![[PDF]](/pb-assets/Icons/adobe-pdf-icon-1498649896243.png){kind=icon}
Abstract
Diabetes is a leading cause of cardiovascular disease. Persons with diabetes are at greater risk for early cardiac mortality, and for repeat events if they survive their first cardiac event. Recently, low serum concentrations of vitamin D have been associated with increased risk for cardiac events. Evidence indicates that persons with diabetes have lower serum concentrations of vitamin D. In addition, persons at risk for diabetes or metabolic syndrome have inadequate serum concentrations of vitamin D. This review will assess the evidence relative to the impact of vitamin D in the development of diabetes, metabolic syndrome, and diabetes complications. Studies that address vitamin D and its impact on metabolic outcomes as well as possible mechanisms of action are provided. Finally, the assessment and suggested treatment for vitamin D deficiency is addressed. Effective detection and treatment of inadequate vitamin D concentrations in persons with diabetes or those at risk for diabetes may be an easy and cost-effective therapy which could improve their long-term health outcomes as well as their quality of life.
References
Section:
| Holick MF High prevalence of vitamin D inadequacy and implications for health . Mayo Clin Proc. 2006;81:353-373. Google Scholar, Crossref, Medline | |
| Holick MF Vitamin D deficiency. N Engl J Med. 2007;357:266-281. Google Scholar, Crossref, Medline, ISI | |
| Pittas AG Nutrition interventions for prevention of type 2 diabetes and the metabolic syndrome. Nutr Clin Care. 2003;6:79-88. Google Scholar, Medline | |
| Pittas AG , Dawson-Hughes B. , Li T. , et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;29:650-656. Google Scholar, Crossref, Medline | |
| 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. J Clin Endocrinol Metab. 2007;92:2017-2029. Google Scholar, Crossref, Medline | |
| Hyppönen 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;358:1500-1503. Google Scholar, Crossref, Medline, ISI | |
| The EURODIAB Substudy 2 Study Group. Vitamin D supplement in early childhood and risk for type I (insulin-dependent) diabetes mellitus. Diabetologia. 1999;42:51-54. Google Scholar, Crossref, Medline | |
| Zipitis CS , Akobeng AK Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child. 2008;93:512-517. Google Scholar, Crossref, Medline | |
| Gianocarlo I. , Ruben G. , Silvano A. High prevalence of hypovitaminosis D in female type 2 diabetic population. Diabetes Care. 2001;24:1496. Google Scholar, Crossref | |
| Scragg R. , Sowers MF , Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third national health and nutrition examination survey. Diabetes Care. 2004;27:2813-2818. Google Scholar, Crossref, Medline | |
| Matilla C. , Knekt P. , Mannisto S. , et al. Serum 25-Hydroxyvitamin D concentration and subsequent risk of type 2 diabetes. Diabetes Care. 2007;30:2569-2570. Google Scholar, Crossref, Medline | |
| Liu S. , Song Y. , Ford ES , Manson JE , Buring JE , Ridker PM Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care. 2005;28:2926-2932. Google Scholar, Crossref, Medline | |
| Ford ES , Ajani UA , McGuire LC , Liu S. Concentrations of serum vitamin D and the metabolic syndrome in U.S. Adults . Diabetes Care. 2005;28:1228-1230. Google Scholar, Crossref, Medline | |
| Reis JP , Von Mühlen D. , Kritz-Silverstein D. , Wingard DL , Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care . 2007;30:1549-1555. Google Scholar, Crossref, Medline | |
| Zittermann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol . 2006;92:39-48. Google Scholar, Crossref, Medline | |
| Forman JP , Giovannucci E. , Holmes MD , et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension . Hypertension. 2007;49:1063-1069. Google Scholar, Crossref, Medline | |
