OH)D levels between 40 and 70 ng/mL would provide greater protection against many adverse health outcomes. Future guidelines and recommendations should integrate the findings from observational prospective cohort studies and well-designed RCTs to improve public health and personalized care.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, 1745 Pacific Ave., Ste. 504, San Francisco, CA 94109, USA
| | - Sunil J. Wimalawansa
- Endocrinology & Human Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08902, USA;
| | - Pawel Pludowski
- Department of Clinical Biochemistry, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Richard Z. Cheng
- Orthomolecular Medicine News Service, Columbia, SC 29212, USA
- Low Carb Medicine Alliance, Shanghai 201613, China
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Balshi A, Leuenberger G, Dempsey J, Baber U, Sloane JA. Glucagon-like peptide-1 agonist safety and efficacy in a multiple sclerosis cohort. Mult Scler Relat Disord 2025; 93:106229. [PMID: 39693702 DOI: 10.1016/j.msard.2024.106229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 11/15/2024] [Accepted: 12/09/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND While glucagon-like peptide-1 agonist medications (GLP-1s) are on the rise, their safety and efficacy have not been studied in people with MS (PwMS). OBJECTIVE To investigate any adverse effects of GLP-1 medications in the MS population as well as their effectiveness for weight loss and vitamin D augmentation. METHODS We retrospectively identified PwMS who utilized a GLP-1 medication from 2006 to 2024. Wilcoxon signed rank tests for paired samples were used to compare pre- and post-GLP-1 body mass index (BMI), expanded disability status scale (EDSS), timed 25-foot walk (25FTW), and mean vitamin D values. Additional safety outcomes assessed during GLP-1 treatment were deaths, hospitalizations, clinician-confirmed relapses, and new MRI activity. RESULTS Following GLP-1 initiation, PwMS had a decrease in BMI (mean % BMI loss 3.7, p = 0.001) and an increase in vitamin D values (mean increase of 8.1 ng/mL, p = 0.0002), while no change in EDSS or T25FW was seen. There were no hospitalizations or deaths after GLP-1 initiation. CONCLUSION GLP-1 medications are safe and effective in PwMS and can help augment vitamin D levels.
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Affiliation(s)
- Alexandra Balshi
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA
| | - Grace Leuenberger
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA
| | - John Dempsey
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA
| | - Ursela Baber
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA
| | - Jacob A Sloane
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA 02215, USA.
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Das L, Sachdeva N, Holick MF, Devnani M, Dutta P, Marwaha RK. Impact of BMI on serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D with calcifediol supplementation in young adults: a longitudinal study. Endocrine 2024; 86:391-399. [PMID: 38861119 DOI: 10.1007/s12020-024-03895-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/27/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND High body mass index (BMI) is a risk factor for vitamin D deficiency. The rise in serum 25-hydroxyvitamin D [25(OH)D] concentrations following cholecalciferol supplementation is suboptimal, owing to adipose tissue sequestration and/or volumetric dilution. Calcifediol is a proven potent oral alternative for vitamin D supplementation, but whether BMI adversely affects its efficacy in raising 25(OH)D concentrations, is not well known. MATERIAL AND METHODS Adults with serum concentrations of 25(OH)D < 30 ng/mL were recruited and stratified as normal, overweight, or obese using WHO criteria. Baseline evaluation included 25(OH)D, parathyroid hormone (PTH), and total 1,25-dihydroxyvitamin D [1,25(OH)2D] based on BMI category (n = 883). A subset of participants was supplemented with 50 µg calcifediol (n = 193) and assessed for the rise in serum concentrations of 25(OH)D at 3- and 6-months following supplementation. RESULTS Participants were stratified as obese (11.2%), overweight (32.1%), or normal weight (56.7%). There were no significant baseline differences in serum concentrations of 25(OH)D among the groups (13.1 ± 6.4 vs 12.8 ± 6.8 vs 11.6 ± 6.6 ng/mL, p = 0.62). Similarly, PTH or 1,25(OH)2D concentrations were not different among the groups. On follow-up, 25(OH)D concentrations increased in all three groups at 3 and 6 months from baseline. The increase in 25(OH)D was 74.4 ng/mL (IQR 35.3-115.3) in obese, followed by overweight 62.2 ng/mL (18.1-98.7) and normal weight groups 47.1 ng/mL (17.5-89.7) at 3 months. 1,25(OH)2D also increased in all groups, without any significant intergroup differences (p > 0.05). CONCLUSION BMI does not impede the rise in 25(OH)D concentrations following supplementation with calcifediol in young adults with vitamin D deficiency.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Telemedicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Michael F Holick
- Section of Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Mahesh Devnani
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Raman Kumar Marwaha
- Society of Endocrine Health Care for Elderly, Adolescents and Children (SEHEAC), New Delhi, India.
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Mohamed B, Ghareib SA, Alsemeh AE, El-Sayed SS. Telmisartan ameliorates nephropathy and restores the hippo pathway in rats with metabolic syndrome. Eur J Pharmacol 2024; 973:176605. [PMID: 38653362 DOI: 10.1016/j.ejphar.2024.176605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 04/19/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
The main objective of this study was to determine if the telmisartan-ameliorative effects of metabolic syndrome (MetS)-evoked nephropathy are attributed to the Hippo pathway. A secondary objective was to investigate the potential of vitamin D3 to enhance telmisartan-favourable effects. A diet composed of 24% fat and 3% salt, along with drinking water containing 10% fructose, was administered for 12 weeks to induce MetS. MetS-rats were given telmisartan (5 mg/kg/day), vitamin D3 (10 μg/kg/day) or both by gavage, starting in the sixth week of experimental diet administration. Assessments performed at closure included renal function, histological examination, catalase, malondialdehyde (MDA), nuclear factor kappa-B (NF-κB), interleukin-6 (IL-6), peroxisome proliferator-activated receptor-γ (PPAR-γ), phosphatase and tensin homolog (PTEN), and transforming growth factor-β (TGF-β). Matrix metalloproteinase-9 (MMP-9) immunostaining was conducted. The expression of the Hippo pathway components, as well as that of angiotensin II type 1 and type 2 (AT1 and AT2), receptors was evaluated. Telmisartan attenuated MetS-evoked nephropathy, as demonstrated by improvement of renal function and histological features, enhancement of catalase, reduction of MDA, inflammation (NF-κB, IL-6), and renal fibrosis (increased PPAR-γ and PTEN and reduced MMP-9 and TGF-β). Telmisartan downregulated AT1-receptor, upregulated AT2-receptor and restored the Hippo pathway. Vitamin D3 replicated most of the telmisartan-elicited effects and enhanced the antifibrotic actions of telmisartan. The alleviative effects of telmisartan on MetS-evoked nephropathy may be related to the restoration of the Hippo pathway. The combination of vitamin D3 and telmisartan exerted more favourable effects on metabolic and nephropathic biomarkers compared with either one administered alone.
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Affiliation(s)
- Badria Mohamed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Salah A Ghareib
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Amira Ebrahim Alsemeh
- Department of Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
| | - Shaimaa S El-Sayed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
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Shen Y, Xia J, Yi C, Li T, Wang P, Dai L, Shi J, Wang K, Sun C, Ye H. The association between circulating 25-hydroxyvitamin D and pancreatic cancer: a systematic review and meta-analysis of observational studies. Eur J Nutr 2024; 63:653-672. [PMID: 38170272 DOI: 10.1007/s00394-023-03302-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The relationship between circulating 25-hydroxyvitamin D [25(OH)D] and pancreatic cancer has been well studied but remains unclear. The purpose of this study was to elucidate the association between circulating 25(OH)D and pancreatic cancer by using a meta-analytic approach. METHODS PubMed, Embase, and Wed of Science databases were searched through October 15, 2022. A random or fixed-effects model was used to estimate the pooled odds ratio (OR), risk ratio (RR), hazard ratio (HR) and their 95% confidence intervals (CIs). RESULTS A total of 16 studies including 529,917 participants met the inclusion criteria, of which 10 reported incidence and 6 reported mortality. For the highest versus lowest categories of circulating 25(OH)D, the pooled OR of pancreatic cancer incidence in case-control studies was 0.98 (95% CI 0.69-1.27), and the pooled HRs of pancreatic cancer mortality in cohort and case-control studies were 0.64 (95% CI 0.45-0.82) and 0.78 (95% CI 0.62-0.95), respectively. The leave-one-out sensitivity analyses found no outliers and Galbraith plots indicated no substantial heterogeneity. CONCLUSION Evidence from this meta-analysis suggested that high circulating 25(OH)D levels may be associated with decreased mortality but not incidence of pancreatic cancer. Our findings may provide some clues for the treatment of pancreatic cancer and remind us to be cautious about widespread vitamin D supplementation for the prevention of pancreatic cancer.
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Affiliation(s)
- Yajing Shen
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Junfen Xia
- Office of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Chuncheng Yi
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Tiandong Li
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Peng Wang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
| | - Liping Dai
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Jianxiang Shi
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Keyan Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Changqing Sun
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Hua Ye
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, 450052, Henan, China.
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Balshi A, Saart E, Dempsey J, Baber U, Sloane JA. Bariatric surgery outcomes in multiple sclerosis: Interplay with vitamin D and chronic pain syndromes. Mult Scler Relat Disord 2023; 79:105006. [PMID: 37734186 DOI: 10.1016/j.msard.2023.105006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Obesity and lower vitamin D levels are associated with adverse outcomes in multiple sclerosis (MS). Bariatric surgery is a safe intervention in patients with MS, although it lowers vitamin D levels in the general population. OBJECTIVE To investigate the effects of bariatric surgery on vitamin D levels and interrogate risk factors for unsuccessful post-operative weight loss in patients with MS. METHODS We retrospectively identified patients with MS who underwent bariatric surgery from 2001 to 2023. Wilcoxon signed rank tests for paired samples were used to compare pre- and post-operative body mass index (BMI), expanded disability status scale (EDSS), timed 25-foot walk (T25FW), and median vitamin D values. RESULTS Following bariatric surgery, patients with MS had a decrease in BMI (mean percent total weight loss of 18.4 %, range 0-38 %, p < 0.001) and an increase in vitamin D values (mean increase of 23 ng/mL, range -4-32 ng/mL, p < 0.001), while no change in EDSS or T25FW was seen. Four out of 20 patients did not lose more than 5 % of their pre-operative BMI, all of whom had chronic pain syndromes and were on gabapentin. CONCLUSION Healthy vitamin D levels are attainable following bariatric surgery in patients with MS.
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Affiliation(s)
- Alexandra Balshi
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emma Saart
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - John Dempsey
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ursela Baber
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jacob A Sloane
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Huang X, Yang Y, Jiang Y, Zhou Z, Zhang J. Association between vitamin D deficiency and lipid profiles in overweight and obese adults: a systematic review and meta-analysis. BMC Public Health 2023; 23:1653. [PMID: 37644450 PMCID: PMC10464009 DOI: 10.1186/s12889-023-16447-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 08/03/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE The association between vitamin D deficiency and lipid profiles in adults with overweight or obesity remains unclear and inconsistent. The aim of our study was to determine the relationship between lipid profiles and vitamin D deficiency in the overweight and obese adults. METHODS Four databases, including PubMed, the Web of Science, EMBASE and the Cochrane Library, were used to identify all studies on vitamin D status and lipid levels, including the serum levels of triglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL). The Weighted mean difference (WMD) with 95% confidence intervals (CIs) using random-effects models was used to assess the association between the lipid profile and vitamin D deficiency. RESULTS Twenty-one articles that included a total of 7952 adults with overweight or obesity (BMI ≥ 25 kg/m2) were included. The overall results revealed that compared with the controls, individuals with vitamin D deficiency showed higher levels of TG (WMD = 15.01; 95%CI, 2.51-27.52) and TC (WMD = 8.61; 95%CI, 1.31-15.92). Moreover, vitamin D deficiency was related to an increased level of LDL (WMD = 6.12; 95%CI, 0.02-12.23). HDL level was inversely associated with the vitamin D deficiency status (WMD = -2.57; 95%CI, -4.26, -0.88). CONCLUSIONS Among the adults with overweight or obesity, the vitamin D deficient group displayed impaired lipid profiles, including increased TG, TC and LDL levels and reduced HDL level.
