Main Article Content
Objective: Vitamin D (VD) could play a role in pathogenesis of Type 2 Diabetes Mellitus (T2DM) by affecting either insulin sensitivity or pancreatic β-cell function. This article is about the relationship between T2DM and VD levels.
Material and Methods: The 4678 individuals were included in the study. Of these, 1764 were T2DM patients and 2914 were healthy individuals. Correlation analysis was carried out between VD, age, Body Mass Index (BMI), Hemoglobin A1c (HbA1c), and duration of illness in the T2DM patients. Logistic regression analysis was used to determine the independent predictors.
Results: VD levels were significantly lower in the T2DM patients compared to the control group. The VD level of T2DM patients with HbA1c >7% was lower than those with HbA1c <7%. The VD level of T2DM patients using insulin was found to be significantly lower compared to those not using insulin. Among the T2DM patients, VD level was found to be the highest in those without complications and the lowest in those with nephropathy. The cut-off value for VD was calculated as 16.95 ng/mL. According to the logistic regression test, low serum VD levels were found to be an independent risk factor for the development of T2DM and its complications.
Conclusion: VD deficiency may be a risk factor for the development of T2DM. In our study, VD levels were significantly lower in the T2DM patients and those having complications of T2DM than the healthy individuals.
Grant WB. Vitamin D and health in the Mediterranean countries. Hormones. 2019;18(1):23-35.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.
Schwalfenberg G. Vitamin D and diabetes: improvement of glycemic control with vitamin D3 repletion. Can Fam Physician. 2008;54(6):864-6.
Nakashima A, Yokoyama K, Yokoo T, et al. Role of vitamin D in diabetes mellitus and chronic kidney disease. World J Diabetes. 2016;7(5):89.
Baynes KC, Boucher BJ, Feskens EJ, et al. Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia. 1997;40(3):344-7.
Chiu KC, Chu A, Go VL, et al. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79(5):820-5.
Palomer X, González-Clemente JM, Blanco-Vaca F, et al. Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes Obes Metab. 2008;10(3):185-97.
Shymanskyi I, Lisakovska O, Mazanova A, et al. Vitamin D Deficiency and Diabetes Mellitus. Vitamin D Deficiency: IntechOpen; 2019.
Riachy R, Vandewalle B, Kerr Conte J, et al. 1,25-dihydroxyvitamin D3 protects RINm5F and human islet cells against cytokine-induced apoptosis: implication of the antiapoptotic protein A20. Endocrinology. 2002;143(12):4809-19.
Long M, Wang C, Liu D. Glycated hemoglobin A1C and vitamin D and their association with diabetic retinopathy severity. Nutr Diabetes. 2017;7(6):e281-e.
Bener A, Eliaçık M, Cincik H, et al. The impact of vitamin D deficiency on retinopathy and hearing loss among Type 2 diabetic patients. BioMed Res Int. 2018;2018.
Scragg R, Holdaway I, Singh V, et al. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Res Clin Pract. 1995;27(3):181-8.
Lu M, Xu Y, Lv L, et al. Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis. Arch Gynecol Obstet. 2016;293(5):959-66.
Basit A, Basit KA, Fawwad A, et al. Vitamin D for the treatment of painful diabetic neuropathy. BMJ Open Diabetes Res Care. 2016;4(1).
Greenhagen RM, Frykberg RG, Wukich DK. Serum vitamin D and diabetic foot complications. Diabet Foot Ankle. 2019;10(1):1579631.
Suzuki A, Kotake M, Ono Y, et al. Hypovitaminosis D in type 2 diabetes mellitus: association with microvascular complications and type of treatment. Endocrine J. 2006:0607070010-.
Xiao X, Wang Y, Hou Y, et al. Vitamin D deficiency and related risk factors in patients with diabetic nephropathy. J Int Med Res. 2016;44(3):673-84.
Horikawa C, Aida R, Tanaka S, et al. Higher Dietary Intake of Vitamin D Is Associated with Lower Incidence of Diabetic Nephropathy in Japanese Patients with Type 2 Diabetes. Am Diabetes Assoc; 2018.
Hu X, Liu W, Yan Y, et al. Vitamin D protects against diabetic nephropathy: evidence-based effectiveness and mechanism. Eur J Pharmacol. 2019;845:91-8.
Özdoğan E, Özdoğan O, Altunoğlu EG, et al. Relationship of blood lipid levels with Hba1c and obesity in patients with type 2 diabetes mellitus. Med Bulletin Sisli Etfal Hospital. 2015;49(4):248-54.
Selvin E, Marinopoulos S, Berkenblit G, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004;141(6):421-31.
Cigolini M, Iagulli MP, Miconi V, et al. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2006;29(3):722-4.
Inzucchi SE, Maggs DG, Spollett GR, et al. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med. 1998;338(13):867-72.
Gao Y, Zheng T, Ran X, et al. Vitamin D and incidence of prediabetes or type 2 diabetes: a four-year follow-Up community-based study. Disease Markers. 2018;2018.
Yıldırım Dİ. Diyabet Hastalarında D Vitamini İle Hba1c İlişkisinin Değerlendirilmesi. Selcuk Med J. 2019;35(1):37-42.
Pittas AG, Dawson-Hughes B. Vitamin D and diabetes. J Steroid Biochem Mol Biol. 2010;121(1-2):425-9.
Barbarawi M, Zayed Y, Barbarawi O, et al. Effect of Vitamin D Supplementation on the Incidence of Diabetes Mellitus. J Clin Endocrinol Metab. 2020.
Krul-Poel YH, Ter Wee MM, Lips P, et al. Management of endocrine disease: the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Eur J Endocrinol. 2017;176(1):R1-R14.
Dehkordi EH, Dehkordi VH, Fatemi SMR, et al. Effect of vitamin D supplement therapy on HbA1C and IGF-1 levels in children with type 1 diabetes mellitus and vitamin D deficiency. Electron J Gen Med. 2018;15(4):em69.
George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis. Diabet Med : a journal of the British Diabetic Association. 2012;29(8):e142-50.
Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metabol. 1988;67(2):373-8.
Manios Y, Moschonis G, Lambrinou C-P, et al. A systematic review of vitamin D status in southern European countries. Eur J Nutr. 2018;57(6):2001-36.