Havva SERT, Serap ÇETİNKAYA, Dilek AYGİN

D Vitaminin Obezite, Diabetes Mellitus, Hipertansiyon ve Kanser İle İlişkisi

D vitamini kalsiyum ve fosfor metabolizmasını düzenleyen, yağda eriyen vitaminler arasında yer alan ve diğer vitaminlerden farklı olarak vücutta üretilen hormon ve hormon öncüleri olan bir grup steroldür. D vitamininin sadece kemik, böbrek ve bağırsak üzerinde değil, aynı zamanda beyin, prostat, meme, kolon, pankreas, immün hücreler, kaslar, endotel ve miyokard olmak üzere pek çok organ üzerinde de etkisi olduğu belirtilmektedir. D vitamini pankreasta Beta hücreleri üzerinde stokinlerin neden olduğu hücre harabiyetini engeller, insülin salınımını uyarır, kardiyovasküler sistemde köpük hücre oluşumunu ve makrofajların kolesterol alımını inhibe eder, ayrıca vasküler düz kas hücrelerin proliferasyonunu azaltır, lenfositlerden salınan sitokinlerin inhibisyonu ile endotel hücrelerinde adezyon moleküllerinin üretimini baskılayarak ateroskleroz gelişimini engeller. Aynı zamanda vitamin D' nin aktif formu olan 1,25(OH)2D, renin seviyelerini baskılayarak antihipertansif etki gösterir. Vitamin D’nin endokrin ve kardiyovasküler sisteme olan bu etkileri göz önüne alındığında eksikliğinin pek çok hastalığa yol açabileceği düşünülmektedir. Son yıllarda yapılan çalışmalarda D vitamini eksikliğinin insulin direncini, metabolik sendrom riskini artırdığı, obezite, kanser, Tip 1, Tip 2 DM ve hipertansiyon gibi birçok hastalık için risk faktörü olduğu görülmektedir. Çalışma, D vitamini eksikliğinin obezite, diabetes mellitus, hipertansiyon ve kanser arasındaki ilişki üzerine mevcut literatürü gözden geçirmeyi hedeflemektedir.

Anahtar Kelimeler:

D vitamini eksikliği, Obezite, Diabetes Mellitus, Hipertansiyon, Kanser

D Vitaminin Obezite, Diabetes Mellitus, Hipertansiyon ve Kanser İle İlişkisi

Vitamin D is a group of sterols that regulate calcium and phosphorus metabolisma are one of the fat-soluble vitamins and among hormones and hormone precursors produced in thebody unlike the other vitamins. Vitamin D is reported to have an effect not only on bone, kidney, and intestine, but also on many organs such as brain, prostate, breast, colon, pancreas,immune cells, muscles, and including myocardium and endothelium. Vitamin D prevents the damage of cells caused by cytokines in the pancreason Beta cells, stimulates insulin secretion,inhibits formation of the foam cell in the cardiovascular system and the cholesterol intake of macrophages, and also reduces the proliferation of vascular smooth muscle cells,and inhibitsthe development of atherosclerosis by suppressing the production of adhesion molecules in endothelial cells with the inhibition of cytokines released from lymphocytes. At the sametime, 1,25(OH)2D,which is the active form of vitamin D shows an antihypertensive effect by suppressing the levels of renin. Upon taking those effects of vitamin D on endocrine andcardiovascular systems into account, a lack of it is thought to lead to many health problems. Studies having been conducted in recent years show that vitamin D deficiency increasesinsulin resistance and the risk of metabolic syndrome and seems to be a risk factor for many diseases such as obesity, cancer, Type1, Type 2 Diabetes Mellitus (DM) and hypertension.Our study aims to review existing literature on relationship between vitamin D deficiency and obesity, diabetes mellitus , hypertension and cancer

Keywords:

Vitamin D deficiency, diabetes mellitus, hypertension, cancer,

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Fidan F, Alkan B M, Tosun A. Çağın Pandemisi: D vitamini eksikliği ve
yetersizliği. Türk Osteoporoz Dergisi 2014;20:71-4.
Wacker M, Holick M. Vitamin D-effects on skeletal and extraskeletal health
and the need for supplementation. Nutrients 2013;5(1):111-148.
Ataş A, Çakmak A, Soran M. Metabolism of Vitamin D and Rickets disease,
BTDMJB 2008;4(1):1-7.
Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: An Evidence-
Based Review. J Am Board Fam Med 2009; 22(6):698-706.
Tellioğlu A, Başaran S. Güncel bilgiler ışığında Vitamin D. Arşiv Kaynak
Tarama Dergisi 2013; 22(2): 259-271.
Djennane M, Lebbah S, Roux C, Souberbielle J, Djoudi H, Cavalier E. Vitamin
D status of schoolchildren in Northern Algeria, seasonal variations and
determinants of vitamin D deficiency. Osteoporos Int 2014; 25(5): 1493-
-
Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal
health: A review. Altern Med Rev 2005; 10: 94-111.
Goh KS, Zhang D, Png GK, Lin H, Ang W, Low S, Lim J. Vitamin D Status
in Elderly Inpatients in a Tertiary Hospital in Singapore. J Am Geriatr Soc
; 7:1398.
Grover SR, Morley R. Vitamin D deficiency in veiled or dark-skinned
pregnant women. Med J Aust 2001;5:251-252.
Kmie
Vitamin D deficiency during winter months among an adult, predominantly
urban, population in northern Poland. Endokrynol Pol 2014;65(2):105-113.
Pereira-Santos, Costa P, Santos C, Santos D. Obesity and vitamin D
deficiency: A systematic review and meta-analysis. Obes Rev 2015;16(4):
-349.
Bachhel R, Singh NR, Sidhu JS. Prevalence of vitamin D deficiency in northwest
Punjab population: A cross-sectional study. Int J App Basic Med Res
;5(1):7-11.
Forman JP, Williams JS, Fisher NL. Plasma 25-Hydroxyvitamin D and
regulation of the renin-angiotensin system in humans. Hypertension 2010;
(5): 1283-1288.
Bilge U, Ünalacak M, Ünlüoglu I, Ipek M., Çeler Ö, Akalin A. Relationship
between 1,25-dihydroxy Vitamin D levels and homeostatic model
assessment insulin resistance values in obese subjects. Niger J Clin Pract
;18(3):377-380.
Ghanei L, Ziaee A, Rostami P, Oveisi S, Esmailzadehha N, Kazemifar AM,
Zargar A. Association of serum 25-hydroxyvitamin d levels and vitamin d
dietary intake with metabolic syndrome: a case control study. J Res Health
Sci 2015; 15(1): 32-36.
Griz L, Bandeira F, Gabbay M, Dib S, de Carvalho E. Vitamin D and diabetes
mellitus: an update-2013. Arq Bras Endocrinol Metab 2014; 58(1):1-8.
Shi L, Nechuta S, Gao Y, Zheng Y, Dorjgochoo T, Wu J, Shu XO. Correlates
of 25-hydroxyvitamin D among Chinese breast cancer patients. Plos One
; 9(1):
World Health Organization. Obesity and overweight. http://www.who.int/
mediacentre/factsheets/fs311/en/ erişim tarihi: 05.10.2015.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the
United States, 2009-2010. NCHS Data Brief. 2012;(82):1-8.
Satman I, Yilmaz T, Sengul A, Salman S, Salman F, Uygur S, Bastar
I, Tütüncü Y, Sargın M, Diççağ N, Karsıdag K, Kalaça S, Özcan C, King
