Background: Type 2 diabetes mellitus (T2DM) is a chronic disease that is characterized by β -cell dysfunction and resistance for insulin. Vitamin D is necessary for insulin secretion so it is a crucial factor in the development of T2DM. This study was done to investigate the association between serum 25-hydroxy Vitamin D [25(OH)3D], VDR (Vitamin D receptor) and VDBP (Vitamin D binding protein) with type 2 diabetic patients compared to control subjects. Subjects and Methods: This study carried out 110 female patients who were previously diagnosed with type 2 diabetes and 110 age, sex and weight matched as controls. All participants were subjected to full history taking, clinical examination and assessment of fasting blood glucose, HbA1c , lipid profile, 25-hydroxy Vitamin D [25(OH)3D], VDR and VDBP. Results: Results showed that the level of 25(OH)3D was significantly lower in diabetic group compared to controls and was significantly negatively correlated with glycated hemoglobin, serum total cholesterol and low density lipoprotein cholesterol in type 2 DM. Decreasing Vitamin D level was significantly associated with decreasing VDR. No significant association was found between Vit D and VDBP levels. Conclusions: Vitamin D deficiency is frequent in diabetic patients and associated with poor control and outcome. This suggests a role of Vitamin D in the pathogenesis and control of T2DM. Serum VDBP in diabetes may be independent to the level of 25(OH)3D and needs further studies.
KeywordsDiabetes MellitusType 225-Hydroxy Vitamin DVitamin D ReceptorVitamin D Binding Protein
Mogahed, M.M. (2018) Vitamin D Status in Patients with Type-2 Diabetes Mellitus in Riyadh City, Saudi Arabia. Kasr El Ainy Medical Journal, 24, 19-25. https://doi.org/10.4103/kamj.kamj_30_17
Lu, D.-Y., Che, J.-Y., Yarla, N.S., Zhu, H., Lu, T.-R., Xu, B. and Puttas, S. (2019) Type 2 Diabetes Study, Introduction and Perspective. The Open Diabetes Journal, 9, 1876-5246.
Skyler, J.S., Bakris, G.L., Bonifacio, E., et al. (2017) Differentiation of Diabetes by Pathophysiology, Natural History and Prognosis. Diabetes, 66, 241-255. https://doi.org/10.2337/db16-0806
Adams, J.S. and Hewison, M. (2010) Update in Vitamin D. The Journal of Clinical Endocrinology & Metabolism, 95, 471-478. https://doi.org/10.1210/jc.2009-1773
Khan, A.S, Sane, D.C., Wannenburg, T., et al. (2002) Growth Hormone, Insulin-Like Growth Factor and the Aging Cardiovascular System. Cardiovascular Research, 54, 25-35. https://doi.org/10.1016/S0008-6363(01)00533-8
Ekmekcioglu, C., Haluza, D. and Kundi, M. (2017) 25-Hydroxyvitamin D Status and Risk for Colorectal Cancer and Type Diabetes Mellitus: A Systematic Review and Meta Analysis of Epidemiological Studies. International Journal of Environmental Research, 14, 127. https://doi.org/10.3390/ijerph14020127
Abdella, N.A. and Mojiminiyi, O.A. (2018) Vitamin D-Binding Protein Clearance Ratio Is Significantly Associated with Glycemic Status and Diabetes Complications Ina Predominantly Vitamin D-Deficient Population. Journal of Diabetes Research, 2018, Article ID: 6239158. https://doi.org/10.1155/2018/6239158
Mirkovic, K, Doorenbos, C.R.C., Dam, W.A., et al. (2013) Urinary Vitamin D Binding Protein: A Potential Novel Marker of Renal Interstitial Inflammation and Fibrosis. PLoS ONe, 8, e55887. https://doi.org/10.1371/journal.pone.0055887
Jamka, M., Wozniewicz, M., Walkowiak, J., et al. (2016) The Effect of Vitamin D Supplementation on Selected Inflammatory Biomarkers in Obese and Overweight Subjects: A Systematic Review with Meta-Analysis. European Journal of Nutrition, 55, 2163-2176. https://doi.org/10.1007/s00394-015-1089-5
Pittas, A.G., Lau, J., Hu, F.B., et al. (2007) The Role of Vitamin D and Calcium in Type 2 Diabetes. A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism, 92, 2017-2029. https://doi.org/10.1210/jc.2007-0298
Handrail, F., Zakerkish, M., Karandish, M., et al. (2016) Association between Serum Vitamin D Level and Glycemic and Inflammatory Markers in Non-Obese Patients with Type 2 Diabetes. Iranian Journal of Medical Sciences, 41, 367-373.
