The effects of short-term vitamin D supplementation on glucose metabolism in dialysis patients: a systematic review and meta-analysis

Sarathy, Harini; Pramanik, Vedatrayee; Kahn, Jared S.; Abramowitz, Matthew K.; Meier, Kristen; Kishore, Preeti; Melamed, Michal L.

doi:10.1007/s11255-015-0909-0

Cited by 20 publications

(16 citation statements)

References 40 publications

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“…A meta-analysis conducted by Zhang et al [24] had observed a consistent association between vitamin D deficiency and an increased risk of GDM. Similar results on fasting glucose levels were reported in a previous systematic review and meta-analysis of vitamin D supplementation in patients with end stage renal disease (ESRD) [25]. Consistently, Perez-Lopez et al [26] observed that vitamin D supplementation during pregnancy was not associated with maternal outcomes.…”

Section: Discussionsupporting

confidence: 80%

The Effects of Vitamin D Supplementation on Glucose Metabolism and Lipid Profiles in Patients with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of vitamin D supplementation on glucose homeostasis parameters and lipid profiles in gestational diabetes (GDM) patients. We conducted an electronic systematic search of MEDLINE, and 4 other research databases from inception to August 2016, in addition to performing hand searches and consulting with experts in the field. The index of heterogeneity between studies was determined using Cochran (Q) and I-squared tests. Given the existing heterogeneity between studies, a fix or random effect model was performed to estimate the standardized mean difference (SMD) for each variable by using inverse variance method and Cohen statistics. Six randomized clinical trials (187 subjects and 184 controls) were included. The results showed that vitamin D supplementation significantly reduced the homeostasis model assessment of insulin resistance (HOMA-IR) [SMD -0.66; 95% confidence interval (CI), -1.14 to -0.18], homeostatic model assessment-B cell function (HOMA-B) (SMD -0.52; 95% CI, -0.79 to -0.25), LDL-cholesterol levels (SMD -0.33; 95% CI, -0.58 to -0.07), and significantly increased quantitative insulin sensitivity check index (QUICKI) (SMD 0.73; 95% CI, 0.26 to 1.20). We found no beneficial effect of vitamin D supplementation on fasting plasma glucose (FPG), insulin, HbA1c, total-, HDL-cholesterol, and triglycerides concentrations. In conclusion, this meta-analysis demonstrated that vitamin D supplementation may lead to an improvement in HOMA-IR, QUICKI, and LDL-cholesterol levels, but did not affect FPG, insulin, HbA1c, triglycerides, total- and HDL-cholesterol levels; however, vitamin D supplementation increased HOMA-B.

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Section: Discussionsupporting

confidence: 80%

The Effects of Vitamin D Supplementation on Glucose Metabolism and Lipid Profiles in Patients with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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“…Although it was of retrospective design, additional information was offered on possible influences of interethnic differences and environmental factors in deciding the optimal vitamin D repletion regime among the CKD cohort. Short‐term (<12 weeks) vitamin D repletion was significantly associated with a decrease in fasting glucose level in a meta‐analysis of 17 trials involving end‐stage renal disease patients. However, those trials were of small sample sizes, heterogenous population and mainly using an activated vitamin D formulation.…”

Section: Discussionmentioning

confidence: 99%

Association between serum 25‐hydroxyvitamin D and glycated hemoglobin levels in type 2 diabetes patients with chronic kidney disease