H. Population-based study of diabetes and risk characteristics in Turkey:
results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care
;25:1551–6.
Abacı A. Kardiyovasküler risk faktörlerinin ülkemizdeki durumu. Arch Turk
Soc Cardiol 2011;39 Suppl 4:1-5.
Türkiye İstatistik Kurumu, Sağlık Araştırması 2012. http://www.tuik.gov.
tr/Kitap.do?metod=KitapDetay&KT_ID=1&KITAP_ID=223. erişim tarihi:
08.2015.
T.C.Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu Türkiye Sağlıklı Beslenme
ve Hareketli Hayat Programı 2014-2017. http://diyabet.gov.tr/content/
files/yayinlar/kitaplar/turkiye_sagliklibeslenme_ve_hareketli_hayat_
programi.2014_2017.pdf erişim tarihi: 17.07.2015.
Türkiye Halk Sağlığı Kurumu Obezite, Diabet ve Metabolik Hastalıklar
Daire Başkanlığı. Obezitenin Nedenleri. http://beslenme.gov.tr/index.
php?lang=tr&page=41 erişim tarihi: 25.09.2015.
Pereira-Santos, Costa P, Santos C, Santos D. Obesity and vitamin D
deficiency: A systematic review and meta-analysis. Obes Rev 2015;16(4):
-349.
Zhang L, Wang S, Che X, Li X. Vitamin D and lung cancer risk: a
comprehensive review and meta-analysis. CELL PHYSIOL BIOCHEM
;36(1): 299-305.
Saliba W, Barnett-Griness O, Rennert G. Obesity and association of serum
(OH)D levels with all-cause mortality. Calcif Tissue Int 2014;95(3):222-
-
González L, Ramos-Trautmann G, Díaz-Luquis GM, Pérez CM, Palacios C.
Vitamin D status is inversely associated with obesity in a clinic-based sample
in Puerto Rico. Nutrition Research 2015;35(4):287-293.
Heller JE, Thomas JJ, Hollis, BW, Larson-Meyer DE. Relation between
vitamin D status and body composition in collegiate athletes. Int J Sport
Nutr Exerc Metab 2015;25(2):128-135.
Bhatt SP, Misra A, Sharma M, Guleria R, Pandey RM, Luthra K, Vikram NK.
(). Vitamin D insufficiency is associated with abdominal obesity in Urban
Asian Indians without diabetes in North India. Diabetes Technol Ther 2014;
(6):392-397.
Marcotorchino J, Tourniaire F, Astier J, Karkeni E, Canault M, Amiot MJ,
Bendahan D, Bernard M, Martin JC, Giannesini B, Landrier JF. Vitamin D
protects against diet-induced obesity by enhancing fatty acid oxidation. J
Nutr Biochem 2014;25(10):1077-83.
Grønborg IM., Lundby IM., Mølgaard C, Jakobsen J, Ovesen L, Andersen R.
(). Association of body fat and vitamin D status and the effect of body fat
on the response to vitamin D supplementation in Pakistani immigrants in
Denmark. Eur J Clin Nutr 2015;69(3):405-407.
Chandler PD. Scott JB, Drake BF, Ng K, Chan AT, Hollis BW, Emmons KM,
Giovannucci EL, Fuchs CS, Bennett GG. Impact of vitamin D supplementation
on adiposity in African-Americans. Nutr Diabetes 2015;5(6):164-165.
Pathak K, Soares MJ, Calton EK, Zhao Y, Hallett J. Vitamin D supplementation
and body weight status: a systematic review and meta-analysis of
randomized controlled trials. Obes Rev 2014;15(6):528-537.
Yalçın GS. Yeni Tespit Tip 2 Diabetes Mellituslu Hastalarda Pankreas
Beta Hücre Rezervinin Değerlendirilmesi. Uzmanlık Tezi 2004, T.C. Sağlık
Bakanlığı Şişli Etfal Eğitim ve Araştırma Hastanesi, İstanbul.