Talaei, A., Mohamadi, M. and Adgi, Z. (2013) The Effect of Vitamin D on Insulin Resistance in Patients with Type 2 Diabetes. Diabetology & Metabolic Syndrome, 5, Article No. 8. https://doi.org/10.1186/1758-5996-5-8
Shanthi, B., Revathy, C., Jagadeeshwaran, A., Devi, J.M., Parameshwari, P.J. and Stephen T. (2012) Serum 25(OH)D and Type 2 Diabetes Mellitus. Journal of Clinical and Diagnostic Research, 6, 774-776.
Cimbek, A., Gursoy, G., Kirnap, N.G., Acar, Y., Erol, B., Ozasik, I. and Gungor, F. (2012) Relation of Serum 25 Hydroxy Vitamin D3 Levels with Insulin Resistance in Type 2 Diabetic Patients and Normal Subjects. Medicine Science, 1, 305-314. https://doi.org/10.5455/medscience.2012.01.8031
Trinder, P. (1969) Determination of Glucose in Blood Using Glucose Oxidase with an Alternative Oxygen Acceptor. Annals of Clinical Biochemistry, 6, 24-25. https://doi.org/10.1177/000456326900600108
Remaley, A.T., Rifai, N. and Warnick, G.R. (2012) Lipids, Lipoproteins, Apolipoproteins and Other Cardiovascular Risk Factors. In: Carl, R.A. and David, E.B., Eds., Tietz Textbook of Clinical Chemistry and Molecular Diagnosis, 4th Edition, Saunders, 731-805.
Friedewald, W.T., Levy, R.I. and Fredrickson, D.S. (1972) Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, without Use of the Preparative Ultracentrifuge. Clinical Chemistry, 18, 499-502. https://doi.org/10.1093/clinchem/18.6.499
Gordon, T., Zidek, W. and Amer, M. (1977) Determination of High Density Lipoprotein Cholesterol. Journal of Medicine, 42, 707-710.
Fossati, P. and Prenciphe, L. (1982) Determination of Serum Triglyceride. inical Chemistry, 28, 207-210. https://doi.org/10.1093/clinchem/28.10.2077
Heaney, R.P. and Holick, M.F. (2011) Why the IOM Recommendations for Vitamin D Are Deficient. Journal of Bone and Mineral Research, 26, 455-457. https://doi.org/10.1002/jbmr.328
Gonen, B. and Rubenstien, A.H. (1978) Haemoglobin A1 and Diabetes Mellitus. Diabetologia, 15, 1-8. https://doi.org/10.1007/BF01219319
Gao, Y., Zheng, T.P., Ran, X.W., Ren, Y., Chen, T., Zhong, L., Yan, D.G., Yan, F.F., Wu, Q.L. and Tian, H.M. (2018) Vitamin D and Incidence of Prediabetes or Type 2 Diabetes: A Four-Year Follow-Up Community-Based Study. Disease Markers, 2018, Article ID: 1926308. https://doi.org/10.1155/2018/1926308
Moore, W.T., Bowser, S.M., Fausnacht, D.W., Staley, L.L., Suh, K.S. and Liu. D.M. (2015) Beta Cell Function and the Nutritional State: Dietary Factors That Influence Insulin Secretion. Current Diabetes Reports, 15, Article No. 76. https://doi.org/10.1007/s11892-015-0650-1
Mohammad Hassan, J., Hamed, M., Koorosh, F., et al. (2016) Are Serum Levels of F2-Isoprostane and Oxidized-LDL Related to Vitamin D Status in Type 2 Diabetic Patients? A Case-Control Study. Reports of Biochemistry and Molecular Biology, 5, 26-32.
Giril, D., Pintus, D., Burnside, G., Ghatak, A., Mehta, F., Paul, P. and Senniappan, S. (2017) Treating Vitamin D Deficiency in Children with Type I Diabetes Could Improve Their Glycaemic Control. BMC Research Notes, 10, Article No. 465. https://doi.org/10.1186/s13104-017-2794-3
Eckel, R.H., Kahn, S.E., Eleferrannini, Goldfine, A.B., Nathan, D.M., Schwartz, M.W., Smith, R.J. and Smith, S.R. (2011) Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? Diabetes Care, 34, 1424-1430. https://doi.org/10.2337/dc11-0447
Adu, E.M., Ukwamedu, H.A. and Oghagbon, E.S. (2015) Assessment of Cardiovascular Risk Indices in Type 2 Diabetes Mellitus. Tropical Medicine & Surgery, 3, Article ID: 1000184.