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Affiliation(s)
- Xiao Huang
- Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yan Yang
- Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yingling Jiang
- Department of Metabolism and Endocrinology, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Changsha, China
| | - Zhiguang Zhou
- Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Jingjing Zhang
- Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Vetrani C, Barrea L, Verde L, Docimo A, Aprano S, Savastano S, Colao A, Muscogiuri G. Vitamin D and chronotype: is there any relationship in individuals with obesity? J Endocrinol Invest 2023; 46:1001-1008. [PMID: 36454438 DOI: 10.1007/s40618-022-01973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE Chronotype is the attitude to perform most of the daily activities in the morning ("morning chronotype", MC) or in the evening ("evening chronotype", EC). The latter, as well as vitamin D deficiency, has been associated with an increased risk of obesity-related complications, likely through the promotion of insulin resistance. Therefore, we aimed to investigate whether there is any relationship between vitamin D (25-OH-D) and chronotype in individuals with obesity. METHODS In this cross-sectional study, we enrolled 59 individuals (43.1 ± 13 years; 17M/42F) with obesity. Anthropometric parameters, lifestyle habits, personal medical history, chronotype, insulin resistance, and 25-OH-D were assessed. RESULTS Individuals with EC presented significantly higher BMI than MC (p < 0.001), greater waist (p = 0.012), and hip circumferences (p = 0.001). Individuals with EC showed significantly lower insulin sensitivity (p = 0.017) and 25-OH-D than MC. In addition, the prevalence of vitamin D deficiency and impaired fasting glucose was significantly higher in EC than in MC. 25-OH-D directly correlated with chronotype score (r = 0.351; p = 0.019) whereas inversely with BMI (r = - 0.363; p = 0.016). The regression analysis showed that BMI was most tightly associated with 25-OH-D concentrations (β = - 0.323, p = 0.032), followed by chronotype score (β = 0.340, p = 0.042). Using chronotype score as the dependent variable, BMI significantly predicted a lower chronotype score (β = - 0.586, p < 0.001). CONCLUSION The present study showed that 25-OH-D, as well as chronotype, correlate independently with obesity.
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Affiliation(s)
- C Vetrani
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy
| | - L Barrea
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, 80143, Naples, Italy
| | - L Verde
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy
| | - A Docimo
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy
| | - S Aprano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy
| | - S Savastano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy
| | - A Colao
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy
- UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy
| | - G Muscogiuri
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", 5, Sergio Pansini, 80131, Naples, Italy.
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples "Federico II", Naples, Italy.
- UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy.
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Khattab Y, Reda R, El-Gaafary M, Zeitoun Y, Abo-Shady R, Abdelhady W. BsmI gene polymorphism of vitamin D receptor in obese Egyptian male medical students and its relationship with vitamin D deficiency. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00275-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Vitamin D regulates cell proliferation and differentiation and exhibits immunoregulatory, antiangiogenic, and antioxidant characteristics. Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms have been associated with an increased risk of metabolic syndrome components such as abdominal obesity, with both vitamin D deficiency and VDR gene polymorphisms contributing to its development. Obesity, metabolic disorders, and bone mass defects are associated with VDR alleles. The importance of VDR in the etiology of obesity has been related to the existence of the VDR polymorphisms FokI, BsmI, ApaI, and TaqI. VDR expression in adipocytes affects energy metabolism and aids in obesity development.
Objective
The aim of this study was to examine a possible association between BsmI (B, b allele) polymorphism in the VDR gene and vitamin D status in obese Egyptian male medical students.
Patients and methods
This study was based on a comprehensive experiment known as “Nutritional Assessment of Medical Educational Students (NAMES)” that was completed in 2018 with 700 healthy participants (men and women). In total, out of the 700 participants 30 healthy men were enrolled in this study who matched our inclusion criteria. They attended Ain Shams University Hospital in Cairo between April 2019 and November 2020. This study was conducted at the Clinical Pathology Department of Ain Shams University Hospital, which is a part of the Faculty of Medicine. Participants were divided into two groups: Group I consisted of 12 obese men with nondeficient vitamin D levels (> 20 ng/dl), and Group II consisted of 18 obese men with deficient vitamin D levels (20 ng/dl). Peripheral blood samples were collected into EDTA tubes from all groups, and DNA was extracted and purified using spin purification for PCR (QIA amp DNA Mini Kit). A commercial real-time polymerase chain reaction (PCR) kit with predesigned TaqMan probes was used to analyze the single nucleotide polymorphism (SNP) (BsmI) rs 1544410 in the VDR gene.
Results
No statistically significant relationship was observed between vitamin D levels and all InBody bioelectrical impedance characteristics, as well as BsmI gene polymorphism and all InBody bioelectrical impedance parameters (P > 0.05). Regarding Bb and BB genotypes, no statistically significant difference was observed between Groups I and II. The prevalence of BB genotype was higher in vitamin-D-deficient individuals, and Bb genotype was more common among obese participants than BB genotype, which showed a higher prevalence of the “b” gene; however, these were not significant. Iron profile (iron level, ferritin level, TIBC, and transferrin saturation) and BsmI gene polymorphism showed no statistically significant relationship (P > 0.05). Glycated hemoglobin (HbA1c) level and BsmI gene polymorphism showed a statistically significant relationship (P = 0.002), with a higher mean value among Bb genotype carriers than among BB genotype carriers. Eosinophil count showed a statistically significant difference between BB and Bb genotype carriers (P = 0.045), with a higher mean value among Bb genotype carriers than among BB genotype carriers. Bsml gene polymorphism showed no statistically significant relationship with any other complete blood count parameters (P > 0.05.)
Conclusion
There was no significant relationship between VDR gene polymorphism (BsmI) and body mass index (BMI) nor between the different InBody bioelectrical impedance parameters. We noticed the prevalence of BB genotype among vitamin-D-deficient obese students and the frequency of the “b” allele among obese candidates according to the findings of our study. There was also no significant relationship between BsmI gene polymorphism and vitamin D levels. However, BsmI gene polymorphism and HbA1c levels and eosinophil count showed a relationship, which requires further investigation.
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Jibril AT, Ghorbaninejad P, Sheikhhossein F, Shab-Bidar S. Positive Association Between Nutrient Adequacy and Waist Circumference: Results of a Cross-Sectional Study. Clin Nutr Res 2022; 11:204-213. [PMID: 35949561 PMCID: PMC9348912 DOI: 10.7762/cnr.2022.11.3.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/04/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Metabolic syndrome (MetS) is a multifactorial disease with its exact causes not completely clear. Micronutrients such as vitamin A, vitamin D, zinc, and magnesium have been associated with MetS components. Our objective was to investigate the association of nutrient adequacy (NA) with MetS components. The present cross-sectional study consisted of 850 adults between 18-59 years from Tehran, Iran. Dietary intake, socio-demographic data, medical history, and anthropometric indices were collected by trained personnel. NA was calculated as the mean intake ratio to the recommended amount of 16 micronutrients. MetS were defined by the consensus of National Cholesterol Education Program-Adult Treatment Panel III criteria. The association between NA and MetS was examined using linear regression analyses after controlling potential confounders. More participants in the highest quartile were obese in terms of general obesity (p = 0004) and abdominal obesity (p = 0.003) compared with subjects in the least quartile. A significant positive correlation was found between waist circumference (WC) and NA even after controlling for all potential confounders (p < 0.001). NA was positively associated with WC among adults living in Tehran.
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Affiliation(s)
- Aliyu T. Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Fatemeh Sheikhhossein
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
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12
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Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance. Nutrients 2021; 13:nu13124358. [PMID: 34959910 PMCID: PMC8705502 DOI: 10.3390/nu13124358] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.
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Rajabi S, Aghamohammadi V, Moradpour G, Amini M, Hosseini SV, Sobhani Z, Medhati P, Hosseini E, Hosseini B, Haghighat N, Vafa L, Moeinvaziri N. Vitamin D Status in Patients with Morbid Obesity Following Bariatric Surgery in Shiraz, Iran: A Retrospective Observational Study. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Shirin Rajabi
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Gholamreza Moradpour
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Amini
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Vahid Hosseini
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Colorectal Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sobhani
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pourya Medhati
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elahe Hosseini
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Hosseini
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Haghighat
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Vafa
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Moeinvaziri
- Laparascopy Research Center, Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Kobylińska M, Antosik K, Decyk A, Kurowska K. Malnutrition in Obesity: Is It Possible? Obes Facts 2021; 15:19-25. [PMID: 34749356 PMCID: PMC8820192 DOI: 10.1159/000519503] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) classifies malnutrition as the biggest threat to public health worldwide, and this condition is observed in 20-60% of hospitalized patients. Malnutrition is a state of the body in which due to insufficient supply or incorrect absorption of essential nutrients, the body composition changes and the body's functions are impaired. Malnutrition is associated not only with reduced body mass index but also with obesity. SUMMARY Obesity is defined as a paradoxical state of malnutrition, which despite excessive energy consumption is associated with a shortage of individual microelements. Deficiency or lack of homeostasis of essential micronutrients can significantly affect daily performance, intellectual and emotional state, but also the physical state of the body. Food deficiency can also contribute to further weight gain or the development of other metabolic diseases. Micronutrient deficiency may include not only incorrect dietary choices and insufficient access to nutrient-rich foods but also changes in the absorption, distribution or excretion of nutrients, and altered micronutrient metabolism resulting from systemic inflammation caused by obesity. An effective therapy method recommended for people with morbid obesity is bariatric surgery aimed at both weight loss and improving quality of life. Unfortunately, the effects of these treatments are often medium- and long-term complications associated with micronutrient deficiency as a result of reduced consumption or absorption. Therefore, the use of bariatric surgery in patients with extreme obesity can affect the metabolism of microelements and increase the risk of nutritional deficiencies. Key Messages: Studies by many authors indicate a higher incidence of food deficiency among people with excessive body weight, than in people with normal body weight of the same age and same sex. Monitoring the concentration of minerals and vitamins in blood serum is a good practice in the treatment of obesity. The proper nutritional status of the body affects not only the state of health but also the effectiveness of therapy. The aim of the review was to present the issue of malnutrition in the context of obesity.