| Wang TJ , Pencia MJ , Booth SL , et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503-511. Google Scholar, Crossref, Medline | |
| Autier P. , Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167:1730-1737. Google Scholar, Crossref, Medline | |
| Wolf M. , Shah A. , Gutierrez O. , et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2007;72:1004-1013. Google Scholar, Crossref, Medline | |
| Zhang Z. , Sun L. , Wang Y. , et al. Renoprotective role of the vitamin D receptor in diabetic nephropathy . Kidney Int. 2008;73:163-171. Google Scholar, Crossref, Medline | |
| Chonchol M. , Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey . Kidney Int. 2007;71:134-139. Google Scholar, Crossref, Medline | |
| Lee P. , Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med. 2008;168:771-772. Google Scholar, Crossref, Medline | |
| Ljunghall S. , Lind L. , Lithell H. , et al. Treatment with one-alphahydroxycholecalciferol in middle-aged men with impaired glucose tolerance-a prospective randomized double-blind study. Acta Med Scand. 1987;222:361-367. Google Scholar, Crossref, Medline | |
| Lind L. , Hanni A. , Lithell H. , Hvarfner A. , Sorensen OH , Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8:894-901. Google Scholar, Crossref, Medline | |
| Orwoll E. , Riddle M. , Prince M. Effects of vitamin D on insulin and glucagon secretion in non-insulin-dependent diabetes mellitus. Am J Clin Nutr. 1994;59:1083-1087. Google Scholar, Crossref, Medline | |
| Baynes KCR , Boucher BJ , Feskens EJM , Kromhout D. Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia. 1997;40:344-347. Google Scholar, Crossref, Medline | |
| Chiu KC , Chu A. , Go VL , Saad MF Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction . Am J Clin Nutr. 2004;79:820-825. Google Scholar, Medline | |
| Need AG , O'Loughlin PD , Horowitz M. , Nordin C. Relationship between fasting serum glucose, age, body mass index, and serum 25 hydroxyvitamin D in postmenopausal women. Clin Endocrinol . 2005;62:738-741. Google Scholar, Crossref, Medline | |
| 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 ;57:258-261. Google Scholar, Medline | |
| Pittas AG , Harris SS , Stark PC , Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care . 2007;30:980-986. Google Scholar, Crossref, Medline | |
| Suzuki A. , Kotake M. , Ono Y. , et al. Hypovitaminosis D in type 2 diabetes mellitus: association with microvascular complications and type of treatment. Endocr J. 2006;53:503-510. Google Scholar, Crossref, Medline, ISI | |
| Boucher BJ Inadequate vitamin D status: does it contribute to the disorders comprising syndrome `X'? Br J Nutr. 1998;79:315-327. Google Scholar, Crossref, Medline | |
| Peechakara SV , Pittas AG Vitamin D as a potential modifier of diabetes risk. Nat Clin Pract Endocrinol Metab. 2008 ;4:182-183. Google Scholar, Crossref, Medline | |
| Mathieu C. , Gysemans C. , Giulietti A. , Bouillon R. Vitamin D and diabetes. Diabetologia. 2005 ;48:1247-1257. Google Scholar, Crossref, Medline | |
| Flores M. A role of vitamin D in low intensity chronic inflammation and insulin resistance in type 2 diabetes mellitus. Nutr Res Rev. 2005;18:175-182. Google Scholar, Crossref, Medline | |
| Cigolini M. , Iagulli MP , Miconi V. , Galiotto M. , Lombardi S. , Targher G. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2006;29:722-724. Google Scholar, Crossref, Medline | |
| Chang TJ , Lei HH , Yeh JI , et al. Vitamin D receptor gene polymorphisms influence susceptibility to type 1 diabetes mellitus in the Taiwanese population. Clin Endocrinol. 2000;52:575-580. Google Scholar, Crossref, Medline | |
| Oh JY , Barrett-Connor E. Association between vitamin D receptor polymorphism and type 2 diabetes or metabolic syndrome in community dwelling older adults: The Rancho Bernardo Study. Metabolism. 2002;51:356-359. Google Scholar, Crossref, Medline | |
