Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 10, 2016; 7(5): 89-100
Published online Mar 10, 2016. doi: 10.4239/wjd.v7.i5.89
Role of vitamin D in diabetes mellitus and chronic kidney disease
Akio Nakashima, Keitaro Yokoyama, Takashi Yokoo, Mitsuyoshi Urashima
Akio Nakashima, Keitaro Yokoyama, Takashi Yokoo, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo 105-8461, Japan
Akio Nakashima, Mitsuyoshi Urashima, Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo 105-8461, Japan
Author contributions: Nakashima A, Yokoyama K and Yokoo T contributed equally to the work performing the literature review and writing the manuscript; Urashima M provided support with proofing and editing paper; all authors reviewed and edited the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitsuyoshi Urashima, MD, PhD, MPH, Division of Molecular Epidemiology, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan. urashima@jikei.ac.jp
Telephone: +81-3-34331111 Fax: +81-3-54001250
Received: August 28, 2015
Peer-review started: September 5, 2015
First decision: November 24, 2015
Revised: December 24, 2015
Accepted: January 16, 2016
Article in press: January 19, 2016
Published online: March 10, 2016
Abstract

Approximately 30%-50% of people are recognized to have low levels of vitamin D, and insufficiency and deficiency of vitamin D are recognized as global health problems worldwide. Although the presence of hypovitamin D increases the risk of rickets and fractures, low vitamin D levels are also associated with hypertension, cancer, and cardiovascular disease. In addition, diabetes mellitus (DM) and chronic kidney disease (CKD) are also related to vitamin D levels. Vitamin D deficiency has been linked to onset and progression of DM. Although in patients with DM the relationship between vitamin D and insulin secretion, insulin resistance, and β-cell dysfunction are pointed out, evidence regarding vitamin D levels and DM is contradictory, and well controlled studies are needed. In addition, vitamin D influences the renin-angiotensin system, inflammation, and mineral bone disease, which may be associated with the cause and progression CKD. There is increasing evidence that vitamin D deficiency may be a risk factor for DM and CKD; however, it remains uncertain whether vitamin D deficiency also predisposes to death from DM and CKD. Although at this time, supplementation with vitamin D has not been shown to improve glycemic control or prevent incident DM, clinical trials with sufficient sample size, study periods, and optimal doses of vitamin D supplementation are still needed. This review focuses on the mechanism of vitamin D insufficiency and deficiency in DM or CKD, and discusses the current evidence regarding supplementation with vitamin D in patients with these diseases.

Keywords: Vitamin D, Vitamin D deficiency, Diabetes mellitus, Chronic kidney disease, Cardiovascular disease

Core tip: Vitamin D plays an essential role in diabetes mellitus (DM) and chronic kidney disease (CKD). The relationship between vitamin D and insulin secretion, insulin resistance, and β-cell dysfunction are pointed out. Vitamin D deficiency has been linked with the renin-angiotensin system and inflammation, which may be associated with the cause and progression CKD. There is increasing evidence that vitamin D deficiency may be a risk factor for DM and CKD. Clinical trials with sufficient sample size, study periods, and optimal doses of vitamin D supplementation are still needed.