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Affiliation(s)
| | - Katarzyna Antosik
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce, Poland
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15
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Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice. Nutrients 2021; 13:nu13103491. [PMID: 34684492 PMCID: PMC8539968 DOI: 10.3390/nu13103491] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022] Open
Abstract
Recent evidence has revealed anti-inflammatory properties of vitamin D as well as extra-skeletal activity. In this context, vitamin D seems to be involved in infections, autoimmune diseases, cardiometabolic diseases, and cancer development. In recent years, the relationship between vitamin D and insulin resistance has been a topic of growing interest. Low 25-hydroxyvitamin D (25(OH)D) levels appear to be associated with most of the insulin resistance disorders described to date. In fact, vitamin D deficiency may be one of the factors accelerating the development of insulin resistance. Vitamin D deficiency is a common problem in the population and may be associated with the pathogenesis of diseases related to insulin resistance, such as obesity, diabetes, metabolic syndrome (MS) and polycystic ovary syndrome (PCOS). An important question is the identification of 25(OH)D levels capable of generating an effect on insulin resistance, glucose metabolism and to decrease the risk of developing insulin resistance related disorders. The benefits of 25(OH)D supplementation/repletion on bone health are well known, and although there is a biological plausibility linking the status of vitamin D and insulin resistance supported by basic and clinical research findings, well-designed randomized clinical trials as well as basic research are necessary to know the molecular pathways involved in this association.
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Rajaie H, Rabiee MR, Bellissimo N, Faghih S. Independent and Combined Effects of Calcium and Vitamin D Supplementation on Blood Lipids in Overweight or Obese Premenopausal Women: A Triple-Blind Randomized Controlled Clinical Trial. Int J Prev Med 2021; 12:52. [PMID: 34447494 PMCID: PMC8356995 DOI: 10.4103/ijpvm.ijpvm_294_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/04/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Dyslipidemia is often associated with obesity and contributes to the increased risk of atherosclerosis, heart disease, and stroke. This study was designed to evaluate the independent or combined effect of calcium and vitamin D (Ca + Vit D) supplementation on blood lipid profile in overweight or obese premenopausal women. Methods: This study is a triple-blind, randomized, parallel, placebo-controlled trial. About 100 overweight or obese (body mass index (BMI) of 25–40 kg/m2) premenopausal (aged 30–50 years) women, recruited from Shiraz University of Medical Sciences (SUMS) clinics, were allocated into 4 groups: (1) calcium (Ca) supplementation (2 tablets per day; each containing 500 mg calcium carbonate), (2) vitamin D (Vit D) supplementation (2 tablets per day; each containing 200 IU vitamin D3), (3) Ca + Vit D supplementation (2 tablets per day; each containing 500 mg calcium carbonate plus 200 IU vitamin D3), (4) placebo supplementation (2 tablets per day, containing micro-cellulose). All participants received a 500 kcal energy-restricted diet. Blood lipids, serum vitamin D, and anthropometric indices were measured at baseline and after 8 weeks. Physical activity and 3-day dietary records were taken at baseline and every 4 weeks during the intervention. Results: At 8 weeks, triglyceride levels were significantly decreased in the Ca group (P = 0.002). Low-density lipoprotein (LDL) levels were decreased in the Ca + Vit D group (P = 0.04) and high-density lipoprotein (HDL) levels decreased in both the Ca and Ca + Vit D groups (P = 0.006, P = 0.004, respectively). The results of one-way ANOVA indicated that changes in the serum lipid profile levels were not significantly different among the four groups (P = 0.90, P = 0.86, P = 0.61, P = 0.27, and P = 0.19, respectively for TG, TC, LDL, HDL, and LDL/HDL). The results were not significant even after adjusting for potential covariates. Conclusions: Although the results were not significantly different among the four treated groups at 8 weeks, within-group changes like the reduction in triglyceride and LDL levels, respectively in the Ca group and Ca + Vit D group, and HDL levels in both the Ca and Ca + Vit D groups were significant. These changes may have potentially significant public health implications.
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Affiliation(s)
- Hamideh Rajaie
- Research Center of Nutrition and Food Sciences, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Rabiee
- Department of Physical Education and Sport Physiology, Shiraz University, Shiraz, Iran
| | - Nick Bellissimo
- Faculty of Community Services, School of Nutrition, Ryerson University, Toronto, ON, Canada
| | - Shiva Faghih
- Research Center of Nutrition and Food Sciences, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Cătoi AF, Iancu M, Pârvu AE, Cecan AD, Bidian C, Chera EI, Pop ID, Macri AM. Relationship between 25 Hydroxyvitamin D, Overweight/Obesity Status, Pro-Inflammatory and Oxidative Stress Markers in Patients with Type 2 Diabetes: A Simplified Empirical Path Model. Nutrients 2021; 13:nu13082889. [PMID: 34445049 PMCID: PMC8399080 DOI: 10.3390/nu13082889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/15/2021] [Accepted: 08/19/2021] [Indexed: 12/22/2022] Open
Abstract
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.
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Affiliation(s)
- Adriana Florinela Cătoi
- Department of Pathophysiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania or (A.F.C.); (A.E.P.); (A.D.C.); (E.I.C.)
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence:
| | - Alina Elena Pârvu
- Department of Pathophysiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania or (A.F.C.); (A.E.P.); (A.D.C.); (E.I.C.)
| | - Andra Diana Cecan
- Department of Pathophysiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania or (A.F.C.); (A.E.P.); (A.D.C.); (E.I.C.)
| | - Cristina Bidian
- Department of Physiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Elisabeta Ioana Chera
- Department of Pathophysiology, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania or (A.F.C.); (A.E.P.); (A.D.C.); (E.I.C.)
| | - Ioana Delia Pop
- Department of Exact Sciences, Faculty of Horticulture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania;
| | - Adrian Maximilian Macri
- Department of Animal production and Food Safety, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania;
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Rafiq S, Jeppesen PB. Insulin Resistance Is Inversely Associated with the Status of Vitamin D in Both Diabetic and Non-Diabetic Populations. Nutrients 2021; 13:1742. [PMID: 34063822 PMCID: PMC8224049 DOI: 10.3390/nu13061742] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D has been implicated in the regulation of glucose metabolism and insulin resistance. We designed this study to provide evidence that insulin resistance is dependent on the concentration of vitamin D in the body. Forty observational studies of both type 2 diabetes mellitus patients and healthy subjects were included in this meta-analysis. Related articles were searched from Embase, PubMed, and Medline through January 2021. Filters for search were used to obtain more focused results. We used Comprehensive Meta-Analysis Version 3 for the construction of forest plots. RevMan software version 5.3 was used to build the risk of bias tables and summary plots. The observational studies included in this systematic review and meta-analysis showed an inverse relationship of insulin resistance with the status of vitamin D both in non-diabetic (r = -0.188; 95% CI = -0.141 to -0.234; p = 0.000) and diabetic (r = -0.255; 95% CI = -0.392 to -0.107, p = 0.001) populations. From the meta-analysis we concluded that hypovitaminosis D is related to increased levels of insulin resistance in both type 2 diabetes patients and the healthy population all over the world.
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Affiliation(s)
- Shamaila Rafiq
- Department of Clinical Medicine, Aarhus University, Aarhus N, 8200 Aarhus, Denmark;
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19
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The effect of vitamin D fortified products on anthropometric indices: A systematic review and meta-analysis. Complement Ther Clin Pract 2020; 41:101242. [DOI: 10.1016/j.ctcp.2020.101242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 01/19/2023]
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20
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Lontchi-Yimagou E, Kang S, Goyal A, Zhang K, You JY, Carey M, Jain S, Bhansali S, Kehlenbrink S, Guo P, Rosen ED, Kishore P, Hawkins M. Insulin-sensitizing effects of vitamin D repletion mediated by adipocyte vitamin D receptor: Studies in humans and mice. Mol Metab 2020; 42:101095. [PMID: 33045433 PMCID: PMC7585951 DOI: 10.1016/j.molmet.2020.101095] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
Objective Adipose tissue inflammation and fibrosis appear to contribute to insulin resistance in obesity. Vitamin D receptor (Vdr) genes are expressed by adipocytes, macrophages, and fibroblasts, all of which could potentially play a role in adipose tissue inflammation and fibrosis. As vitamin D has been shown to have direct anti-inflammatory effects on adipocytes, we determined whether specific vitamin D receptor-mediated effects on adipocytes could impact adipose tissue inflammation and fibrosis and ultimately insulin resistance. Methods We examined the effects of repleting vitamin D in 25(OH)D-deficient, insulin resistant, overweight-to-obese human subjects (n = 19). A comprehensive assessment of whole-body insulin action was undertaken with stepped euglycemic (∼90 mg/dL) hyperinsulinemic clamp studies both before and after the administration of vitamin D or placebo. Adipose tissue fibrosis and inflammation were quantified by real-time rt-PCR and immunofluorescence in subcutaneous abdominal adipose tissue. To determine whether vitamin D's effects are mediated through adipocytes, we conducted hyperinsulinemic clamp studies (4 mU/kg/min) and adipose tissue analysis using an adipocyte-specific vitamin D receptor knockout (VDR-KO) mouse model (adiponectin-Cre + VDR+/fl) following high-fat diet feeding for 12 weeks. Results 25(OH)D repletion was associated with reductions in adipose tissue expression of pro-inflammatory and pro-fibrotic genes, decreased collagen immunofluorescence, and improved hepatic insulin sensitivity in humans. Worsening trends after six months on placebo suggest progressive metabolic effects of 25(OH)D deficiency. Ad-VDR-KO mice mirrored the vitamin D-deficient humans, displaying increased adipose tissue fibrosis and inflammation and hepatic insulin resistance. Conclusions These complementary human and rodent studies support a beneficial role of vitamin D repletion for improving hepatic insulin resistance and reducing adipose tissue inflammation and fibrosis in targeted individuals, likely via direct effects on adipocytes. These studies have far-reaching implications for understanding the role of adipocytes in mediating adipose tissue inflammation and fibrosis and ultimately impacting insulin sensitivity.
Vitamin D repletion improved hepatic insulin sensitivity in obese insulin-resistant and vitamin D deficient human. Correcting vitamin D deficiency concomitantly reduced adipose tissue expression of pro-inflammatory and pro-fibrotic genes. Worsening trends in these metabolic parameters were observed following 6 months of uncorrected vitamin D deficiency. Adipocyte-specific depletion of VDR in mice induced adipose tissue inflammation and fibrosis and hepatic insulin resistance.
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Affiliation(s)
| | - Sona Kang
- Nutritional Sciences and Toxicology Department, University of California, Berkeley, CA 94720-3100, USA
| | | | - Kehao Zhang
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jee Y You
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Michelle Carey
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Swati Jain
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Sylvia Kehlenbrink
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Peng Guo
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Evan D Rosen
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Preeti Kishore
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
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21
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Muscogiuri G, Barrea L, Somma CD, Laudisio D, Salzano C, Pugliese G, de Alteriis G, Colao A, Savastano S. Sex Differences of Vitamin D Status across BMI Classes: An Observational Prospective Cohort Study. Nutrients 2019; 11:nu11123034. [PMID: 31842281 PMCID: PMC6950363 DOI: 10.3390/nu11123034] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 12/22/2022] Open
Abstract
Growing evidence reported that vitamin D deficiency is a common finding in obesity. Vitamin D status also seems to be sex-related, although little is known regarding this association. Therefore, the aim of this study was to investigate the sex-related differences of serum 25OH vitamin D (25OHD) concentrations across body mass index (BMI) classes and, if there were any differences, whether they could be explained by sex-related differences in body composition. We enrolled 500 subjects (250 males, age 37.4 ± 11.8 years; 250 females, age 36.6 ± 11.8 years). Body composition was assessed by bioelectrical impedance analysis (BIA) phase-sensitive system. Serum 25OHD concentration was quantified by a direct, competitive chemiluminescence immunoassay. Vitamin D deficiency was defined as a serum 25OHD concentrations < 20 ng/mL (50 nmol/L). Stratifying the sample population according to sex and BMI categories, 25OHD concentrations were significantly higher in males compared to females in all BMI classes and decreased along with the increase of BMI values. Females with vitamin D deficiency had higher fat mass (FM) % compared to males with vitamin D deficiency. The 25OHD concentrations inversely correlated with FM % in both sexes. In a multiple regression analysis model, sex, FM %, and BMI were predictive factors of 25OHD concentration. In conclusion, our study suggests that 25OHD concentrations were lower in females than males across all BMI categories. Given the tight correlation between 25OHD concentrations and FM %, it can be hypothesized that the lower 25OHD concentrations in females than males can be explained by the fact that females have a higher amount of fat than males.
