Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

Felício, João Soares; Oliveira, Alana Ferreira de; Peixoto, Amanda Soares; Souza, Ana Carolina Contente Braga de; Neto, João Felício Abrahão; Melo, Franciane Trindade Cunha de; Carvalho, Carolina Tavares; Lemos, Manuela Nascimento de; Cavalcante, Sávio Diego Nascimento; Resende, Fabrício de Souza; Santos, Márcia Costa Dos; Motta, Ana Regina Bastos; Janaú, Luísa Corrêa; Yamada, Elizabeth Sumi; Felício, Karem Miléo

doi:10.3389/fendo.2017.00199

Cited by 22 publications

(23 citation statements)

References 34 publications

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“…The relatively low number of patients might be considered as a limitation of our study. Nevertheless, a similar or even smaller number of diabetic patients were recruited in other studies on the same field ( 27 , 28 , 42 , 43 ). It should be added that according to the protocol of our study, AN and CGMS assessments were performed only in those cases in which both were indicated as a part of a medical management.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Autonomic Neuropathy and Glucose Variability in Patients With Type 1 Diabetes: Is There an Association?

et al. 2018

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IntroductionThe oxidative stress associated with glucose variability might be responsible for neuronal damage while autonomic neuropathy (AN) has a detrimental effect on metabolism. The aim of the study was to find relationship between AN and GV in type 1 diabetic patients and to identify further factors that affect GV.Patients and methodsTwenty type 1 diabetic patients were involved (age: 39.5 ± 3.4 years, duration of diabetes: 17.5 ± 2.5 years; HbA1c: 8.1 ± 0.2%, mean ± SE). AN was assessed by the cardiovascular reflex tests. The interstitial glucose levels were determined following insertion of a subcutaneous electrode during the continuous glucose monitoring (CGM) method on six consecutive days. GV was characterized by calculation of four parameters.ResultsSD of interstitial glucose values correlated positively with the overall AN score and the degree of the orthostatic reduction of systolic blood pressure (AN-score-SD ρ = 0.47, p < 0.05; orthostasis-SD: ρ = 0.51, p < 0.05). Mean absolute glucose (MAG) correlated with three parameters of AN (AN-score-MAG: ρ = 0.62, p < 0.01; 30/15 ratio-MAG: ρ = −0.50, p < 0.05; orthostasis-MAG: ρ = 0.59, p < 0.01). The HbA1c also correlated with two parameters of GV (HbA1c-continuous overlapping net glycemic action: ρ = 0.56, p < 0.05; HbA1c-MAG: ρ = 0.45, p < 0.05). The frequency of hypoglycemia did not exhibit any correlation with measures of GV.ConclusionSeverity of glucose variability but not overall glucose load correlates with both parasympathetic and sympathetic dysfunctions in type 1 diabetes. Higher HbA1c is associated with more severe glucose variability. The observed correlation between increased glucose variability and the severity of AN necessitates the further exploration of this relationship.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Autonomic Neuropathy and Glucose Variability in Patients With Type 1 Diabetes: Is There an Association?

et al. 2018

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“…It was the first clinical test of the hypothesis that underlying paricalcitol possesses pleiotropic effects and can influence albuminuria in the case of a stable dose of ACEI and/or ARB treatment [ 57 ]. There is a study suggesting that high-dose supplementations of VD is associated with albuminuria reduction and the amelioration of renal injury in type 1 diabetes mellitus (T1DM) [ 58 ]. Subsequently, other researchers studied the effects of VD on bone mineral density (BMD) and bone metabolism in patients with type 2 diabetic nephropathy (T2DN).…”

Section: The Role Of Vd/vdr Of the Clinical Treatment In Diabetic mentioning

confidence: 99%

The Emerging Role of Vitamin D and Vitamin D Receptor in Diabetic Nephropathy

Lei

Liu

Guo

2020

BioMed Research International

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Diabetic nephropathy (DN), one of the most common and severe microvascular complications of diabetes mellitus (DM), is an important risk factor for DM patient’s death. Nowadays, DN has become the leading cause of end-stage renal disease (ESRD) in most countries without effective therapeutic methods. Recently, the renoprotective effects mediated by vitamin D (VD) and vitamin D receptor (VDR) have been evidenced. VD, a kind of steroid with the active form 1,25(OH)2D3, has been known for the crucial roles in the modulation of serum calcium and phosphorus concentrations. It exerts important functions by binding with its receptor VDR.VDR, a transcription factor located at chromosome 12 containing 9 exons, is one of the nonsteroid nuclear hormone receptor superfamily, which participates in transcriptional regulation of genes in tissue- and cell-specific ways. Increasing evidences have demonstrated that VD/VDR signaling pathway possesses a variety of kidney-protective effects in DN patients, such as antiproteinuria, antifibrosis, anti-inflammatory, and preventing podocyte damage. Although there are many studies on the role of the VD/VDR signaling pathway in DN, the effects and mechanisms still need to be further explained. This review summarized the multiple roles of VD/VDR in podocyte injury, tubule lesions, interstitial fibrosis, and inflammation, as well as the clinical applications about DN to explore much more and effective therapeutic methods for DN.

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“…We performed a prospective study to evaluate the effect of vitamin D supplementation on CAN in T1DM patients as part of a research protocol (ISRCTN32601947) that has already provided evidence on other aspects of VD supplementation outcomes (17)(18)(19)(20).…”

Section: Study Design and Patientsmentioning

confidence: 99%

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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BackgroundCardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients.MethodsWe performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30–60 ng/ml were given 4,000 IU/day for 12 weeks.ResultsThere was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively).ConclusionOur pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.

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Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

Cited by 22 publications

References 34 publications

Cardiovascular Autonomic Neuropathy and Glucose Variability in Patients With Type 1 Diabetes: Is There an Association?

Cardiovascular Autonomic Neuropathy and Glucose Variability in Patients With Type 1 Diabetes: Is There an Association?

The Emerging Role of Vitamin D and Vitamin D Receptor in Diabetic Nephropathy

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

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