Vitamin D, a steroid hormone is primarily known for its role in calcium and bone
mineral homeostasis. Over the years, vitamin D has been implicated in various non-skeletal
diseases. The extraskeletal phenomenon can be attributed to the presence of vitamin D receptors
(VDRs) in almost all cells and identification of 1-α hydroxylase in extrarenal tissues. The vitamin D
deficiency (VDD) pandemic was globally reported with increasing evidence and paralleled the
prevalence of diabetes, obesity and cardiovascular diseases (CVDs). A dependent link was proposed
between hypovitaminosis D glycemic status, insulin resistance and also the other major factors
associated with type 2 diabetes leading to CVDs. Insulin resistance plays a central role in both type
2 diabetes and insulin resistance syndrome. These 2 disorders are associated with distinct etiologies
including hypertension, atherogenic dyslipidemia, and significant vascular abnormalities that could
lead to endothelial dysfunction. Evidence from randomised clinical trials and meta-analysis,
however, yielded conflicting results. This review summarizes the role of vitamin D in the regulation
of glucose homeostasis with an emphasis on insulin resistance, blood pressure, dyslipidaemia,
endothelial dysfunction and related cardiovascular diseases and also underline the plausible
mechanisms for all the documented effects.
Introductionand Aim: Etiopathogenesis of Pulmonary tuberculosis(PTB), is well established. Yet, the mechanisms by which a treatment regimen brings about remodelling of the pulmonary tissue during recovery phase is not well understood. The involvement of matrix metalloproteinase in this regard is debated, due to its dual role, either in disseminating the disease due to lung cavitation or reducing the inflammation due to recruitment of macrophages to the lung granulomas. PTB is a disease also driven by undernourishment.This study focuses on the association of nutritional status of PTB patients in restoring healthy lung tissue, monitored by blood levels of albumin, iron and MMP9, during the course of intensive treatment.
Materials and Methods: Serum levels of MMP9, iron, Total protein and albumin were estimated in 30 PTB patients who visited the Directly Observed Treatment Short course (DOTS) Centre at Government Wenlock Hospital, Mangalore, Karnataka,India. Twenty controls were enrolled for comparative statistics. Samples were collected at baseline and after two months of DOTS treatment in case of patients.Pre-treatment and post treatment values were compared by paired t test.Student’s ‘t’ test was used for comparing parameters in controls and patients. Correlation between parameters was done by Pearson’s correlation test.
Results: A significant increase was observed in serum iron (P=0.002) and total protein(P=0.01) levels post treatment but there was no significance in the levels of MMP9. Further, serum MMP9 correlatednegatively with body weight, BMI and serum total protein levels, post treatment, which was statistically significant. No other correlations were significant.
Conclusion: We conclude that MMP9 neither seems to be a diagnostic marker nor a therapeutic target in the treatment of tuberculosis. Although serum iron appears to be a predictor of improved nutritional status post treatment, it probably may have a role in tissue remodelling independent of MMP-9.
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