Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes

Yiu, Yau Chuen; Yiu, Kai‐Hang; Siu, Chung‐Wah; Chan, Yap‐Hang; Li, Sheung-Wai; Wong, Lai-Yung; Lee, Stephen W.L.; Tam, Sidney; Wong, Eric W. K.; Lau, Chu‐Pak; Cheung, Bernard Man Yung; Tse, Hung‐Fat

doi:10.1016/j.atherosclerosis.2012.12.013

Cited by 156 publications

(131 citation statements)

References 34 publications

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“…A couple of cross-sectional studies in healthy adults show lower serum levels of 25(OH)D to be associated with endothelial dysfunction (91,92) . A few trials show an improvement in flow-mediated dilation with vitamin D supplementation (93)(94)(95) , but most show no effect (79,(96)(97)(98) ( Table 2).…”

Section: Endothelial Functionmentioning

confidence: 99%

“…Currently, the best available inflammatory biomarker is CRP, an acute phase reactant that is a reliable, independent predictor of the risk of myocardial infarction, stroke and cardiovascular death (111) . Clinical trials of vitamin D supplementation show inconsistent results regarding an effect on CRP concentrations: most report no effect (77,80,97,(112)(113)(114)(115)(116) , whereas some show reductions in CRP concentrations (74,117,118) . Some trials have measured highsensitivity CRP (hsCRP), which can detect low-grade inflammation.…”

Section: Inflammationmentioning

confidence: 99%

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Vitamin D and risk of CVD: a review of the evidence

Fry

Sanders

2015

Proc. Nutr. Soc.

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This review summarises evidence for an association between vitamin D status and CVD and the mechanisms involved. Vitamin D 3 is predominantly provided by the action of UVB from sunlight on skin. Average UK diets supply 2-3 μg/d vitamin D but diets containing at least one portion of oily fish per week supply about 7 μg/d. Pharmacological doses of vitamin D 2 (bolus injection of 7500 μg or intakes >50 μg/d) result in a smaller increase in plasma 25 (OH)D than those of D 3 but physiological doses 5-25 μg/d seem equivalent. Plasma 25 (OH)D concentrations are also influenced by clothing, obesity and skin pigmentation. Up to 40 % of the population have plasma 25(OH)D concentrations <25 nmol/l in the winter compared with <10 % in the summer. The relative risk of CVD death is 1·41 (95 % CI 1·18, 1·68) greater in the lowest quintile of plasma 25(OH)D according to meta-analysis of prospective cohort studies. Acute deficiency may inhibit insulin secretion and promote inflammation thus increasing the risk of plaque rupture and arterial thrombosis. Chronic insufficiency may increase arterial stiffness. There is no evidence to support claims of reduced CVD from existing trials with bone-related health outcomes where vitamin D was usually co-administered with calcium. Although several trials with cardiovascular endpoints are in progress, these are using pharmacological doses. In view of the potential toxicity of pharmacological doses, there remains a need for long-term trials of physiological doses of D 2 and D 3 with CVD incidence as the primary outcome. Ergocalciferol: Cholecalciferol: Cardiovascular riskVitamin D deficiency causes rickets in children and osteomalacia in adults and may contribute to the causation of CVD. Cholecalciferol (vitamin D 3 ) is made by the action of UVB light on the skin but is also provided in the diet from foods of animal origin (eggs, oily fish and meat). Ergocalciferol (vitamin D 2 ) is present in fungi that have been exposed to UVB irradiation. Both forms of vitamin D undergo 25-hydroxylation in the liver to form 25(OH) metabolites, most of which circulate in plasma bound to the vitamin D binding protein (VDBP). In the kidney, 25 hydroxyvitamin D (25(OH)D) is converted to the biologically active metabolite 1,25 dihydroxyvitamin D (1,25 (OH) 2 D) by the action of 1α-hydroxylase (Fig. 1). This then binds to the vitamin D receptor, which is a highaffinity nuclear hormone receptor that regulates gene expression (1) . Measurement of serum 25(OH)D to assess vitamin D status has predominantly used immunoassays, which show lower sensitivity (about 30 %) to D 2 metabolites than gold-standard methods such as HPLC/tandem MS. Formerly, a lack of standardisation of methods and appropriate quality control made comparisons between studies difficult (2) . The situation has been remedied by the availability (3) of standard reference serum (SRM 972, National Institute of Standards and Technology) and a quality control programme in the UK organised by the Vitamin D External Quality Assessment Scheme (4) . It has...

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Section: Endothelial Functionmentioning

confidence: 99%

Section: Inflammationmentioning

confidence: 99%

Vitamin D and risk of CVD: a review of the evidence

Fry

Sanders

2015

Proc. Nutr. Soc.

