Is there a relationship between vitamin D with insulin resistance and diabetes mellitus?

Abstract

Available data suggest a possible link between abnormal vitamin D level and abnormal glucose homeostasis, two of the most common chronic medical conditions. Both conditions are associated with inflammation, and the exact mechanism for role of either on the other is not well clear. Literature investigating the link between vitamin D and either pre-diabetic states or diabetes is reviewed. Vitamin D deficiency is detrimental to insulin synthesis and secretion in animal and human studies. In humans, it has been shown by majority of observational studies, that vitamin D is positively correlated with insulin sensitivity and its role is mediated both by direct mechanism through the availability of vitamin D receptors in several tissues and indirectly through the changes in calcium levels. Large number of, but not all, variable samples cross sectional human trials have demonstrated an inverse relation between vitamin D status and impaired glucose tolerance, insulin resistance or diabetes. To compliment this conclusively, evidence from intervention studies is critically warranted before we can frankly state that vitamin D plays a role in diabetes prevention or treatment. Absence of both sizable prospective observational trials utilizing 25(OH)D as the main variable and the non-availability of randomized studies specifically designed to assess the effects of vitamin D on pre-diabetes and diabetes states, are the main obstacles to draw solid and conclusive relationships.

Association of Vitamin D Repletion with Normalization of Elevated Serum 17-OH-Progesterone

“…Vitamin D repletion in patients who are vitamin D-deficient/insufficient mitigates insulin-resistanceassociated disorders such as T2DM, PCOS, and NCAH [1,2,4]; however, the present report is the first report of the amelioration of elevated serum 17-OHP during vitamin D repletion in a patient with likely NCAH.…”

“…Serum 25-OH-vitamin D levels have been reported to be lower than in the general population in many conditions associated with insulin resistance, including: obesity, T2DM, PCOS, and both classic and non-classic congenital adrenal hyperplasia [1][2][3][4]. Vitamin D receptors are abundant in the adrenal cortex [6], suggesting a possible direct regulatory role for vitamin D in the biosynthesis of adrenal steroids.…”

“…Vitamin D deficiency and abnormal glucose metabolism have been shown to be associated in humans and causally related in animal models [1,2], although the efficacy of vitamin D repletion/supplementation as a diabetes treatment is not yet universally accepted. We have previously reported that diverse interventions that reduce insulin resistance and hyperinsulinemia ameliorate non-classic adrenal hyperplasia (NCAH), biochemically and phenotypically, much as such interventions ameliorate polycystic ovarian syndrome (PCOS) [3,4].…”

Deficiencia de vitamina D en la práctica clínica pediátrica

“…[28][29][30] Aunque los mecanismos biológicos involucrados en estas asociaciones no han sido totalmente dilucidados, la evidencia sugiere un efecto cardiovascular y reno protector de la VD a través de la supresión del sistema renina angiotensina aldosterona, que inhibe la calcificación vascular y la formación de la capa ateroesclerótica, además de su acción antiinflamatoria e inmunomoduladora. [31][32][33] Enfermedades con malabsorción intestinal y DVD: La prevalencia de DVD en pacientes con síndromes de malabsorción intestinal, que incluyen fibrosis quística (FQ), enfermedad celíaca (EC), síndrome de intestino corto y enfermedad inflamatoria intestinal, es mayor que en la población general. La disminución de VD en estos pacientes se debe a varios factores, tales como la disminución de absorción de vitaminas liposolubles y la mayor expresión extrarrenal de CYP27B1 mediada por la inflamación y el hiperparatiroidismo secundario a la hipocalcemia en algunos pacientes; esto lleva a una mayor conversión de 25(OH)D en 1,25(OH) 2 D y, por tanto, a unas concentraciones de 25(OH)D más bajas.…”

Association of Apa I polymorphism of vitamin d receptor gene with type 2 diabetes mellitus in Saudi population

“…Deficiency of vitamin D is a worldwide public health issue. A study by James in 2008, reports that over 1 billion individuals suffer either from insufficient or deficient levels of vitamin D. Further, the association between vitamins D deficiency and abnormal glucose metabolism as seen in T2DM has been shown by various researchers (Melamed et al, 2008;Palomer et al, 2008;Pittas et al, 2010;Al-Shoumer & Al-Essa, 2015). A direct action via vitamin D receptor (VDR) gene activation or indirect action via calcemic hormones or inflammation was demonstrated by Thorand et al (2011) and Sung et al (2012).…”