Relation of Serum 25 Hydroxy Vitamin D3 Levels with Insulin Resistance in Type 2 Diabetic Patients and Normal Subjects

Hypovitaminosis D is supposed to be associated with diabetes mellitus and metabolic syndrome. Defects in pancreatic β cell function and/or insulin sensitivity are often present, to develop glucose intolerance or type 2 diabetes mellitus. There are accumulating evidence that vitamin D may influence these mechanisms. Aim of our study was to test the hypothesis of an association between hypovitaminosis D and insulin resistance in diabetic patients and normal subjects. We studied 101 type 2 diabetic patients and 60 controls. After detailed physical examination the venous blood was withdrawn, anthropometric measurements were taken, then an indirect measure of insulin resistance was calculated. Study population composed of diabetic and control groups. An indirect insulin resistance index was calculated and compared with other parameters including their 25 hydroxy vitamin D3 levels. In diabetic patients without insulin resistance; fasting blood glucose, fasting insulin and indirect insulin resistance index levels were significantly lower compared to diabetic patients with insulin resistance (p <0.05, <0.01 and <0.01 respectively). We also found that fasting insulin and indirect insulin resistance index levels of the control group without insulin resistance were significantly lower compared to controls with insulin resistance (p <0.001 both). We did not observe any difference in other parameters including vitamin D levels in all groups. These findings suggests that at least in Turkish population vitamin D levels are not associated with insulin resistance both in diabetics and normals.
Anahtar Kelimeler:

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Relation of Serum 25 Hydroxy Vitamin D3 Levels with Insulin Resistance in Type 2 Diabetic Patients and Normal Subjects

Hypovitaminosis D is supposed to be associated with diabetes mellitus and metabolic syndrome. Defects in pancreatic β cell function and/or insulin sensitivity are often present, to develop glucose intolerance or type 2 diabetes mellitus. There are accumulating evidence that vitamin D may influence these mechanisms. Aim of our study was to test the hypothesis of an association between hypovitaminosis D and insulin resistance in diabetic patients and normal subjects. We studied 101 type 2 diabetic patients and 60 controls. After detailed physical examination the venous blood was withdrawn, anthropometric measurements were taken, then an indirect measure of insulin resistance was calculated. Study population composed of diabetic and control groups. An indirect insulin resistance index was calculated and compared with other parameters including their 25 hydroxy vitamin D3 levels. In diabetic patients without insulin resistance; fasting blood glucose, fasting insulin and indirect insulin resistance index levels were significantly lower compared to diabetic patients with insulin resistance (p <0.05, <0.01 and <0.01 respectively). We also found that fasting insulin and indirect insulin resistance index levels of the control group without insulin resistance were significantly lower compared to controls with insulin resistance (p <0.001 both). We did not observe any difference in other parameters including vitamin D levels in all groups. These findings suggests that at least in Turkish population vitamin D levels are not associated with insulin resistance both in diabetics and normals.

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  • Holick MF. Vitamin D. The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9(1):97-98.
  • EURODIAB Substudy 2 study group. Vitamin D supplement in early childhood and risk for type 1 (insulin dependent) diabetes mellitus. Diabetologia 1999;42(1):51-4.
  • Fowlkes JL, Bunn RC, Cockrell GE, Clark LM, Wahl EC, Lumpkin CK et al. Dysregulation of the intrarenal vitamin D endocytic pathway in a nephropathy-prone mouse model of type 1 diabetes. Exp Diabetes Res 2011;2011(1):269378.
  • Hypönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth cohort study. Lancet 2001;358(9292):1500-3.
  • Zippitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a sysytemetic review and meta-analysis. Arch Dis Child 2008;93(6):512-7.
  • Matilla C, Knekt P, Mannisto S, Rissanen H, Laaksonen MA, Montenen J et al. Serum 25-hydroxyvitamin D concentration and subsequent risk of type 2 diabetes. Diabetes Care 2007;30(10):2569-70.
  • Pittas AG, Dawson- Hughes B, Li T, Van Dam RM, Willett WC, Manson JE et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006;29(3):650-6.
  • Thorand B, Zierer A, Huth C, Linseisen J, Meisinger C, Roden M et al. Effect of serum 25-hydroxyvitamin D on risk for type 2 diabetes may be partially mediated by subclinical inflammation: results from the MONICA/KORA Augsburg study. Diabetes Care 2011 Oct;34(10):2320-2.
  • Dalgård C, Petersen MS, Weihe P, Grandjean P. Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians. Diabetes Care 2011 Jun;34(6):1284-8.
  • Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietery Ca, Vitamin D, and the prevelance of metabolic syndrom in middle aged and older US. Women. Diabetes Care 2005;28(12):2926-32.
  • Ford ES, Ajani UA, Mc Guire LC, Liu S. Concentrations of serum Vitamin D and the metabolic syndrome in US adults. Diabetes Care. 2005;28(5):1228-30.
  • Ford ES, Zhao G, Li C, Pearson WS. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes 2009;1(4):296-303. doi: 10.1111/j.1753-0407.2009.00046.x.
  • Zittemann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol 2006; 92(1):39-48.
  • Wang TJ, Pencia MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K et al. Framingham Heart Study. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117(4):503-11.
  • Gianocarlo I, Ruben G, Silvano A. High prevalence of hypovitaminosis D in female type 2 diabetic population. Diabetes Care. 2001;24(8):1496.
  • Koshiyama H, Ikeda H, Honjo S, Nakamura Y, Tanaka K, Tsugawa N et al. Hypovitaminosis D is frequent in Japanese subjects with type 2 diabetes. Diabetes Res Clin Pract 2007;76(3):470-1.
  • Boucher BJ, Manan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairement of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia 1995;38(10):1239-45.
  • Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25- hydroxyvitamin D3 concentrations and prevelance of cardiovascular disease among type 2 diabetic patients. Diabetes Care 2006;29(3):722-4.
  • Hyppönen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity. Diabetes Care 2006;29(10):2244-6.
  • Scragg R, Holdaway I, Singh V, Metcalf P, Baker J, Dryson E. Serum 25- hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Res Clin Pract 1995;27(3):181-8.
  • Christansen C, Christansen MS, McNair P, Nielsen B, Madabad S. Vitamin D metabolites in diabetic patients; decreased serum concentrations of 24, 25- dihydroxyvitamin D. Scand J Clin Lab Invest 1982;42(6):487-91.
  • Acibucu F, Kayataş M, Candan F. The association of insulin resistance and metabolic syndrome in early androgenetic alopecia. Singapore Med J 2010;51(12): 931-6.
  • Van Etten E, Mathiu C. Immunoregulation by 1, 25 dihydroxy vitamin D3: basic concepts. J Steroid Biochem Mol Biol 2005;97(1-2):93-101.
  • Christakos S, Barletta F, Huening M, Dhawan P, Liu Y, Porta A et al. Vitamin D target proteins: function and regulation J Cell Biochem 2003;88(2):238-44.
  • Flores M. A role vitamin D in low intensity chronic inflammation and insulin resistance in type 2 diabetes mellitus. Nutr res Rev. 2005;18(2):175-82.
  • Johnson JA, Grande JP, Roche PC, Kumar R. Immunohistochemical localization of the 1,25(OH)2D3 receptor and calbindin D28k in human and rat pancreas. Am J Physiol 1994; 267(3Pt1):E356-60.
  • Bland R, Markovic D, Hills CE, Hughes SV, Chan SL, Squires PE et al. Expression of 25 hydroxy vitamin D3- 1 α- hydroxylase in pancretic islets. J Steroid Biochem Mol Biol 2004;89-90(1):121-5.
  • Sooy K, Schermerhorn T, Noda M, Surana M, Rhoten WB, Meyer M et al. Calbindin- D (28k) controls Ca(+2) and insulin release. Evidence obtained from calbindin-d (28k) knock-out mice and beta cell lines. J Biol Chem 1999;274(48):34343-9.
  • Beaulieu C, Kestekian R, Havrankova J, Gascon-Barre M. Calcium is essential in normalizing intolerance to glucose that accompanies vitamin D depletion in vitro. Diabetes 1993;42(1):35-43.
  • Gedik O, Zileli MS. Effects of hypocalcemia and theophylline on glucose tolerance and insulin release in human beings. Diabetes 1977;26(9):813-9.
  • Maestro B, Campion J, Davila N, Calle C. Stimulation by 1,25 dihydroxy vitamin D3 of insulin receptor expression and insulin reponsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000;47(4):383-91.
  • Dunlop TW, Vaisanen S, Frank C, Molnar F, Sinkkonen L, Carlberg C. The human peroxisome proliferator activator receptor-δ gene is a primary target of 1 α 25 dihydroxy vitamin D3 and its nuclear receptor. J Mol Biol 2005;349(2):248-60.
  • Williams PF, Caterson ID, Cooney GJ, Zilkens RR, Turtle JR. High affinity insulin binding and insulin receptor effector coupling: modulation by Ca 2+. Cell Calcium 1990;11(8):547-56.