Khattak, M., Nawaz, A., Anis, J. and Farwa, U. (2018) Dyslipidemia in Type 2 Diabetes Mellitus. The Journal of Islamic International Medical College, 13, 128-131.
Rahman, M., Hosen, B., Faruk, O., Hasan, M., Yearulkabir, M and Howlader, Z.H. (2017) Association of Vitamin D and Vitamin D Binding Protein (DBP) Gene Polymorphism with Susceptibility of Type 2 Diabetes Mellitus in Bangladesh. Gene, 636, 42-47. https://doi.org/10.1016/j.gene.2017.09.008
Gangji, S.N. (2017) Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus Leads to Vascular Complications. Health and Natural Sciences, 8.
Moreiraa, T.S. and Hamadeh, M.J. (2017) The Role of Vitamin D Deficiency in the Pathogenesis of Type 2 Diabetes Mellitus. Clinical Nutrition, 5, e155-e165. https://doi.org/10.1016/j.eclnm.2010.05.001
Fawzy, M.S. and Abu Alsel, B.T. (2018) Assessment of Vitamin D-Binding Protein and Early Prediction of Nephropathy in Type 2 Saudi Diabetic Patients. Journal of Diabetes Research, 2018, Article ID: 8517929. https://doi.org/10.1155/2018/8517929
Wortsman, J., Matsuoka, L.Y., Chen, T.C., Lu, Z. and Holick, M.F. (2003) Obesity Is Associated with Vitamin D Insufficiency and Secondary Hyperparathyroidism. The American Journal of Clinical Nutrition, 77, 1342.
Chaudhary, V., Bhaskar, N., Gupta, P.D., Lamichhane, A., Prasad, S. and Sodhi, K.S. (2016) Vitamin D and Glycated Hemoglobin (HbA1c) Levels in Type 2 Diabetes Mellitus. World Journal of Pharmaceutical Sciences, 5, 820-828.
Zhang, J., Ye, J., Guo, G., Lan, Z., Xing, L., Pan, Z., et al. (2016) Vitamin D Status Is Negatively Correlated with Insulin Resistance in Chinese Type 2 Diabetes. International Journal of Endocrinology, 2016, Article ID: 1794894.
Sadiya, A., Ahmed, S.M., Skaria, S. and Abusnana, S. (2014) Vitamin D Status and Its Relationship with Metabolic Markers in Persons with Obesity and Type 2 Diabetes in the UAE: A Cross-Sectional Study. Journal of Diabetes Research, 2014, Article ID: 869307. https://doi.org/10.1155/2014/869307
Gao, S., Han, L.W., Fu, J.L., Li, G., Li, M. and Willi, S.M. (2018) Vitamin D Levels Are Associated with Risk Factors for Type 2 Diabetes and Metabolic Syndrome in Chinese Youths. Diabetes, 67, 1. https://doi.org/10.2337/db18-1365-P
Nwosu, B.U. and Maranda, L. (2014) The Effects of Vitamin D Supplementation on Hepatic Dysfunction, Vitamin D Status, and Glycemic Control in Children and Adolescents with Vitamin D Deficiency and Either Type 1 or Type 2 Diabetes Mellitus. PLoS ONE, 9, e99646. https://doi.org/10.1371/journal.pone.0099646
Olt, S. (2015) Relationship between Vitamin D and Glycemic Control in Patients with Type 2 Diabetes Mellitus. International Journal of Clinical and Experimental Medicine, 8, 19180-19183.
He, R., Hu, Y.Y., Zeng, H., Zhao, J., Zhao, J.G., Chai, Y.M., Lu, F.D. and Liu, F. (2017) Vitamin D Deficiency Increases the Risk of Peripheral Neuropathy in Chinese Patients with Type 2 Diabetes. Diabetes/Metabolism Research and Reviews, 33, e2820. https://doi.org/10.1002/dmrr.2820
Cade, C. and Norman, A.W. (1986) Vitamin D3 Improves Impaired Glucose Tolerance and Insulin Secretion in the Vitamin D Deficient Rat in Vivo. Endocrinology, 119, 84-90. https://doi.org/10.1210/endo-119-1-84