Eroğlu Altinova A, Yetkın İ. Tip 1 Diabetes Mellitus'a yatkınlıkta rolü olabilecek genetik faktörler. MMJ 2011;24(2):126-130.
Türk Diyabet Vakfı, Diabet Tanı ve Tedavi Rehberi 2013. http://www.turkdiab.org/i/2013/D%C4%B0YABET%20REHBER%C4%B0%202013.pdf
erişim tarihi: 15.08.2015.
Steyn NP, Mann J, Bennett PH, Temple N, Zimmet P, Tuomilehto J,
Lindström J, Louheranta A. Diet, nutrition and the prevention of type 2
diabetes. Public Health Nutr. 2004 Feb;7(1A):147-65.
Ahmad S, Chowdhury TA, Boucher BJ. Diabetes and cancer: Could vitamin D
provide the link?. Journal Of Diabetes And Its Complications 2013;27:184-
-
Naharcı Mİ, Bozoğlu E, Karadurmuş N, Türker T, Serdar MA, DorukH.
Prediyabetli yaşlılarda vitamin D düzeylerine göre insülin duyarlılığının
incelenmesi. Gulhane Med J 201153(4):271-276.
Badawi A, Sayegh S, Sadoun E, Al-Thani M, Arora P, Haddad PS. Relationship
between insulin resistance and plasma vitamin D in adults. Diabetes Metab
Syndr Obes 2014;7: 297-303.
Cândido FG, Bressan J. Vitamin D: Link between Osteoporosis, Obesity, and
Diabetes?. Int J Mol Sci. 2014; 15(4): 6569-6591.
Zhou J, Chen H., Wang Z, Li Y, Li M, Xiang H. Effects of vitamin D
supplementation on insulin resistance in patients with type 2 diabetes
mellitus. Zhonghua yi xue za zhi2014;94(43):3407-3410.
Nasri H, Behradmanesh S, Maghsoudi AR, Ahmadi A, Nasri P, Rafieian-
Kopaei M. Efficacy of supplementary vitamin D on improvement of glycemic
parameters in patients with type 2 diabetes mellitus; a randomized double
blind clinical trial. J Renal Inj Prev 2014;3(1):31-34.
Veronese N, Sergi G, De Rui M, Bolzetta F, Toffanello ED, Zambon S, Corti
MC, Sartori L, Musacchio E, Baggio G, Crepaldi G, Perissinotto E, Manzato
EJ. Clin Endocrinol Metab 2014;99(7):2351- 8.
Al-Sofiani ME, Jammah A, Racz M, Khawaja RA, Hasanato R, El-Fawal HN,
Mason DL. Effect of vitamin D supplementation on glucose control and
ınflammatory response in type II diabetes: A double blind, randomized
clinical trial. Int J Endocrinol Metab 2015;13(1): e22604.
De Boer IH, Tinker LF, Connelly S, Curb JD, Howard BV, Kestenbaum B,
Weiss NS. Calcium plus vitamin D supplementation and the risk of incident
diabetes in the Women's Health Initiative. Diabetes Care 2008;31(4):701-
-
Türkiye Endokrinoloji ve Metabolizma Derneği, Hipertansiyon Tedavi
Kılavuzu ve Yaşam Tarzı Önerileri. http://www.turkendokrin.org/files/pdf/
Hipertansiyon.pdf erişim tarihi: 29.07.2015.
Ekmekçi ÖB, Donma O, Aydemir A, Özdemir S, Bağrıaçık N. Hipertansif
diyabetik bireylerin plazma anjiotensin dönüştürücü enzim aktivitesi
ile plazma ve eritrosit çinko düzeyleri. Turkiye Klinikleri J Med Sci,
;22(6):553-556.
Rammos G., Tseke P., Ziakka S. Vitamin D, the renin-angiotensin system,
and insulin resistance. Int. Urol. Nephrol. 2008;40:419–426.
Andersen LB, Przybyl L, Haase N, von Versen-Höynck F, Qadri F, Jørgensen
JS, Sorensen GL, Fruekilde P, Poglitsch M, Szijarto I, Gollasch M, Peters
J, Muller DN, Christesen HT, Dechend R. Vitamin D depletion aggravates
hypertension and target-organ damage. J Am Heart Assoc 2015; 4(2):1-11.