  • Zemel MB. Nutritional and endocrine modulation of intracellular calcium: implications in obesity, insulin resistance and hypertension. Mol Cell Biochem 1998;188(1-2):129-36.
  • Chui KC, Chu A, Go LW, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79(5):820-5.
  • Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract 2003;57(4):258-61.
  • Scragg R, Sowers MF, Bell C. Serum hydroxyvitamin D, diabetes, and ethnicity in the third National Health and Nutrition Examination Survey. Diabetes Care 2004;27(12):2813-8.
  • Ganji V, Zhang X, Shaikh N, Tangpricha V. Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted 25-hydroxyvitamin D data from NHANES 2001-2006. Am J Clin Nutr 2011;94(1):225-33.
  • Garanty-Bogacka B, Syrenicz M, Goral J, Krupa B, Syrenicz J, Walczak M et al. Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents. Endokrynol Pol 2011;62(6):506-11.
  • Pinelli NR, Jaber LA, Brown MB, Herman WH. Serum 25-hydroxy vitamin D and insulin resistance, metabolic syndrome and glucose intolerance among Arab Americans. Diabetes care 2010;33(6):1373-5.
  • Bindal ME, Taskapan H, Hypovitaminosis D andinsulin resistance in peritoneal dialysis patients. Int Urol Nephrol 2011; 43(2):527-34.
  • Fourouhi NG, Luan Ja, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25- hydroxyvitamin D is predictive of future glycemic status and insulin resistance: The Medical Research Council Ely Prospective Study. 1990-2000. 2008;57(10):2619-26.
  • Orwoll E, Riddle M, Prince M. Effect of Vitamin D on insulin and glucagon secretion in non-insulin dependent diabetes mellitus. Am J Clin Nutr 1994;59(5):1083-7.
  • Majumdar V, Nagaraja D, Christopher R. Vitamin d satatus and metabolic syndrome in asian Indians. Int J Obes(London) 2011;35(8):1131-4.
  • Al-Sultan AI, Amin TT, Abou-Seif MA, Al Naboli MR. Vitamin D, Parathyroid hormone levels and insulin sensitivity among obese young adult Saudis. Eur Rev med Pharmacol Sci. 2011;15(2):135-47.
  • Bonakdaran S, Varasteh AR. Correlation between serum 25-hydroxyvitamin D3 and laboratory risk marker of cardiovascular diseases in type 2 diabetic patients. Saudi Med J 2009;30(4):509-14.
  • Kayaniyil S, Retnakaran R, Haris SB, Vieth R, Knight JA, Gerstein HC et al. Prospective associations of vitamin D with beta cell function and glycemia: the PROspective Metabolism and ISlet cell Evaluation (PROMISE) cohort study. Diabetes 2100;60(11):2947-53.
  • Nazarian S, St Peter JV, Boston RC, Jones SA, Mariash CN. Vitamin D3 supplementation improves insulin sensitisity in subjects with impaired fasting glucose. Transl Res 2011;158(5):276-81. 49. Grimnes G, Figenschau Y, Almas B, Jorde R. Vitamin D,insulin secretion,sensitivity,and lipids: results from a case-control study and a randomized controlled trial using hyperglycemic clamp technique. Diabetes 2011;60(11):2748-57.
  • Bowen J, Noakes M, Cliffton PM. Effect of calcium and diary foods in high protein, energy –restricted diets on weight loss and metabolic parameters in overweight adults. Int J Obes (London) 2005;29(8):957-65.
  • Von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zeland who are insulin resistant and Vitamin D dficient- a randomised, placebo-controlled trial. British Journal of Nutrition 2010;103(4):549-55.
  • Zemel MB, Thompson W, Milstead A, Morris K, Campbell P. Calcium and diary accelaration of weight and fat loss during energy restriction in obese adults. Obes Res 2004;12(4):582-90.
  • Pittas AG, Haris SS, Stark PC, Dawson-Hughes B. The effects of Calcium and vitamin D supplementation on blood glucose and markers of inflammation in non-diabetic adults. Diabetes Care 2007;30(4):980-6.
  • Pittas AG, Lau J, Hu FB, Dawson- Hughes B. Review: the role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. JCEM 2007;92(6):2017-29.
  • Arasıl Tansu, Uysal AR, İdil A, Ağbant K, Güllü S, Yalçın P. Vitamin D status in women living in Ankara. Turk Jem 2010; 14(2):39-43.
  • Andıran N, Çelik N, Akça H, Doğan G. Vitamin D Deficiency in Children and Adolescents. J Clin Res Ped Endo 2012;4(1):25-9.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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