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“…The quality assessment of the studies resulted in 14 out of 23 studies having a good quality (Appendix 1, see section on Appendix given at the end of this article) (12,19,20,21,22,23,24,25,26,27,28,29,30,31). The main characteristics and main outcomes of the included studies are given in Table 1.…”

Section: Description Of the Studiesmentioning

confidence: 99%

“…The main characteristics and main outcomes of the included studies are given in Table 1. All studies had a randomized controlled trial design, of which 18 studies used a placebo for control (12,19,20,22,23,24,25,27,29,30,31,32,33,34,35,36,37,38), three studies compared vitamin D fortified yoghurt versus plain yoghurt (21,28,39), one study used oral calcium supplementation for control (26), and one study used vitamin C supplementation for control (40). Apart from two studies, which solely included post-menopausal women (21,33), all studies included both men and women.…”

Section: Description Of the Studiesmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Krul-Poel

Wee

Lips

et al. 2017

European Journal of Endocrinology

101

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Objective: Epidemiologic studies suggest that vitamin D status plays a role in glycaemic control in patients with type 2 diabetes. However, intervention studies yielded inconsistent results. The aim of this study is to systematically review the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. Methods: Systematic review and meta-analysis. We searched Medline, Embase and the Cochrane Library for RCTs examining the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. A random-effects model meta-analysis was performed to obtain a summarized outcome of vitamin D supplementation on HbA 1c , fasting glucose and homeostasis model assessment -insulin resistance (HOMA-IR). Results: Twenty-three RCTs were included in this systematic review representing a total of 1797 patients with type 2 diabetes. Mean (± s.d.) change in serum 25-hydroxyvitamin D varied from 1.8 ± 10.2 nmol/L to 80.1 ± 54.0 nmol/L. Nineteen studies included HbA 1c as outcome variable. Combining these studies no significant effect in change of HbA 1c was seen after vitamin D intervention compared with placebo. A significant effect of vitamin D supplementation was seen on fasting glucose in a subgroup of studies (n = 4) with a mean baseline HbA 1c ≥ 8% (64 mmol/mol) (standardized difference in means: 0.36; 95% CI: 0.12-0.61, P = 0.003). Conclusions: Current evidence of RCTs does not support short-term vitamin D supplementation in a heterogeneous population with type 2 diabetes. However, in patients with poorly controlled diabetes, a favourable effect of vitamin D is seen on fasting glucose.

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“…Low 25(OH)D levels have been found to be associated with endothelial dysfunction, infl ammation, increased vascular stiffness and high coronary artery calcium scores [5]. In addition, 25(OH)D defi ciency aff ects vascular functions by aggravating atherosclerosis, while treatment with 25(OH)D may have protective eff ects on atherosclerosis [6,7]. Low 25(OH)D levels have been found to be associated with early signs of atherosclerosis such as increased carotid intima-media wall thickness [8].…”

Section: -Oh Vitamin D (25(oh)d)mentioning

confidence: 99%

Association between serum vitamin D levels and subclinical coronary atherosclerosis and plaque burden/composition in young adult population

Satılmış

Çelik²,

Bıyık

et al. 2015

Biomol Biomed

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Evidence suggests that low 25-OH vitamin D 25(OH)D concentrations may increase the risk of several cardiovascular diseases such as hypertension, peripheral vascular disease, diabetes mellitus, obesity, myocardial infarction, heart failure and cardiovascular mortality. Recent studies suggested a possible relationship between vitamin D defi ciency and increased carotid intima-media wall thickness and vascular calcifi cation. We hypothesized that low 25(OH)D may be associated with coronary atherosclerosis and coronary plaque burden and composition, and investigated the relationship between serum vitamin D levels and coronary atherosclerosis, plaque burden or structure, in young adult patients by using dual-source 128x2 slice coronary computed tomography angiography (CCTA). We included 98 patients with coronary atherosclerosis and 110, age and gender matched, subjects with normal fi ndings on CCTA examinations. Patients with subclinical atherosclerosis had signifi cantly higher serum total cholesterol, triglycerides, hs-CRP, uric acid, HbA1c and creatinine levels and lower serum 25(OH)D levels in comparison with controls. Th ere was no signifi cant correlation between 25(OH)D and plaque morphology. Th ere was also a positive relationship between 25(OH)D and plaque burden of coronary atherosclerosis. In multivariate analysis, coronary atherosclerosis was associated high hs-CRP (adjusted OR: 2.832), uric acid (adjusted OR: 3.671) and low 25(OH)D (adjusted OR: 0.689). Low levels of 25(OH)D were associated with coronary atherosclerosis and plaque burden, but there was no signifi cant correlation between 25(OH)D and plaque morphology.

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Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes

Cited by 156 publications

References 34 publications

Vitamin D and risk of CVD: a review of the evidence

Vitamin D and risk of CVD: a review of the evidence

MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Association between serum vitamin D levels and subclinical coronary atherosclerosis and plaque burden/composition in young adult population

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