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Szymczak-Pajor I, Śliwińska A. Analysis of Association between Vitamin D Deficiency and Insulin Resistance. Nutrients 2019; 11:E794. [PMID: 30959886 PMCID: PMC6520736 DOI: 10.3390/nu11040794] [Citation(s) in RCA: 177] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
Recent evidence revealed extra skeleton activity of vitamin D, including prevention from cardiometabolic diseases and cancer development as well as anti-inflammatory properties. It is worth noting that vitamin D deficiency is very common and may be associated with the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes. This review aims to provide molecular mechanisms showing how vitamin D deficiency may be involved in the insulin resistance formation. The PUBMED database and published reference lists were searched to find studies published between 1980 and 2019. It was identified that molecular action of vitamin D is involved in maintaining the normal resting levels of ROS and Ca2+, not only in pancreatic β-cells, but also in insulin responsive tissues. Both genomic and non-genomic action of vitamin D is directed towards insulin signaling. Thereby, vitamin D reduces the extent of pathologies associated with insulin resistance such as oxidative stress and inflammation. More recently, it was also shown that vitamin D prevents epigenetic alterations associated with insulin resistance and diabetes. In conclusion, vitamin D deficiency is one of the factors accelerating insulin resistance formation. The results of basic and clinical research support beneficial action of vitamin D in the reduction of insulin resistance and related pathologies.
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Affiliation(s)
- Izabela Szymczak-Pajor
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland.
| | - Agnieszka Śliwińska
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland.
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Durgarao Y, Manjrekar PA, Adhikari P, Chakrapani M, Rukmini MS. Comprehensive Review on Diabetes Associated Cardiovascular Complications - The Vitamin D Perspective. Cardiovasc Hematol Disord Drug Targets 2019; 19:139-153. [PMID: 30648528 DOI: 10.2174/1871529x19666190114155302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/14/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D, a steroid hormone is primarily known for its role in calcium and bone mineral homeostasis. Over the years, vitamin D has been implicated in various non-skeletal diseases. The extraskeletal phenomenon can be attributed to the presence of vitamin D receptors (VDRs) in almost all cells and identification of 1-α hydroxylase in extrarenal tissues. The vitamin D deficiency (VDD) pandemic was globally reported with increasing evidence and paralleled the prevalence of diabetes, obesity and cardiovascular diseases (CVDs). A dependent link was proposed between hypovitaminosis D glycemic status, insulin resistance and also the other major factors associated with type 2 diabetes leading to CVDs. Insulin resistance plays a central role in both type 2 diabetes and insulin resistance syndrome. These 2 disorders are associated with distinct etiologies including hypertension, atherogenic dyslipidemia, and significant vascular abnormalities that could lead to endothelial dysfunction. Evidence from randomised clinical trials and meta-analysis, however, yielded conflicting results. This review summarizes the role of vitamin D in the regulation of glucose homeostasis with an emphasis on insulin resistance, blood pressure, dyslipidaemia, endothelial dysfunction and related cardiovascular diseases and also underline the plausible mechanisms for all the documented effects.
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Affiliation(s)
- Y Durgarao
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Poornima A Manjrekar
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prabha Adhikari
- Department of Internal Medicine, Yenepoya University, Mangalore, Karnataka, India
| | - M Chakrapani
- Department of Internal Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - M S Rukmini
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Muscogiuri G, Barrea L, Annunziata G, Di Somma C, Laudisio D, Colao A, Savastano S. Obesity and sleep disturbance: the chicken or the egg? Crit Rev Food Sci Nutr 2018; 59:2158-2165. [PMID: 30335476 DOI: 10.1080/10408398.2018.1506979] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Epidemiological studies suggested an association between obesity and sleep disturbances. Obstructive sleep apnea is the most prevalent type of obesity-related sleep disorder that lead to an increased risk for numerous chronic health conditions. In addition the increased visceral adipose tissue might be responsible for the secretion of inflammatory cytokines that could contribute to alter the sleep-wake rhythm. Unhealthy food characterized by high consumption of fat and carbohydrate seems to negatively influence the quality of sleep while diet rich of fiber is associated to more restorative and deeper sleep. Although obesity could cause through several pathogenetic mechanisms an alteration of sleep, it has been reported that subjects suffering from sleep disorders are more prone to develop obesity. Experimental laboratory studies have demonstrated that decreasing either the amount or quality of sleep increase the risk of developing obesity. Experimental sleep restriction also causes physiological, hormonal and food behavioral changes that promote a positive energy balance and a compensatory disproportionate increase in food intake, decrease in physical activity, and weight gain. Thus, the aim of this review is to provide observational evidence on the association of obesity with sleep disturbances and viceversa with emphasis on possible pathophysiological mechanisms (hormonal and metabolic) that link these two pathological conditions.
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Affiliation(s)
- Giovanna Muscogiuri
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Luigi Barrea
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Giuseppe Annunziata
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | | | - Daniela Laudisio
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Annamaria Colao
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Silvia Savastano
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
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25
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De novo vitamin D supplement use post-diagnosis is associated with breast cancer survival. Breast Cancer Res Treat 2018; 172:179-190. [PMID: 30039288 DOI: 10.1007/s10549-018-4896-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/17/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE Experimental laboratory data have indicated a protective effect of vitamin D on breast cancer progression, while epidemiological evidence is growing. Using pharmacy claims data, this study investigates the association between vitamin D supplement use initiated after a breast cancer diagnosis and associated mortality. METHODS Women aged 50-80 years with a record of invasive breast cancer were identified on the National Cancer Registry Ireland database (n = 5417). Initiation of de novo vitamin D post-diagnosis was identified from linked national prescription data (n = 2581, 49%). Multivariate Cox proportional hazards models were used to estimate adjusted HRs (95% CIs) for breast cancer-specific mortality. RESULTS There was a 20% reduction in breast cancer-specific mortality in de novo vitamin D users (modelled as a time-varying variable) compared to non-users (HR 0.80; 95% CI 0.64-0.99, p = 0.048) and the reduction was greater at 49% (HR 0.51; 95% CI 0.34-0.74, p < 0.001), if vitamin D was initiated soon after the breast cancer diagnosis (within 6 months). CONCLUSIONS In this large national breast cancer cohort, de novo vitamin D use post-diagnosis was found to be associated with a reduction in breast cancer-specific mortality. Vitamin D, therefore, has the potential as a non-toxic and inexpensive agent to improve survival in breast cancer patients. Findings support the need for RCTs exploring the effect of vitamin D supplementation on breast cancer survival.
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Khosravi ZS, Kafeshani M, Tavasoli P, Zadeh AH, Entezari MH. Effect of Vitamin D Supplementation on Weight Loss, Glycemic Indices, and Lipid Profile in Obese and Overweight Women: A Clinical Trial Study. Int J Prev Med 2018; 9:63. [PMID: 30123437 PMCID: PMC6071442 DOI: 10.4103/ijpvm.ijpvm_329_15] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/15/2017] [Indexed: 12/26/2022] Open
Abstract
Introduction Vitamin D (vit D) deficiency has defined as a health problem worldwide. World Health Organization (WHO) has declared that obesity is an epidemic of the 21st century. Previous studies have shown that obesity may increase the risk of Vit D deficiency. Furthermore, other studies have demonstrated that vit D insufficiency was accompanied with higher risk of type 2 diabetes, cardiovascular diseases, hypertension, and obesity. The aim of this study was to survey the effect of vit D supplementation on weight loss among overweight and obese women aged 20-40 years in Isfahan. Methods This double-blind clinical trial was done on 50 overweight and obese women who were divided into two groups, in which one group received vit D supplements and the other group received placebo. Intervention group received vit D with dozes 50,000 IU/w for 6 weeks. The levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting blood sugar (FBS), insulin (ins), homeostasis model assessment of ins resistance (IR), C-reactive protein (CRP), height, weight (WT), waist circumference (WC), hip circumference (HC), and blood pressure (BP) were measured before and after intervention. Results After using vit D supplementation for 6 weeks, WT, WC, and body mass index (BMI) were decreased significantly and serum vit D increased significantly compared to control group (P < 0.001). Other factors including TC, TG, LDL-c, HDL-c, FBS, CRP, ins, IR, and waist to hip ratio (WHR) did not change significantly (P > 0.05). Conclusions After 6 weeks of intervention, the means of WT, BMI, WC, and HC decreased significantly. Previous studies have shown that vit D deficiency was more prevalence in obese people and there was an inverse association among vit D with BMI and WC. The relationship between vit D and lipid profiles such as glycemic indexes, anthropometric indexes, CRP, and BP is not clear and needs more study in the future.
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Affiliation(s)
- Zahra Sadat Khosravi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Kafeshani
- Clinical Nutrition/Community Nutrition/Food Science and Technology, Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parastoo Tavasoli
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassan Zadeh
- Department of Epidemiology and Biostatic, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Entezari
- Clinical Nutrition/Community Nutrition/Food Science and Technology, Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Seyyed Abootorabi M, Ayremlou P, Behroozi-Lak T, Nourisaeidlou S. The effect of vitamin D supplementation on insulin resistance, visceral fat and adiponectin in vitamin D deficient women with polycystic ovary syndrome: a randomized placebo-controlled trial. Gynecol Endocrinol 2018; 34:489-494. [PMID: 29271278 DOI: 10.1080/09513590.2017.1418311] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Low plasma 25-hydroxy-vitamin D (25OHD) is associated with polycystic ovary syndrome (PCOS). Vitamin D deficiency may contribute to the development of insulin resistance, visceral fat and low level of adiponectin which are common feature in PCOS women. This study aimed to evaluate the effect of vitamin D supplementation on insulin resistance, visceral fat, and adiponectin in hypovitaminosis D women with polycystic ovary syndrome. METHODS In this randomized, placebo-controlled clinical trial, 44 PCOS women aged 20-38 years with plasma 25OHD <20 ng/mL were randomized in the intervention or placebo groups and followed for 8 weeks. Participants received 50,000 IU of oral vitamin D3 once weekly in the intervention group or placebo. The visceral adipose tissue, Insulin resistance (HOMA-IR), HOMA-B, QUICKI, and circulating adiponectin were compared before and after the intervention within groups using paired tests and the mean changes were analyzed between two groups by independent t-test. RESULTS Of 44 eligible participates, 36 patients (81.8%) completed the study. After 8 week intervention, vitamin D supplementation compared to the placebo group significantly decreased fasting plasma glucose (FPG) (7.67 ± 7.66 versus 1.71 ± 7.50 mg/dL, p = .001) and significantly increased homeostasis model of assessment-estimated B cell function (HOMA-B) (129.76 ± 121.02 versus 48.32 ± 128.35, p = .014), Adiponectin (5.17 ± 8.09 versus -5.29 ± 8.64 mg/dL, p = .001), and serum vitamin D level (28.24 ± 6.47 versus 3.55 ± 4.25 ng/mL, p = .001). CONCLUSION Vitamin D supplementation in vitamin D deficient women with PCOS, improved the FPG, HOMA-B, Adiponectin, and serum vitamin D level.
