Parathyroid Gland Response to Vitamin D Deficiency in Type 2 Diabetes Mellitus: An Observational Study

Abstract

BackgroundStudies have linked vitamin D deficiency with the risk of type 2 diabetes mellitus (T2DM) and to the development of chronic complication of diabetes. Vitamin D receptors (VDR) have been found in many tissues in the body including the pancreas, a finding that indicates its role in insulin secretion. In addition, many studies have demonstrated the role of vitamin D and its receptor in insulin sensitivity and signal transduction. Vitamin D deficiency is common throughout the world, but not all vitamin D deficiencies are accompanied by a rise in parathyroid hormone (PTH). The present study was conducted to assess vitamin D deficiency in type 2 diabetic patients in comparison to healthy control and to determine parathyroid gland response to vitamin D deficiency in both groups.MethodsThis observational study was performed during a period from January to October 2018. The study included 151 type 2 diabetic patients selected from three diabetes clinics and 43 age and sex-matched healthy subjects. Informed consent and clinical information were obtained from all participants before the study. Results of the laboratory analysis for serum 25-hydroxyvitamin D (25-OHD), PTH, calcium, and phosphorous were recorded. The data was analyzed using the statistical package for the social sciences (SPSS) Statistics 17.ResultsThe results showed low vitamin D concentration in both groups; however, there was no significant difference in vitamin D concentration between diabetic patients and the control patients. A high percentage of PTH level was found in severe vitamin D deficient diabetic patients and healthy controls. The higher percentage of diabetic and normal subjects with mild vitamin D deficiency had a normal PTH level. All healthy subjects with vitamin D insufficiency showed normal PTH concentration. About 10% of diabetic patients with severe vitamin D deficiency had a low PTH level.ConclusionThe population in our study was generally deficient in 25-OHD irrespective of diabetes mellitus, indicating a greater need for vitamin D supplementation. Not all vitamin D deficient patients have high PTH levels, a finding that supports the emergence of new criteria for vitamin D deficiency, diagnosis and treatment, and highlights the importance of testing PTH in this regard.

Role of Metformin on Osteoblast Differentiation in Type 2 Diabetes

“…Diabetes mellitus is manifested with abnormal bone mineral density (BMD), hyperglycemia, secondary calcium imbalance, disturbances in vitamin D [26], microvascular disease [27], and an increased risk of fall [28, 29]. With a high morbidity and mortality, it also adversely affects bone metabolism and increases the fracture risk [30–32].…”

Investigating The Effects Of Diet-Induced Pre-Diabetes On Calciotropic Hormones In Male Sprague Dawley Rats

“…Previous studies have found reduced plasma vitamin D and calcitriol levels among T2DM individuals [49,50]. These studies have shown that impaired renal reabsorption of vitamin D binding proteins, impaired intestinal vitamin D absorption and increased sequestration of vitamin D by adipose tissue may be responsible for decreased plasma vitamin D and calcitriol concentrations in T2DM [39,43]. Furthermore, studies have shown that calcitriol production is impaired due to renal damage, low plasma PTH levels and PTH resistance in T2DM [47,51].…”

“…Previous research has shown increased concentrations of PTH and calcitonin in plasma of type 2 diabetic individuals [37,38]. According to studies the increased PTH concentration may have compensated for the increased calcium loss in urine and the increased plasma calcitonin concentration may have protected the body against the adverse effects of PTH oversecretion [13,39]. The harmful effects associated with elevated PTH secretion include hypercalcaemia and bone loss [23].…”

“…Previous studies have shown that calciotropic hormones participate in the regulation of glucose homeostasis by modulating effects on gluconeogenesis, glycogenolysis and insulin-signaling [23,39]. Studies have shown that plasma PTH and calcitonin levels were positively correlated with hyperglycaemia and insulin resistance in T2DM [40,47].…”

Vitamin D eksikliği olan bireylerde paratiroid bezlerinin ultrasonografik değerlendirilmesi ve paratiroid bezi boyutlarının anksiyete-depresyon ile ilişkisinin belirlenmesi

“…Evre 2; Orta vitamin D eksikliğinde (25-OH vitamin D seviyesi <25 nmol/L ) parathormon seviyesinde %15-30 artış beklenir. Evre 3; ağır vitamin D eksikliğinde (25-OH vitamin D seviyesi <12,5 nmol/L) parathormon seviyesinde %30' dan fazla artış izlenmektedir (3). Şu anki verilere göre vitamin D düzeyi <20 ng/ml vitamin D eksikliği olarak tanımlanmaktadır (4).…”