| Ramos-Lopez E. , Bruck P. , Jansen T. , Herwig J. , Badenhoop K. CYP2R1(vitamin D 25-hydroxylase) gene is associated with susceptibility to type 1 diabetes and vitamin D levels in Germans. Diabetes Metab Res Rev. 2007;23:631-636. Google Scholar, Crossref, Medline | |
| Binkley N. , Novotny R. , Krueger D. , et al. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. 2007;92:2130-2135. Google Scholar, Crossref, Medline | |
| Holick MF Vitamin D. In: Shils ME , Shike M , Ross AC , Caballero B , Cousins, RJ , eds. Modern nutrition in health and disease. 10 th ed. Baltimore MD: Lippincott Williams and Wilkins; 2006. Google Scholar | |
| Rucker D. , Allan JA , Fick GH , Hanley DA Vitamin D insufficiency in a population of healthy western Canadians . CMAJ. 2002;166: 1517-1524. Google Scholar, Medline | |
| Nesby-O'Dell S. , Scanlon KS , Cogswell ME , et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988-1995. Am J Clin Nutr. 2002; 76:187-192. Google Scholar, Medline | |
| Hollis BW , Wagner CL , Drezner MK , Binkley NC Circulating vitamin D3 and 25-hydroxyvitamin D in humans: an important tool to define adequate nutritional vitamin D status. J Steroid Biochem Mol Biol. 2007;103:631-634. Google Scholar, Crossref, Medline | |
| Levis S. , Gomez A. , Jimenez C. , et al. Vitamin D deficiency and seasonal variation in an adult South Florida population. J Clin Endocrinol Metab. 2005;90:1557-1562. Google Scholar, Crossref, Medline | |
| Kakarala RR , Chandana SR , Harris SS , Kocharla L. , Dvorin E. Prevalence of vitamin D deficiency in uninsured women. J Gen Intern Med . 2007;22:1180-1183. Google Scholar, Crossref, Medline, ISI | |
| Powell HS , Greenberg D. Tackling vitamin D deficiency. Postgrad Med. 2006;119:25-30. Google Scholar, Crossref | |
| Plotnikoff GA , Quigley JM Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78:1463-1470. Google Scholar, Crossref, Medline | |
| Otten JJ , Hellwig JP , Meyers LD , eds. Dietary reference intakes: the essential guide to nutrient requirements . Washington, DC: National Academies Press; 2006. Google Scholar | |
| Whiting SJ , Calvo MS Overview of the proceedings from Experimental Biology 2005 Symposium: optimizing Vitamin D intake for populations with special needs: barriers to effective food fortification and supplementation. J Nutr. 2006;136:1114-1116. Google Scholar, Crossref, Medline | |
| Moore C. , Murphy MM , Keast DR , Holick M. Vitamin D intake in the United States. J Am Diet Assoc . 2004;104:980-983. Google Scholar, Crossref, Medline | |
| Office of Dietary Supplements. Dietary supplement fact sheet: vitamin D, National Institutes of Health Clinical Center. http://dietary-supplements.info.nih.gov/factsheets/vitamind.asp . Accessed March 6, 2008. Google Scholar | |
| Vieth R. , Bischoff-Ferrari H. , Boucher B. , et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr. 2007;85:649-650. Google Scholar, Medline | |
| Trivedi DP , Doll R. , Khaw KT Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. 2003;326:469. Google Scholar, Crossref, Medline | |
| Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety . Am J Clin Nutr. 1999;69:842-856. Google Scholar, Medline | |
| Talwar SA , Aloia JF , Pollack S. , Yeh JK Dose response to vitamin D supplementation among postmenopausal African American women. Am J Clin Nutr. 2007;86:1657-1662. Google Scholar | |
| Koutkia P. , Lu Z. , Chen TC , Holick MF Treatment of vitamin D deficiency due to Crohn's disease with tanning bed ultraviolet B radiation. Gastroenterology. 2001;121:1485-1488. Google Scholar, Crossref, Medline | |
| Harris SS , Dawson-Hughes B. Reduced sun exposure does not explain the inverse association of 25-hydroxyvitamin D with percent body fat in older adults. J Clin Endocrinol Metab. 2007; 92:3155-3157. Google Scholar, Crossref, Medline |