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Affiliation(s)
- Maryam Seyyed Abootorabi
- a Department of Nutrition, School of Medicine , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Parvin Ayremlou
- b Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Tahereh Behroozi-Lak
- c Reproductive Health Research Center, Department of Infertility , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Sakineh Nourisaeidlou
- d Food and Beverages Safety Research Center , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
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28
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Cefalo CM, Conte C, Sorice GP, Moffa S, Sun VA, Cinti F, Salomone E, Muscogiuri G, Brocchi AA, Pontecorvi A, Mezza T, Giaccari A. Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial. Obesity (Silver Spring) 2018; 26:651-657. [PMID: 29504254 PMCID: PMC6175391 DOI: 10.1002/oby.22132] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim was to investigate whether vitamin D supplementation, combined with a hypocaloric diet, could have an independent effect on insulin sensitivity in subjects with both overweight and hypovitaminosis D. Changes from baseline in anthropometric parameters, body composition, glucose tolerance, and insulin secretion were considered as secondary outcomes. METHODS Eighteen volunteers who were nondiabetic and vitamin D deficient and had BMI > 25 kg/m2 were randomized (1:1) in a double-blind manner to a hypocaloric diet + either oral cholecalciferol at 25,000 IU/wk or placebo for 3 months. Hyperinsulinemic-euglycemic clamp to measure insulin sensitivity was performed at baseline and after intervention. RESULTS Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Serum 25-hydroxyvitamin D levels in the vitamin D group increased considerably (from 36.7 ± 13.2 nmol/L to 74.8 ± 18.7 nmol/L; P < 0.001). Insulin sensitivity in the vitamin D group improved (from 4.6 ± 2.0 to 6.9 ± 3.3 mg·kg-1 ·min-1 ; P < 0.001), whereas no changes were observed in the placebo group (from 4.9 ± 1.1 to 5.1 ± 0.3 mg·kg-1 ·min-1 ; P = 0.84). CONCLUSIONS Cholecalciferol supplementation, combined with a weight loss program, significantly improves insulin sensitivity in healthy subjects with obesity and might represent a personalized approach for insulin-resistant subjects with obesity.
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Affiliation(s)
- Chiara M.A. Cefalo
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Caterina Conte
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
- Internal Medicine and Transplant Unit, San Raffaele HospitalMilanItaly
| | - Gian Pio Sorice
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Simona Moffa
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Vinsin A. Sun
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Francesca Cinti
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Enrica Salomone
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
- Center for Diabetes and Metabolic Diseases, Association of Italian Knights of the Sovereign Military Order of MaltaRomeItaly
| | - Giovanna Muscogiuri
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
- Division of Endocrinology, Department of Clinical Medicine and SurgeryFederic II UniversityNaplesItaly
| | - Alex A.G. Brocchi
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Alfredo Pontecorvi
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Teresa Mezza
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
| | - Andrea Giaccari
- Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred HeartRomeItaly
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Daniele G, Winnier D, Mari A, Bruder J, Fourcaudot M, Pengou Z, Hansis-Diarte A, Jenkinson C, Tripathy D, Folli F. The potential role of the osteopontin-osteocalcin-osteoprotegerin triad in the pathogenesis of prediabetes in humans. Acta Diabetol 2018; 55:139-148. [PMID: 29151224 PMCID: PMC5816090 DOI: 10.1007/s00592-017-1065-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/15/2017] [Indexed: 01/10/2023]
Abstract
AIMS To examine the relationship between hormones involved in bone remodeling and glucose metabolism alterations in prediabetes. METHODS Individuals (n = 43) with NGT (BMI = 31.1 ± 1.1 kg/m2) and individuals (n = 79) with impaired glucose regulation (IGR) (BMI = 31.9 ± 1.2 kg/m2) including subjects with IFG, IGT, and IFG-IGT underwent OGTT and DXA. Osteopontin (OPN), osteocalcin (OCN), osteoprotegerin (OPG), and PTH levels were measured at fasting. Beta-cell function was calculated using C-peptide deconvolution. Dynamic indexes of insulin sensitivity were calculated from OGTT. A subgroup underwent to a euglycemic hyperinsulinemic clamp with 3-3H-glucose to estimate the endogenous glucose production (EGP) and insulin-mediated body glucose disposal (TGD/SSPI). RESULTS OPN was higher in IGR compared to NGT (5.3 ± 0.5 vs. 3.3 ± 0.2 μg/mL; p = 0.008) and in isolated IGT compared to IFG and IFG-IGT (6.3 ± 0.5 vs. 4.5 ± 0.3 and 5.4 ± 0.5 μg/mL; p = 0.02). OCN was similar in IFG and NGT but lower in IGT and IFG-IGT compared to NGT (7.2 ± 0.3 and 5.4 ± 0.2 vs. 8.3 ± 0.3 ng/mL; p < 0.01). OPN was positively correlated with HbA1c, fasting and 2 h plasma glucose and PTH. OCN was negatively correlated with body fat, 2 h plasma glucose, insulin and positively correlated with Stumvoll index. OPG correlated with TGD/SSPI (r = - 0.29; p < 0.05), EGP, and hepatic insulin resistance index in IGR (r = 0.51, r = 0.43; p < 0.01). There was no correlation between PTH and insulin sensitivity or Beta-cell function parameters. CONCLUSIONS In prediabetes, hormones known to be involved in bone remodeling may affect glucose metabolism before overt T2DM occurs with tissue-specific mechanisms.
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Affiliation(s)
- Giuseppe Daniele
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Deidre Winnier
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Andrea Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - Jan Bruder
- Department of Medicine, Endocrine division, University of Texas, Health Science Center, San Antonio, TX, USA
| | - Marcel Fourcaudot
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Zuo Pengou
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Andrea Hansis-Diarte
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Christopher Jenkinson
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Devjit Tripathy
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Franco Folli
- Department of Medicine, Division of Diabetes, University of Texas, Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
- Universita' degli Studi di Milano, School of Medicine, Dipartimento di Scienze Della Salute, Milan, Italy.
- Department of Medicine, Azienda Socio-Sanitaria Santi Paolo e Carlo, Via A. Di Rudini, 8, 20100, Milan, Italy.
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30
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Altieri B, Grant WB, Della Casa S, Orio F, Pontecorvi A, Colao A, Sarno G, Muscogiuri G. Vitamin D and pancreas: The role of sunshine vitamin in the pathogenesis of diabetes mellitus and pancreatic cancer. Crit Rev Food Sci Nutr 2018; 57:3472-3488. [PMID: 27030935 DOI: 10.1080/10408398.2015.1136922] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests that vitamin D exerts multiple effects beyond bone and calcium metabolism. Vitamin D seems to play a role in pancreatic disease, including type 1 and type 2 diabetes mellitus as well as pancreatic cancer. Vitamin D's immune-modulatory action suggests that it could help prevent type 1 diabetes. In type 2 diabetes, vitamin D may influence β-cell function, insulin sensitivity, and systematic inflammation-all characteristic pathways of that disease. Data from observational studies correlated vitamin D deficiency with risk of type 1 and type 2 diabetes. Prospective and ecological studies of pancreatic cancer incidence generally support a beneficial effect of higher 25-hydroxyvitamin D concentration as well as inverse correlations between UVB dose or exposure and incidence and/or mortality rate of pancreatic cancer. This review discusses the literature regarding vitamin D's role in risk of diabetes and pancreatic cancer. The results to date generally satisfy Hill's criteria for causality regarding vitamin D and incidence of these pancreatic diseases. However, large randomized, blinded, prospective studies are required to more fully evaluate the potential therapeutic role of vitamin D in preventing pancreatic diseases.
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Affiliation(s)
- Barbara Altieri
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - William B Grant
- b Sunlight , Nutrition, and Health Research Center , San Francisco , California , USA
| | - Silvia Della Casa
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Francesco Orio
- c Endocrinology, Department of Sports Science and Wellness , Parthenope University , Naples , Italy.,d Fertility Techniques SSD , San Giovanni di Dio e Ruggi D'Aragona University Hospital , Salerno , Italy
| | - Alfredo Pontecorvi
- a Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart , Rome , Italy
| | - Annamaria Colao
- e Department of Clinical Medicine and Surgery, Section of Endocrinology , University "Federico II," Naples , Italy
| | - Gerardo Sarno
- f Department of General Surgery and Transplantation Unit , San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana , Salerno , Italy
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31
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Piantanida E, Gallo D, Veronesi G, Dozio E, Trotti E, Lai A, Ippolito S, Sabatino J, Tanda ML, Toniolo A, Ferrario M, Bartalena L. Cardiometabolic healthy and unhealthy obesity: does vitamin D play a role? Endocr Connect 2017; 6:943-951. [PMID: 29089365 PMCID: PMC5717541 DOI: 10.1530/ec-17-0304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/31/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this observational study was to clarify the link between vitamin D status and metabolic syndrome (MetS) in people with visceral obesity. DESIGN AND METHODS One hundred ninety-six consecutive patients (152 women; mean age 51 ± 13 years) with visceral obesity (mean body weight 103 ± 20 kg, mean waist circumference (WC) 119 ± 13 cm) were enrolled at the Obesity Outpatient Clinic of the University of Insubria in Varese. Anthropometric measurements were recorded. Laboratory tests, including vitamin D (25(OH)D)), fasting blood glucose (FBG), lipid profile, liver and kidney function tests were assessed. Vitamin D status was defined according to the European Society of Endocrinology guidelines, MetS to the 2009 harmonized definition. RESULTS An inverse association emerged among 25(OH)D, body mass index (BMI) (P = 0.001) and WC (all P = 0.003). Serum 25(OH)D levels were inversely related to FBG and systolic blood pressure (SBP) (respectively, P = 0.01 and 0.02). Median serum 25(OH)D levels were 13.3 ng/mL (CI 95% 12; 15) in MetS and 16 ng/mL (CI 95% 14; 18) (P = 0.01) in non-MetS patients. Among patients with MetS, lower 25(OH)D concentrations were related to higher risk of hypertension (HT) (odds ratio (OR) 1.7, CI 95%, 0.7;4) and hyperglycemia (IFG)/type 2 diabetes (OR 5.5, CI 95% 2; 14). CONCLUSION Vitamin D status and MetS are inversely correlated in visceral obesity, particularly with regard to glucose homeostasis and BP. More extensive studies are required to investigate the potential for causality.
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Affiliation(s)
- Eliana Piantanida
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Daniela Gallo
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Giovanni Veronesi
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED)University of Insubria, Varese, Italy
| | - Eugenia Dozio
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Eugenia Trotti
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Adriana Lai
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Silvia Ippolito
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Jessica Sabatino
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Maria Laura Tanda
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
| | - Antonio Toniolo
- Department of Biotechnology and Life ScienceUniversity of Insubria, Varese, Italy
| | - Marco Ferrario
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED)University of Insubria, Varese, Italy
| | - Luigi Bartalena
- Department of Medicine and SurgeryUniversity of Insubria, Varese, Italy
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Vitamin D supplementation restores the blunted muscle protein synthesis response in deficient old rats through an impact on ectopic fat deposition. J Nutr Biochem 2017; 46:30-38. [DOI: 10.1016/j.jnutbio.2017.02.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/23/2017] [Accepted: 02/28/2017] [Indexed: 02/06/2023]
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Wang Q, Liu Y, Ma Y, Han L, Dou M, Zou Y, Sun L, Tian H, Li T, Jiang G, Du B, Kou T, Song J, Kok FJ, Schouten EG. Severe hypovitaminosis D in active tuberculosis patients and its predictors. Clin Nutr 2017; 37:1034-1040. [PMID: 28514999 DOI: 10.1016/j.clnu.2017.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/18/2017] [Accepted: 04/21/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). METHODS A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. RESULTS The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1%) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1%) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95% CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. CONCLUSIONS Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.