Lim

Kang

et al. 2017

J of Diabetes Invest

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Aims/IntroductionVitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25‐hydroxyvitamin D (25[OH]D) and glycemic control in non‐chronic kidney disease (CKD) patients with type 2 diabetes was reported. We aimed to examine this association among type 2 diabetes patients with CKD.Materials and MethodsA total of 100 type 2 diabetes participants with stage 3–4 CKD were recruited. Blood for glycated hemoglobin (HbA1c), serum 25(OH)D, renal and lipid profiles were drawn at enrollment. Correlation and regression analyses were carried out to assess the relationship of serum 25(OH)D, HbA1c and other metabolic traits.ResultsA total of 30, 42, and 28% of participants were in CKD stage 3a, 3b and 4, respectively. The proportions of participants based on ethnicity were 51% Malay, 24% Chinese and 25% Indian. The mean (±SD) age and body mass index were 60.5 ± 9.0 years and 28.3 ± 5.9 kg/m2, whereas mean HbA1c and serum 25(OH)D were 7.9 ± 1.6% and 37.1 ± 22.2 nmol/L. HbA1c was negatively correlated with serum 25(OH)D (r s = −0.314, P = 0.002), but positively correlated with body mass index (r s = 0.272, P = 0.006) and serum low‐density lipoprotein cholesterol (P = 0.006). There was a significant negative correlation between serum 25(OH)D and total daily dose of insulin prescribed (r s = −0.257, P = 0.042). Regression analyses showed that every 10‐nmol/L decline in serum 25(OH)D was associated with a 0.2% increase in HbA1c.ConclusionsLower serum 25(OH)D was associated with poorer glycemic control and higher insulin use among multi‐ethnic Asians with type 2 diabetes and stage 3–4 CKD.

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“…Among RCTs, compared with placebo, short‐term (4–12 weeks) supplementation with vitamin D in ESRD was associated with significant decrease in fasting glucose and PTH levels but no change in fasting insulin levels. However, the findings are limited by the studies that were used in the meta‐analysis, which were mostly small, used multiple different vitamin D compounds and dosing regimens, and had large heterogeneity, and funnel plots showed that there was a dearth of studies with null or negative findings …”

Section: Discussionmentioning

confidence: 99%

“…However, the findings are limited by the studies that were used in the meta-analysis, which were mostly small, used multiple different vitamin D compounds and dosing regimens, and had large heterogeneity, and funnel plots showed that there was a dearth of studies with null or negative findings. 35 Several clinical intervention studies in patients with normal renal function reported that vitamin D, or its…”

Section: Discussionmentioning

confidence: 99%

Study of the effect of vitamin D supplementation on glycemic control in type 2 diabetic prevalent hemodialysis patients

Ibrahim

Sarhan

Halawa

et al. 2015

Hemodialysis International

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Vitamin D is claimed to have an adjuvant effect on glycemic control by dual action on pancreatic β-cells and insulin resistance. The aim of this study was to assess the possible effect of short-term alfacalcidol supply on glycemic control in type 2 diabetic hemodialysis (HD) patients. Twenty type 2 diabetic HD patients (using diet and oral drugs but not insulin) were randomly selected from our dialysis unit as well as 20 non-diabetic HD patients as control. A third group of 12 healthy subjects were studied as well. All three groups were similar in age, sex, and body mass index. Oral alfacalcidol therapy was administrated daily as recommended by Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for 12 weeks guided by monthly serum phosphorus and Cax PO4 product. Corrected total calcium, phosphorus, intact parathyroid hormone, 25-hydroxy vitamin D (25[OH]D), and glucoparameters (fasting blood glucose, glycated hemoglobin [HbA1c%], insulin resistance by homeostatic model assessment, and β-cell function by HOMA-β%) were measured under basal conditions and after 3 months of therapy. 25(OH)D was non-significantly lower in diabetic than non-diabetic HD patients, but significantly lower than healthy subjects at the start of the study. However, vitamin D level increased significantly after 3 months of trial, although the levels did not reach normal values. This vitamin D rise was associated with highly significant improvement in concentrations of fasting blood sugar (FBS), fasting insulin, HbA1c%, and HOMA-β-cell function in diabetic and non-diabetic controls. However, there was a significant rise in insulin resistance after treatment. The percentage of change was evident more in diabetics regarding FBS and 25(OH)D concentration. Adjustment of 25(OH)D level in type 2 diabetic prevalent HD patients may improve, at least with short-term therapy, glycemic control mainly through improving β-cell function.

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The effects of short-term vitamin D supplementation on glucose metabolism in dialysis patients: a systematic review and meta-analysis

Cited by 20 publications

References 40 publications

The Effects of Vitamin D Supplementation on Glucose Metabolism and Lipid Profiles in Patients with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The Effects of Vitamin D Supplementation on Glucose Metabolism and Lipid Profiles in Patients with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Association between serum 25‐hydroxyvitamin D and glycated hemoglobin levels in type 2 diabetes patients with chronic kidney disease

Study of the effect of vitamin D supplementation on glycemic control in type 2 diabetic prevalent hemodialysis patients

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