Vimaleswaran KS, Cavadino A, Berry DJ, Jorde R, Dieffenbach AK, Lu
C, Alves AC, Heerspink HJ, Tikkanen E, Eriksson J, Wong A, Mangino
M, Jablonski KA, Nolte IM, Houston DK, Ahluwalia TS, van der Most PJ,
Pasko D, Zgaga L, Thiering E, Vitart V, Fraser RM, Huffman JE, de Boer RA,
Schöttker B, Saum KU et all. Association of vitamin D status with arterial
blood pressure and hypertension risk: a mendelian randomisation study.
The Lancet Diabetes & Endocrinol 2014;2(9):719-729.
Arora P, Song Y, Dusek J, Plotnikoff G, Sabatine MS, Cheng S, Valcour
A, Swales H, Taylor B, Carney E1, Guanaga D, Young JR, Karol C, Torre
M, Azzahir A, Strachan SM, O'Neill DC, Wolf M, Harrell F, Newton-Cheh
C, Wang TJ. Vitamin D therapy in individuals with prehypertension or
hypertension: the DAYLIGHT trial. Circulation 2015 Jan 20;131(3):254-62.
Margolis KL, Ray RM, Van Horn L, Manson JE, Allison MA, Black HR, Torner
JC. Effect of calcium and vitamin d supplementation on blood pressure The
Women’s Health Initiative randomized trial. Hypertension 2008;52(5):847-
-
Cottone S, Guarino L, Arsena R, Scazzone C, Tornese F, Guarneri M, Mulè
G. Vitamin D receptor gene polymorphisms and plasma renin activity in
essential hypertensive individuals. J Hum Hypertens 2015;29(8):483-7.
American Cancer Society. What is Cancer? http://www.cancer.org/ erişim
tarihi:05.06.2015.
Türkiye İstatistik Kurumu http://www.tuik.gov.tr/basinOdasi/
haberler/2015_21_20150416.pdf erişim tarihi: 24.06.2015.
Ames BN, Gold LS. The causes and prevention of cancer: the role of
environment. Biotherapy. 1998;11(2-3):205-20.
Li M, Chen P, Li J, Chu R, Xie D, Wang H. Review: the impacts of circulating
-hydroxyvitamin D levels on cancer patient outcomes: a systematic
review and meta-analysis. J Clin Endocrinol Metab, 2014;99(7):2327-2336.
Zhang L, Wang S, Che X, Li X. Vitamin D and lung cancer risk: a
comprehensive review and meta-analysis. CELL PHYSIOL BIOCHEM
;36(1): 299-305.
Park S, Lee DH, Jeon J, Ryu J, Kim S, Kim JY, Park HS, Kim SI, Park, B.
Serum 25-hydroxyvitamin D deficiency and increased risk of breast cancer
among Korean women: a case-control study. Breast Cancer Res Treat
;152(1):147-154.
Roskies M, Dolev Y, Caglar D, Hier MP, Mlynarek A, Majdan A, Payne
RJ. Vitamin D deficiency as a potentially modifiable risk factor for thyroid
cancer. J Otolaryngol Head Neck Surg 2012;41(3):160-163.
Joh H, Giovannucci EL, Bertrand K A, Lim S, Cho E. Predicted plasma
-hydroxyvitamin D and risk of renal cell cancer. J Natl Cancer Inst
;105(10):726-732.
Imtiaz S, Siddiqui N, Raza SA, Loya A, Muhammad A. Vitamin D deficiency
in newly diagnosed breast cancer patients. Indian J Endocrinol Metab
;16(3):409-13.
Terry P, Baron JA, Bergkvist L, Holmberg L, Wolk A. Dietary calcium and
vitamin D intake and risk of colorectal cancer: a prospective cohort study in
women. Nutr Cancer 2002;43(1):39-46.
Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL,
O'Sullivan MJ, Manson JE. Calcium plus vitamin D supplementation and the
risk of colorectal cancer. N Engl J Med 2006;354(7):684-696.