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Affiliation(s)
- Qiuzhen Wang
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China.
| | - Yufeng Liu
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Yan Ma
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Lei Han
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mei Dou
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Yue Zou
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Limei Sun
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Hong Tian
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Tongxia Li
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Guofeng Jiang
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Baoli Du
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Tingyan Kou
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Jiaqi Song
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Frans J Kok
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Evert G Schouten
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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Vigna L, Cassinelli L, Tirelli AS, Felicetta I, Napolitano F, Tomaino L, Mutti M, Barberi CE, Riboldi L. 25(OH)D Levels in Relation to Gender, Overweight, Insulin Resistance, and Inflammation in a Cross-Sectional Cohort of Northern Italian Workers: Evidence in Support of Preventive Health Care Programs. J Am Coll Nutr 2017; 36:253-260. [DOI: 10.1080/07315724.2016.1264280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Luisella Vigna
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Letizia Cassinelli
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Amedea Silvia Tirelli
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Irene Felicetta
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Filomena Napolitano
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Laura Tomaino
- Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore, Milano, ITALY
| | - Michela Mutti
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
| | - Claudia Eleonora Barberi
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore, Milano, ITALY
| | - Luciano Riboldi
- Department of Preventive Medicine, Workers Health Protection and Promotion Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, ITALY
- Department of Clinical Science and Community Health DISCCO, University of Milan, Milano, ITALY
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Sanghera DK, Sapkota BR, Aston CE, Blackett PR. Vitamin D Status, Gender Differences, and Cardiometabolic Health Disparities. ANNALS OF NUTRITION AND METABOLISM 2017; 70:79-87. [PMID: 28315864 DOI: 10.1159/000458765] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vitamin D deficiency is an unrecognized epidemic found in India and also worldwide. Despite the high prevalence of diabetes among Indians, there is a paucity of data showing the relationship between vitamin D status and cardiometabolic disparities. In this study, we have examined the relationship between vitamin D and cardiometabolic traits in a population from India. METHODS Circulating 25(OH)D levels were measured in 3,879 participants from the Asian Indian Diabetic Heart Study using ELISA kits. RESULTS Vitamin D levels were significantly reduced (p < 0.0001) in both men and women with obesity. However, compared to women, serum vitamin D was consistently lower in men (p < 0.02), irrespective of the presence of obesity and type 2 diabetes. Multivariate regression revealed strong interaction of vitamin D with body mass index that resulted in increased fasting glucose (p = 0.001) and reduced homeostasis model assessment of β-cell function (HOMA-B; p = 0.01) in normoglycemic individuals. However, in gender-stratified analysis, this association was restricted to men for both fasting glucose (p = 2.4 × 10-4) and HOMA-B (p = 0.001). CONCLUSIONS Our findings suggest that vitamin D deficiency may significantly enhance the risk of cardiometabolic disease among Asian Indians. Future randomized trials and genetic studies are expected to clarify the underlying mechanisms for gender differences in vitamin D deficiency, and whether vitamin D-driven improvement in testosterone may contribute to beneficial cardiometabolic outcomes in men.
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Affiliation(s)
- Dharambir K Sanghera
- Department of Pediatrics, Section of Genetics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Al-khalidi B, Kimball SM, Rotondi MA, Ardern CI. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutr J 2017; 16:16. [PMID: 28241878 PMCID: PMC5329954 DOI: 10.1186/s12937-017-0237-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/22/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Previously reported associations between vitamin D status, as measured by serum 25-hydroxyvitamin D [25(OH)D] concentrations, and cardiometabolic risk factors were largely limited by variability in 25(OH)D assay performance. In accordance with the Vitamin D Standardization Program, serum 25(OH)D measurement was recently standardized in the National Health and Nutrition Examination Survey (NHANES) to reduce laboratory and method related differences in serum 25(OH)D results. We evaluated the overall and ethnic-specific associations between the newly standardized serum 25(OH)D concentrations and cardiometabolic risk in U.S. adults. METHODS This study examined standardized 25(OH)D data from five cycles of the NHANES (2001-2010). The total sample included 7674 participants (1794 Mexican-Americans, 4289 non-Hispanic whites, and 1591 non-Hispanic blacks) aged ≥ 20 years who were examined in the morning after overnight fasting. Serum 25(OH)D was directly measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 2007-2010, and was predicted from LC-MS/MS equivalents for 2001-2006. Serum 25(OH)D levels were categorized into quartiles (<43.4, 43.4-58.6, 58.7-74.2, ≥74.3 nmol/L). Cardiometabolic risk was defined by the homeostatic model assessment of insulin resistance (HOMA-IR), metabolic syndrome (MetS), and Framingham cardiovascular disease (CVD) risk. Prevalence ratios and 95% confidence intervals were calculated using modified Poisson regression. RESULTS After full adjustment for confounders, serum 25(OH)D ≥74.3 nmol/L was associated with lower cardiometabolic risk compared to 25(OH)D <43.4 nmol/L in the overall sample [HOMA-IR: 0.70 (0.59, 0.84); MetS: 0.82 (0.74, 0.91); CVD risk: 0.78 (0.66, 0.91)]. These associations remained significant in Mexican-Americans [HOMA-IR: 0.54 (0.35, 0.82); MetS: 0.73 (0.55, 0.96)], non-Hispanic whites [HOMA-IR: 0.81 (0.68, 0.96); MetS: 0.84 (0.73, 0.95); CVD risk: 0.78 (0.64, 0.93)]; and in non-Hispanic blacks [HOMA-IR: 0.67 (0.45, 0.99); MetS: 0.75 (0.56, 0.97); CVD risk: 0.58 (0.41, 0.81)]. CONCLUSIONS Low vitamin D status is a significant risk factor for cardiometabolic disease in U.S. adults based on standardized serum 25(OH)D results, irrespective of ethnic background. Future studies using standardized 25(OH)D data are needed to confirm these results, particularly amongst U.S. blacks with 25(OH)D concentrations above 75 nmol/L.
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Affiliation(s)
- Banaz Al-khalidi
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
| | | | - Michael A. Rotondi
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
| | - Chris I. Ardern
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
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Affiliation(s)
- Gautam Das
- Department of Diabetes and Endocrinology, Prince Charles Hospital; Cwm Taf University Health Board; Merthyr Tydfil UK
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Abbas MA. Physiological functions of Vitamin D in adipose tissue. J Steroid Biochem Mol Biol 2017; 165:369-381. [PMID: 27520301 DOI: 10.1016/j.jsbmb.2016.08.004] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 12/14/2022]
Abstract
Adipose tissue has long been identified as the major site of vitamin D storage. Recent studies have demonstrated that VDR and vitamin D metabolizing enzymes are expressed in adipocytes. Furthermore, it has been shown that vitamin D regulates adipogenic gene expression as well as adipocyte apoptosis. Vitamin D is active in adipocytes at all levels. It interacts with membrane receptors, adaptor molecules, and nuclear coregulator proteins. Several functions of unliganded nVDR were discovered by studying human samples from patients having hereditary vitamin D resistant rickets, transgenic mice overexpressing the VDR and VDR knockout mice. Through its genomic action, vitamin D participates in the regulation of energy metabolism by controlling the expression of uncoupling proteins. In vitro, vitamin D stimulates lipogenesis and inhibits lipolysis by interacting with mVDR. mVDR is present in caveolae of the plasma membrane and is the same as the classic nVDR. In addition, vitamin D affects directly the expression of the appetite regulating hormone, leptin. Some researchers reported also that vitamin D regulates the expression of the insulin sensitizing hormone, adiponectin. Vitamin D reduced cytokine release and adipose tissue inflammation through the inhibition of NF-κB signaling. Scientific research investigating the role of adipose tissue resident immune cells in the pathogenesis of obesity-associated inflammation is scarce. Obesity is associated with vitamin D deficiency. However there is no scientific evidence to prove that vitamin D deficiency predispose to obesity. Vitamin D supplementation may prevent obesity but it does not lead to weight loss in obese subjects.
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ter Horst K, Versteeg R, Gilijamse P, Ackermans M, Heijboer A, Romijn J, la Fleur S, Trinko R, DiLeone R, Serlie M. The vitamin D metabolites 25(OH)D and 1,25(OH)2D are not related to either glucose metabolism or insulin action in obese women. DIABETES & METABOLISM 2016; 42:416-423. [DOI: 10.1016/j.diabet.2016.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/28/2016] [Accepted: 04/30/2016] [Indexed: 02/06/2023]
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40
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Wallace IR, McKinley MC, McEvoy CT, Hamill LL, Ennis CN, McGinty A, Bell PM, Patterson CC, Woodside JV, Young IS, Hunter SJ. Serum 25-hydroxyvitamin D and insulin resistance in people at high risk of cardiovascular disease: a euglycaemic hyperinsulinaemic clamp study. Clin Endocrinol (Oxf) 2016; 85:386-92. [PMID: 27175553 DOI: 10.1111/cen.13100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/02/2016] [Accepted: 05/10/2016] [Indexed: 01/21/2023]
Abstract
CONTEXT In observational studies, low serum 25-hydroxyvitamin D (25-OHD) concentration is associated with an increased risk of type 2 diabetes mellitus (DM). Increasing serum 25-OHD may have beneficial effects on insulin resistance or beta-cell function. Cross-sectional studies utilizing suboptimal methods for assessment of insulin sensitivity and serum 25-OHD concentration provide conflicting results. OBJECTIVE This study examined the relationship between serum 25-OHD concentration and insulin resistance in healthy overweight individuals at increased risk of cardiovascular disease, using optimal assessment techniques. METHODS A total of 92 subjects (mean age 56·0, SD 6·0 years), who were healthy but overweight (mean body mass index 30·9, SD 2·3 kg/m(2) ), underwent assessments of insulin sensitivity (two-step euglycaemic hyperinsulinaemic clamp, HOMA2-IR), beta-cell function (HOMA2%B), serum 25-OHD concentration and body composition (DEXA). RESULTS Mean total 25-OHD concentration was 32·2, range 21·8-46·6 nmol/l. No association was demonstrated between serum 25-OHD concentration and insulin resistance. CONCLUSIONS In this study using optimal assessment techniques to measure 25-OHD concentration, insulin sensitivity and body composition, there was no association between serum 25-OHD concentration and insulin resistance in healthy, overweight individuals at high risk of developing cardiovascular disease. This study suggests the documented inverse association between serum 25-OHD concentration and risk of type 2 DM is not mediated by a relationship between serum 25-OHD concentration and insulin resistance.
