Comprehensive Review on Diabetes Associated Cardiovascular Complications - The Vitamin D Perspective

Abstract

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.

Vitamin D Status and Its Correlation With Anthropometric and Biochemical Indicators of Cardiometabolic Risk in Serbian Underground Coal Miners in 2016

“…According to official data (27), in 2016, in Serbia, there were 2,750 underground coal miners, working in shafts, and the vast majority of them were employed in the Resavica basin (76.4%). The required study sample size was 45 subjects, which was calculated according to the previously published data on summer Serbian general male population VitD levels (28) and the decided precision (margin of error) of ± 5 nmol/L at 95% confidence level, and the formula: needed sample size = (1.96) 2 * (SD) 2 /(decided precision) 2 (29). Considering possible unfitness, dropout, and planned further correlation analyses, we decided to initially include (i.e., invite to participate in the study) all 140 employed miners in this coal mine who attended their preventive systematic medical examinations, which would represent about 5% of Serbian coal miners.…”

“…On the day of the examination, the coal miners attended the center for preventive medical checkups at 07:00, after fasting overnight for 12 h. Detailed examinations to obtain information on their health were performed by medical specialists (including specialists of occupational health and internal medicine), and incorporated, inter alia, blood pressure measurements and fasting blood, and urine sampling for laboratory biochemical analyses. Supplementary analyses for this study involved the following: (1) anthropometric measures (including, among others segmental body composition analysis by bioelectrical impedance, BIA); (2) dietary surveys [such as the two times repeated 24 h recall and FFQ, which was validated for VitD intake (30)], (3) and further analyses of the obtained biochemical serum samples to determine VitD status by high-performance liquid chromatography (HPLC).…”

“…The relationship between vitamin D (VitD) status and obesity, metabolic syndrome, diabetes, and cardiovascular diseases has gained scientific attention over the last decades. Low serum vitamin D levels have been associated with obesity, metabolic syndrome, and increased risk for diabetes and cardiovascular diseases (1)(2)(3)(4). However, inconsistent findings exist, and cause/effect relationships still need to be confirmed (1)(2)(3)(4)(5).…”

“…Low serum vitamin D levels have been associated with obesity, metabolic syndrome, and increased risk for diabetes and cardiovascular diseases (1)(2)(3)(4). However, inconsistent findings exist, and cause/effect relationships still need to be confirmed (1)(2)(3)(4)(5).…”

“…Given that, this study aimed to examine the following: (1) the levels of serum VitD among a sample of underground working coal miners in Serbia; (2)…”