The Effect of Vitamin D and FokI Vitamin D Receptor Polymorphism to 25 (OH) D, TNF-α and Nitric Oxide Levels in Diabetic Foot Patients

Abstract

Vitamin D receptors thought to reduce the inflammatory process activity of diabetic foot ulcers which is influenced by vitamin D receptor polymorphism (VDR). The inflammatory indicators that play a role, including TNF-α and Nitric Oxide (NO), while the VDR gene that mostly studied concerning type 2 DM is FokI variant. This study aimed to analyze the effect of oral vitamin D administration on levels of 25 (OH) D, TNF-α, and NO through VDR Fok-I genetic polymorphism in patients with diabetic foot ulcers. This experimental study used the pre and post-test control group design method with 36 diabetic foot patients of West Sumatera, Indonesia, who randomly divided into two groups, namely the group given once only100, 000 IU vitamin D3, and the control group was given once only placebo capsules before blood examination. Each respondent was examined for blood for levels of 25 (OH) D, TNF-α, NO, VDR FokI gene polymorphism (PCR analysis and sequencing). Blood tests were taken before treatment (H0) and four weeks later (H28). The results showed that the most VDRFokI gene polymorphisms were heterozygous mutant types followed by wild-type and homozygous mutants. Giving vitamin D increases levels of 25 (OH) D and NO, but does not reduce levels of TNF-α. There is no effect of VDR FokI gene polymorphism on levels of 25 (OH) D, TNF-α, and NO levels. CONCLUSIONS Administration of vitamin D is beneficial in diabetic foot patients to increase levels of 25 (OH) D and Nitric oxide (NO) oxide, but not affected by the VDR FokI genetic polymorphism.