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Affiliation(s)
- I R Wallace
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
| | - M C McKinley
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - C T McEvoy
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - L L Hamill
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - C N Ennis
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - A McGinty
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - P M Bell
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - J V Woodside
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - I S Young
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science B, Belfast, UK
| | - S J Hunter
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
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Léger-Guist'hau J, Domingues-Faria C, Miolanne M, Peyrol F, Gerbaud L, Perreira B, Minet-Quinard R, Sapin V, Walrand S, Boirie Y. Low socio-economic status is a newly identified independent risk factor for poor vitamin D status in severely obese adults. J Hum Nutr Diet 2016; 30:203-215. [PMID: 27524803 DOI: 10.1111/jhn.12405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hypovitaminosis D is very prevalent, especially in the obese population. However, the degree of severity and the parameters involved in vitamin D deficiency in this population are still unclear. The present study aimed to identify, from among the factors known to influence vitamin D status in a healthy population, those impacting the same parameter in obese population. METHODS Serum 25-OH-D concentration was measured in 564 patients with class III obesity [i.e. severe and morbid obesity; mean (SD) body mass index (BMI) 42.04 (6.92) kg m-2 ] and their demographic, clinical, biological, anthropometric, dietary and socio-economic data were collected. RESULTS We observed that 96% of the obese patients had serum 25-OH-D lower than 30 ng mL-1 . Severe vitamin D deficiency (serum 25-OH-D concentration <10 ng mL-1 ) affected 35% of this population. We found an inverse relationship between 25-OH-D levels and BMI (P = 0.012), fat mass (P = 0.041), metabolic syndrome (P < 0.0001), fasting blood glucose (P = 0.023), homeostasis model assessment for insulin resistance (P = 0.008), waist circumference (P = 0.001), and fasting blood triglycerides (P = 0.002) and C-reactive protein (P = 0.005). Low socio-economic status independently increased the risk of severe vitamin D deficiency [odds ratio (OR) = 1.98; 95% confidence interval (CI) 1.25-3.13], especially in the autumn-winter season (OR = 2.94; 95% CI 1.98-4.36), morbid obesity (OR = 3.19; 95% CI 1.49-6.82), metabolic syndrome (OR = 1.6; 95% CI 1.06-2.42) and inflammation (OR = 1.03; 95% CI 1.01-1.06). CONCLUSIONS Vitamin D deficiency is extremely common among obese patients, and the prevalence of severe deficiency is high. The association of adiposity, high body mass index, metabolic syndrome and inflammation with vitamin D status is marked, whereas low socio-economic status appears to be a major risk factor for severe vitamin D deficiency, suggesting that vitamin D deficiency may at least in part be responsible for the greater health vulnerability of populations with low socio-economic status.
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Affiliation(s)
- J Léger-Guist'hau
- CHU Clermont-Ferrand, Service Nutrition Clinique, Clermont-Ferrand, France
| | - C Domingues-Faria
- INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France.,Unité de Nutrition Humaine, Clermont Université, Université d'Auvergne, Clermont-Ferrand, France
| | - M Miolanne
- CHU Clermont-Ferrand, Service Nutrition Clinique, Clermont-Ferrand, France
| | - F Peyrol
- CHU Clermont-Ferrand, Santé Publique, Clermont-Ferrand, France.,Clermont Université, Université d'Auvergne Clermont, Clermont-Ferrand, France
| | - L Gerbaud
- CHU Clermont-Ferrand, Santé Publique, Clermont-Ferrand, France.,Clermont Université, Université d'Auvergne Clermont, Clermont-Ferrand, France
| | - B Perreira
- CHU Clermont-Ferrand, Santé Publique, Clermont-Ferrand, France.,Clermont Université, Université d'Auvergne Clermont, Clermont-Ferrand, France
| | - R Minet-Quinard
- CHU Clermont-Ferrand, Service de Biochimie, Clermont-Ferrand, France
| | - V Sapin
- CHU Clermont-Ferrand, Service de Biochimie, Clermont-Ferrand, France
| | - S Walrand
- INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France.,Unité de Nutrition Humaine, Clermont Université, Université d'Auvergne, Clermont-Ferrand, France
| | - Y Boirie
- CHU Clermont-Ferrand, Service Nutrition Clinique, Clermont-Ferrand, France.,INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France.,Unité de Nutrition Humaine, Clermont Université, Université d'Auvergne, Clermont-Ferrand, France
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Motlaghzadeh Y, Sayarifard F, Allahverdi B, Rabbani A, Setoodeh A, Sayarifard A, Abbasi F, Haghi-Ashtiani MT, Rahimi-Froushani A. Assessment of Vitamin D Status and Response to Vitamin D3 in Obese and Non-Obese Iranian Children. J Trop Pediatr 2016; 62:269-75. [PMID: 26995012 DOI: 10.1093/tropej/fmv091] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obesity seems to be a critical issue nowadays because of its high prevalence and its adverse effects on health. There is some evidence indicating the relationship between obesity and lower serum 25-hydroxyvitamin D [25(OH)D] concentration. The aim of the present study was to examine serum 25(OH)D status of obese and non-obese Iranian children and compare their therapeutic response with identical oral vitamin D3 treatment. METHODS In a non-randomized clinical trial, serum 25(OH)D level of 45 obese and 45 non-obese Iranian children aged 2-14 years was measured. Those with serum 25(OH)D status <30 ng/ml (73 cases) were treated with one pearl of vitamin D3 (50 000 International Units) once a week for 6 weeks. Serum vitamin D was measured once more 2 weeks after treatment. RESULTS The frequency of hypovitaminosis D was 43/45 (95.6%) in obese and 30/45 (66.7%) in non-obese children at baseline (p < 0.001). After treatment of 73 cases (43 obese, 30 non-obese), the above percentages were decreased to 24/43 (55.8%) and 1/30 (3.3%), respectively (p < 0.001). CONCLUSION Our study demonstrated a high frequency of vitamin D deficiency among Iranian children, particularly the obese ones. Moreover, low therapeutic response in the obese group is witnessed.
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Affiliation(s)
- Yasaman Motlaghzadeh
- Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sayarifard
- Growth and Development Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Allahverdi
- Pediatric Gastroenterology and Hepetology Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rabbani
- Growth and Development Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Aria Setoodeh
- Growth and Development Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Abbasi
- Growth and Development Research Center, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Taghi Haghi-Ashtiani
- Department of Pathology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi-Froushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate. Obes Surg 2016; 25:2321-7. [PMID: 25910981 DOI: 10.1007/s11695-015-1685-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients who undergo bariatric surgery are at risk for micronutrient deficiencies. The aims of this study were to determine the prevalence and predictors of vitamin D deficiency in obese patients residing in the northern climate, and to evaluate the effectiveness of a daily maintenance dose of vitamin D 2000 IU in preventing hypovitaminosis D within 1 year after bariatric surgery. METHODS A cohort study involving adult patients undergoing RYGB was conducted. Longitudinal changes in serum vitamin D concentrations and clinical parameters were measured and collected. RESULTS Data from 134 recipients of RYGB were analyzed. Hypovitaminosis D was identified in 86 patients (64 %), and was significantly affected by seasonal change and the number of comorbidities. Follow-up data were available in 60 patients. Vitamin D sufficiency was achieved in 62.5 % of those patients with baseline vitamin D insufficiency. A dose-response relationship of vitamin D intake was observed, with the most significant increase in 25(OH)D associated with daily vitamin D intakes ≥ 2000 IU. CONCLUSIONS The prevalence of hypovitaminosis D before RYGB was comparable to patients living in the non-northern climate. Daily vitamin D intake meeting at least 2000 IU is associated with greater improvement in serum vitamin D concentration.
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Wallace IR, Wallace HJ, McKinley MC, Bell PM, Hunter SJ. Vitamin D and insulin resistance. Clin Endocrinol (Oxf) 2016; 84:159-171. [PMID: 25727561 DOI: 10.1111/cen.12760] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/06/2014] [Accepted: 02/26/2015] [Indexed: 12/28/2022]
Abstract
Vitamin D is a steroid hormone, which in active form binds to the vitamin D receptor. Expression of the vitamin D receptor in diverse cell types (pancreatic islet cells, myocytes, hepatocytes and adipocytes) raises the suspicion that vitamin D may be involved in multiple cellular processes, including the response to insulin. Insulin resistance is a characteristic feature of type 2 DM, and its attenuation may reduce the incidence of type 2 DM and cardiovascular disease. In observational studies, low serum 25-hydroxyvitamin D (25-OHD) concentrations are associated with an increased risk of type 2 DM. It has been suggested that increasing serum 25-OHD concentrations may have beneficial effects on glucose and insulin homeostasis. However, cross-sectional and interventional studies of vitamin D supplementation provide conflicting results and demonstrate no clear beneficial effect of vitamin D on insulin resistance. These studies are complicated by inclusion of different patient cohorts, different 25-OHD assays and different doses and preparations of vitamin D. Any possible association may be confounded by alterations in PTH, 1,25-dihydroxyvitamin D or tissue vitamin D concentrations. We identified 39 studies via MEDLINE and PUBMED. We review the evidence from 10 studies (seven observational and three interventional) examining vitamin D and type 2 DM incidence, and 29 studies (one prospective observational, 12 cross-sectional and 16 interventional trials) examining vitamin D and insulin resistance. Based on this data, it is not possible to state that vitamin D supplementation has any effect on type 2 DM incidence or on insulin resistance. Data from the multiple ongoing randomized controlled trials of vitamin D supplementation due to report over the next few years should help to clarify this area.
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Affiliation(s)
- Ian R Wallace
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
- Nutrition and Metabolism Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Helen J Wallace
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
- Nutrition and Metabolism Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Michelle C McKinley
- Nutrition and Metabolism Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Patrick M Bell
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
| | - Steven J Hunter
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
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Muscogiuri G, Nuzzo V, Gatti A, Zuccoli A, Savastano S, Di Somma C, Pivonello R, Orio F, Colao A. Hypovitaminosis D: a novel risk factor for coronary heart disease in type 2 diabetes? Endocrine 2016; 51:268-73. [PMID: 25931413 DOI: 10.1007/s12020-015-0609-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 04/15/2015] [Indexed: 12/21/2022]
Abstract
Vitamin D (25(OH)D) levels have been associated with cardiovascular disease. Thus, the aim of our study was to investigate the association of 25(OH)D levels with coronary heart disease (CHD) in 698 consecutive type 2 diabetic outpatients. 698 consecutive type 2 diabetic outpatients (25.2 % men, age 66 ± 9 years) and 100 (90 % men, age 65 ± 13 years) age-matched non-diabetic volunteers were enrolled. 25(OH)D assay and the main cardiovascular risk factors were explored. 25(OH)D concentration was 22 ± 10 ng/ml in control subjects and 18.23 ± 10 ng/ml in diabetic patients (p < 0.01). The prevalence of hypovitaminosis D was higher in diabetic patients than in control subjects (90 vs. 83 %, p < 0.01). Diabetic subjects with hypovitaminosis D had higher prevalence of high values of A1C (p < 0.01), BMI (p < 0.01), LDL cholesterol (p < 0.01), triglycerides (p < 0.01), and glycemia (p < 0.01) than their vitamin D-sufficient counterparts. 25(OH)D and HDL cholesterol were lower (p < 0.01), while BMI (p < 0.01), age (p < 0.01), systolic (p < 0.01) and diastolic blood pressure (p < 0.01), diabetes duration (p < 0.01), A1C (p < 0.01), glycemia (p < 0.01), fibrinogen (p < 0.01), triglycerides (p < 0.01), and total (p < 0.01) and LDL cholesterol (p < 0.01) were higher in diabetic subjects with CHD than diabetic subjects without CHD. At the logistic regression analysis, the association of vitamin D with CHD was lost, while sex (p = 0.026), diabetes duration (p = 0.023), and age (p = 0.024) were the most powerful predictors of CHD. The current study demonstrates that 25(OH)D does not have a direct effect on CHD but may have an indirect effect mediated by cardiovascular risk factors such as diabetes duration, age, and sex.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy.
