Clinical Trial on the Effects of Vitamin D Supplementation on Metabolic Profiles in Diabetic Hemodialysis

Abstract

The current study was conducted to assess the effects of vitamin D supplementation on insulin metabolism, lipid fractions, biomarkers of inflammation, and oxidative stress in diabetic hemodialysis (HD) patients. This randomized double-blind placebo-controlled clinical trial was carried out among 60 diabetic HD patients. Subjects were randomly allocated into two groups to intake either oral vitamin D3 supplements at a dosage of 50 000 IU (n=30) or placebo (n=30) every 2 weeks for 12 weeks. After 12 weeks of intervention, subjects who received vitamin D supplements compared with the placebo had significantly decreased serum insulin concentrations (-3.4±3.7 vs. +2.0±4.2 μIU/ml, p<0.001), homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (-1.2±1.8 vs. +0.9±2.3, p<0.001), and improved quantitative insulin sensitivity check index (QUICKI) (+0.02±0.03 vs. -0.01±0.02, p<0.001). In addition, compared with the placebo, vitamin D supplementation led to significant reductions in serum high-sensitivity C-reactive protein (hs-CRP) (-1.4±2.5 vs. +1.4±4.8 mg/l, p=0.007), plasma malondialdehyde (MDA) (-0.1±0.2 vs. +0.1±0.2 μmol/l, p=0.009) and a significant increase in plasma total antioxidant capacity (TAC) concentrations (+33.8±56.7 vs. -2.0±74.5 mmol/l, p=0.04). We did not see any significant effect of vitamin D supplementation on lipid profiles and other biomarkers of inflammation and oxidative stress compared with the placebo. Overall, we found that vitamin D supplementation had beneficial effects on serum insulin, HOMA-IR, QUICKI, serum hs-CRP, plasma MDA, and TAC levels among diabetic HD patients for 12 weeks. CLINICAL REGISTRATION:: http://www.irct.ir: IRCT201611155623N92.

Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions

“…At the end of the study period, patients who were treated with vitamin D had significantly decreased serum levels of high-sensitivity CRP and MDA and higher serum TAC levels compared to levels in the placebo group. 150 Compared to the placebo group, the vitamin D group had lower plasma insulin levels and less insulin resistance. Therefore, the authors of the study hypothesized that the beneficial effect of vitamin D therapy might be attributed to the reduced plasma insulin and insulin resistance inhibiting the accumulation of oxidative products linked with poor glycemic control.…”

“…They were randomized to receive either 50 000 IU of vitamin D3 or matching placebo every 2 weeks for 3 months. At the end of the study period, patients who were treated with vitamin D had significantly decreased serum levels of high‐sensitivity CRP and MDA and higher serum TAC levels compared to levels in the placebo group . Compared to the placebo group, the vitamin D group had lower plasma insulin levels and less insulin resistance.…”

“…Compared to the placebo group, the vitamin D group had lower plasma insulin levels and less insulin resistance. Therefore, the authors of the study hypothesized that the beneficial effect of vitamin D therapy might be attributed to the reduced plasma insulin and insulin resistance inhibiting the accumulation of oxidative products linked with poor glycemic control . In another study from the same group with the same design, but using gene expression of OS and inflammatory biomarkers as endpoints, vitamin D intake was accompanied by a significant down‐regulation of gene expression related to inflammation and OS .…”

The Effects of Vitamin D Supplementation on Biomarkers of Inflammation and Oxidative Stress in Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Several studies have demonstrated that vitamin D intake may reduce the inflammatory response and oxidative stress [6,7]. Therefore, hypovitaminosis D has been suggested to contribute to various metabolic-related conditions including insulin resistance [8], diabetes [9], and CVD [10].…”

Comparison of a novel herbal skin care ointment with regular ointments to treat skin around the abdominal stoma: A clinical trial study

“…[36][37][38][39][40][41] The Kolmogorov-Smirnov test was used to assess the normality o� the data. [42][43][44][45][46] All subjects in the two groups were classified and analyzed by statistical tests o� the χ 2 , Mann-Whitney and Fridman tests. [47][48][49][50][51][52] In the present study, a P ≤ 0.05 was considered to be significant.…”