| | - Vincenzo Nuzzo
- Internal Medicine Unit, San Gennaro Hospital, Naples, Italy
| | - Adriano Gatti
- Diabetology Unit, San Gennaro Hospital, Naples, Italy
| | | | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
| | | | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
| | - Francesco Orio
- Department of Endocrinology, University "Parthenope" Naples, Naples, Italy
- Endocrinology of Fertile Age, "S. Giovanni di Dio e Ruggi d'Aragona" University Hospital Salerno, Salerno, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
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Qi Q, Zheng Y, Huang T, Rood J, Bray GA, Sacks FM, Qi L. Vitamin D metabolism-related genetic variants, dietary protein intake and improvement of insulin resistance in a 2 year weight-loss trial: POUNDS Lost. Diabetologia 2015; 58:2791-9. [PMID: 26416604 PMCID: PMC4631625 DOI: 10.1007/s00125-015-3750-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/21/2015] [Indexed: 12/22/2022]
Abstract
AIMS/HYPOTHESIS Vitamin D and related genetic variants are associated with obesity and insulin resistance. We aimed to examine whether vitamin D metabolism-related variants affect changes in body weight and insulin resistance in response to weight-loss diets varying in macronutrient content. METHODS Three vitamin D metabolism-related variants, DHCR7 rs12785878, CYP2R1 rs10741657 and GC rs2282679, were genotyped in 732 overweight/obese participants from a 2 year weight-loss trial (POUNDS Lost). We assessed genotype effects on changes in body weight, fasting levels of glucose and insulin, and HOMA-IR at 6 months (up to 656 participants) and 2 years (up to 596 participants) in response to low-protein vs high-protein diets, and low-fat vs high-fat diets. RESULTS We found significant interactions between DHCR7 rs12785878 and diets varying in protein, but not in fat, on changes in insulin and HOMA-IR at both 6 months (p for interaction <0.001) and 2 years (p for interaction ≤ 0.03). The T allele (vitamin-D-increasing allele) of DHCR7 rs12785878 was associated with greater decreases in insulin and HOMA-IR (p < 0.002) in response to high-protein diets, while there was no significant genotype effect on changes in these traits in the low-protein diet group. Generalised estimating equation analyses indicated significant genotype effects on trajectory of changes in insulin resistance over the 2 year intervention in response to high-protein diets (p < 0.001). We did not observe significant interaction between the other two variants and dietary protein or fat on changes in these traits. CONCLUSIONS/INTERPRETATION Our data suggest that individuals carrying the T allele of DHCR7 rs12785878 might benefit more in improvement of insulin resistance than noncarriers by consuming high-protein weight-loss diets. TRIAL REGISTRATION ClinicalTrials.gov NCT00072995.
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Affiliation(s)
- Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Yan Zheng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Tao Huang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Jennifer Rood
- LSU, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - George A Bray
- LSU, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA.
- Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Wright CS, Weinheimer-Haus EM, Fleet JC, Peacock M, Campbell WW. The Apparent Relation between Plasma 25-Hydroxyvitamin D and Insulin Resistance is Largely Attributable to Central Adiposity in Overweight and Obese Adults. J Nutr 2015; 145:2683-9. [PMID: 26446485 PMCID: PMC4656909 DOI: 10.3945/jn.115.220541] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/10/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Research indicates that plasma 25-hydroxyvitamin D [25(OH)D] is associated with insulin resistance, but whether regional adiposity confounds this association is unclear. OBJECTIVE This study assessed the potential influence of adiposity and its anatomical distribution on the relation between plasma 25(OH)D and insulin resistance. METHODS A secondary analysis of data from middle-aged overweight and obese healthy adults [n = 336: 213 women and 123 men; mean ± SD (range); age: 48 ± 8 y (35-65 y); body mass index (BMI; in kg/m2): 30.3 ± 2.7 (26-35)] from West Lafayette, Indiana (40.4 °N), were used for this cross-sectional analysis. Multiple linear regression analyses that controlled for multiple covariates were used as the primary statistical model. RESULTS Of all participants, 8.6% and 20.5% displayed moderate [20.1-37.5 nmol/L plasma 25(OH)D] to mild (37.6-49.9 nmol/L) vitamin D insufficiency, respectively. A regression analysis controlling for age, sex, race, plasma parathyroid hormone concentration, season of year, and supplement use showed that 25(OH)D was negatively associated with fasting insulin (P = 0.021). Additional regression analyses showed that total and central adiposity but not peripheral adiposity predicted low plasma 25(OH)D [total fat mass index (FMI): P = 0.018; android FMI: P = 0.052; gynoid FMI: P = 0.15; appendicular FMI: P = 0.07) and insulin resistance (homeostasis model assessment of insulin resistance: total and android FMI, P <0.0001; gynoid FMI, P = 0.94; appendicular FMI, P = 0.86). The associations of total and central adiposity with insulin resistance remained significant after adjusting for plasma 25(OH)D. However, adjusting for central adiposity but not other anatomical measures of fat distribution eliminated the association between plasma 25(OH)D and insulin resistance. CONCLUSION Central adiposity drives the association between plasma 25(OH)D and insulin resistance in overweight and obese adults. The trial was registered at clinicaltrials.gov as NCT00812409.
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Affiliation(s)
- Christian S Wright
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | | | - James C Fleet
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Munro Peacock
- Department of Medicine, Indiana University, Indianapolis, IN
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
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Rabenberg M, Scheidt-Nave C, Busch MA, Rieckmann N, Hintzpeter B, Mensink GBM. Vitamin D status among adults in Germany--results from the German Health Interview and Examination Survey for Adults (DEGS1). BMC Public Health 2015; 15:641. [PMID: 26162848 PMCID: PMC4499202 DOI: 10.1186/s12889-015-2016-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/03/2015] [Indexed: 12/31/2022] Open
Abstract
Background In 1998, more than half of the adult population in Germany had serum 25-hydroxy-vitamin-D [25(OH)D] levels below the common threshold of 50 nmol/l. Since then, there has been a lot of attention for vitamin D in the scientific community, the media and the general population and serum 25(OH)D levels may have increased as a consequence. With data from the ‘German Health Interview and Examination Survey for Adults’ (DEGS1) the current situation of vitamin D status can be analysed. Methods DEGS1, a national health survey among adults in Germany conducted by the Robert Koch Institute between 2008 and 2011, included 6,995 persons with available serum 25(OH)D levels. We calculated the proportion of participants with serum 25(OH)D levels <30 nmol/l, 30- < 50 nmol/l and > =50 nmol/l overall and according to age, season and latitude of residence as well as percentiles of serum 25(OH)D according to month of examination. Determinants of vitamin D status were analysed with multiple linear regression models. Results Mean serum 25(OH)D level was 45.6 nmol/l with no significant sex differences (p = 0.47). 61.6 % of the participants had serum 25(OH)D levels <50 nmol/l, 30.2 % had levels <30 nmol/l. During summer, half of the participants had levels > =50 nmol/l, during winter time, 25 % of the participants had levels <30 nmol/l. A significant latitudinal gradient was observed in autumn for men and in winter for women. In multiple linear regression analyses, examination during winter time, residing in northern latitude, non-use of vitamin D supplements, low sport activity, high Body Mass Index (BMI) and high media consumption were independently and significantly associated with lower serum 25(OH)D levels in both sexes. In addition, among women, significant associations with lower 25(OH)D levels were observed for older age and lower socio-economic status, among men, for low vitamin D intake and more residential traffic. Conclusions Serum 25(OH)D levels below the threshold of 50 nmol/l are still common among adults in Germany, especially during winter and spring and in higher latitudes. Potentially modifiable factors of poorer vitamin D status are higher BMI, lack of sport activity and high media use.
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Affiliation(s)
- Martina Rabenberg
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Markus A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Nina Rieckmann
- Berlin School of Public Health, Charité - Universitätsmedizin, Berlin, Germany.
| | | | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
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Strange RC, Shipman KE, Ramachandran S. Metabolic syndrome: A review of the role of vitamin D in mediating susceptibility and outcome. World J Diabetes 2015; 6:896-911. [PMID: 26185598 PMCID: PMC4499524 DOI: 10.4239/wjd.v6.i7.896] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/01/2015] [Accepted: 03/05/2015] [Indexed: 02/05/2023] Open
Abstract
Despite the well-recognised role of vitamin D in a wide range of physiological processes, hypovitaminosis is common worldwide (prevalence 30%-50%) presumably arising from inadequate exposure to ultraviolet radiation and insufficient consumption. While generally not at the very low levels associated with rickets, hypovitaminosis D has been implicated in various very different, pathophysiological processes. These include putative effects on the pathogenesis of neoplastic change, inflammatory and demyelinating conditions, cardiovascular disease (CVD) and diabetes. This review focuses on the association between hypovitaminosis D and the metabolic syndrome as well as its component characteristics which are central obesity, glucose homeostasis, insulin resistance, hypertension and atherogenic dyslipidaemia. We also consider the effects of hypovitaminosis D on outcomes associated with the metabolic syndrome such as CVD, diabetes and non-alcoholic fatty liver disease. We structure this review into 3 distinct sections; the metabolic syndrome, vitamin D biochemistry and the putative association between hypovitaminosis D, the metabolic syndrome and cardiovascular risk.
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Cardoso-Sánchez LI, Gómez-Díaz RA, Wacher NH. Vitamin D intake associates with insulin resistance in type 2 diabetes, but not in latent autoimmune diabetes in adults. Nutr Res 2015; 35:689-99. [PMID: 26101151 DOI: 10.1016/j.nutres.2015.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 01/28/2023]
Abstract
This study aimed to evaluate the relationship between vitamin D (vitD) intake and serum concentrations and insulin secretion (assessed by C-peptide serum concentration)/insulin resistance (determined by estimated glucose disposal rate [eGDR]) in patients with latent autoimmune diabetes in adults (LADA) and type 2 diabetes (T2DM). C-peptide, serum vitD, lipid profile, insulin, glucose, and glycosylated hemoglobin (HbA1c) were assessed; vitD intake was determined; and eGDR was calculated. Groups were compared using the Student t or Mann-Whitney U test. Correlations were performed between insulin secretion, insulin resistance, and vitD, and linear regression models were adjusted for confounding variables. Of 107 patients included, age was 55.3 ± 11.84 years old, and time since diabetes diagnosis was 13.23 ± 5.96 years. There were significant intergroup differences in age, body mass index (BMI), hip measurements, glucose, and HbA1c. The correlation between vitD intake and C-peptide for the whole group was significant (r = 0.213; P = .032) as well as for vitD deficiency/sufficiency in T2DM (P = .042), whereas neither was significant in eGDR. After adjustment for age, HbA1c, disease progression, physical activity, solar exposure, sex, and BMI, vitD intake was only significant in T2DM (P = .028). In serum vitD, only the correlation between eGDR and vitD in T2DM was significant and intragroup when comparing vitD sufficiency. After adjustments, significance was lost. Patients with LADA had lower intake of vitD, poorer metabolic control, lower BMI, and younger age compared to T2DM patients. There was no association between serum vitD or vitD intake and insulin secretion when analyzed by group, although vitD intake was associated with insulin resistance in T2DM, but not LADA.
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Affiliation(s)
| | - Rita A Gómez-Díaz
- Unidad de Investigación en Epidemiología Clínica, Centro Médico Nacional Siglo XXI, DF, Mexico.
| | - Niels H Wacher
- Unidad de Investigación en Epidemiología Clínica, Centro Médico Nacional Siglo XXI, DF, Mexico
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