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Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized, double-blinded, placebo-controlled clinical trial

Bahram Pourghassem Gargari|Roya Yazdchi|Mohammad Asghari Jafar-abadi|Farnaz Sahhaf
한국영양학회 (The Korean Nutrition Society)|2016.06|Nutrition Research and Practice|제10권 제3호|pp. 328-335

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DiabetesC-reactive proteinvitamin Dgestation

초록

BACKGROUND/OBJECTIVES: Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients. SUBJECTS/METHODS: The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin D3 (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters. RESULTS: Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS: In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP.

Abstract

BACKGROUND/OBJECTIVES: Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients. SUBJECTS/METHODS: The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin D3 (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters. RESULTS: Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS: In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP.

참고문헌 (50)

  1. Metzger BE, "International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy", Diabetes Care, 33, pp.676~682 (2010)
  2. Wen SW, "Preeclampsia and gestational diabetes mellitus: pre-conception origins?", Med Hypotheses, 79, pp.120~125 (2012)
  3. Alzaim M, "Vitamin D and gestational diabetes mellitus", Nutr Rev, 71, pp.158~167 (2013)
  4. Burris HH, "Vitamin D deficiency in pregnancy and gestational diabetes mellitus", Am J Obstet Gynecol, 207, pp.182.e1~182.e8 (2012)
  5. Poel YH, "Vitamin D and gestational diabetes: a systematic review and meta-analysis", Eur J Intern Med, 23, pp.465~469 (2012)
  6. Peuchant E, "Oxidative and antioxidative status in pregnant women with either gestational or type 1 diabetes", Clin Biochem, 37, pp.293~298 (2004)
  7. Chu C, "The impacts of maternal gestational diabetes mellitus (GDM) on fetal hearts", Biomed Environ Sci, 25, pp.15~22 (2012)
  8. Sánchez-Vera I, "Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation in pregnancies complicated by gestational diabetes: consequences of obesity", Metabolism, 56, pp.1527~1533 (2007)
  9. Horvath K, "Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis", pp.c1395~ (2010), BMJ
  10. Wang O, "Association between vitamin D insufficiency and the risk for gestational diabetes mellitus in pregnant Chinese women", Biomed Environ Sci, 25, pp.399~406 (2012)
  11. Senti J, "Maternal vitamin D status as a critical determinant in gestational diabetes", J Obstet Gynecol Neonatal Nurs, 41, pp.328~338 (2012)
  12. Burris HH, "Vitamin D and gestational diabetes mellitus", Curr Diab Rep, 14, pp.451~ (2014)
  13. Berti C, "Micronutrients in pregnancy: current knowledge and unresolved questions", Clin Nutr, 30, pp.689~701 (2011)
  14. De-Regil LM, "Vitamin D supplementation for women during pregnancy", Cochrane Database Syst Rev, 2, pp.CD008873~ (2012)
  15. Wagner CL, "Vitamin D and its role during pregnancy in attaining optimal health of mother and fetus", Nutrients, 4, pp.208~230 (2012)
  16. Zhang C, "Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus", PLoS One, 3, pp.e3753~ (2008)
  17. Asemi Z, "Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind randomized controlled clinical trial", Am J Clin Nutr, 98, pp.1425~1432 (2013)
  18. Talaei A, "The effect of vitamin D on insulin resistance in patients with type 2 diabetes", Diabetol Metab Syndr, 5, pp.8~ (2013)
  19. Mozaffari-Khosravi H, "Effects of a single post-partum injection of a high dose of vitamin D on glucose tolerance and insulin resistance in mothers with first-time gestational diabetes mellitus", Diabet Med, 29, pp.36~42 (2012)
  20. Zittermann A, "Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers", Am J Clin Nutr, 89, pp.1321~1327 (2009)
  21. Metzger BE, "American Diabetes Association. Diagnosis and classification of diabetes mellitus", Diabetes Care, 37(Suppl 1), pp.S81~S90 (2014)
  22. Yu CK, "Vitamin D deficiency and supplementation during pregnancy", Clin Endocrinol (Oxf), 70, pp.685~690 (2009)
  23. Singla P, "Benefits of vitamin D supplementation in pregnancy for prevention of preeclampsia", Int J Pharma Bio Sci, 2, pp.144~150 (2012)
  24. Kalra P, "Effect of vitamin D supplementation during pregnancy on neonatal mineral homeostasis and anthropometry of the newborn and infant", Br J Nutr, 108, pp.1052~1058 (2012)
  25. Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)
  26. Wolden-Kirk H, "Vitamin D and diabetes: its importance for beta cell and immune function", Mol Cell Endocrinol, 347, pp.106~120 (2011)
  27. Lu L, "Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals", Diabetes Care, 32, pp.1278~1283 (2009)
  28. El Lithy A, "The relationship between low maternal serum vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels:an observational cross-sectional study", BMC Pregnancy Childbirth, 14, pp.362~ (2014)
  29. Lau SL, "Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus", Med J Aust, 194, pp.334~337 (2011)
  30. Davidson MB, "High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D", Diabetes Care, 36, pp.260~266 (2013)
  31. Wehr E, "Effect of vitamin D3treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study", J Endocrinol Invest, 34, pp.757~763 (2011)
  32. Witham MD, "The effect of different doses of vitamin D(3) on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial", Diabetologia, 53, pp.2112~2119 (2010)
  33. Ryu OH, "A prospective randomized controlled trial of the effects of vitamin D supplementation on long-term glycemic control in type 2 diabetes mellitus of Korea", Endocr J, 61, pp.167~176 (2014)
  34. Ardabili HR, "Vitamin D supplementation has no effect on insulin resistance assessment in women with polycystic ovary syndrome and vitamin D deficiency", Nutr Res, 32, pp.195~201 (2012)
  35. Ghavamzadeh S, "The effect of vitamin D supplementation on adiposity, blood glycated hemoglobin, serum leptin and tumor necrosis factor-α in type 2 diabetic patients", Int J Prev Med, 5, pp.1091~1098 (2014)
  36. Eftekhari MH, "Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients", Asia Pac J Clin Nutr, 20, pp.521~526 (2011)
  37. Rammos G, "Vitamin D, the renin-angiotensin system, and insulin resistance", Int Urol Nephrol, 40, pp.419~426 (2008)
  38. Pittas AG, "Vitamin D and diabetes", J Steroid Biochem Mol Biol, 121, pp.425~429 (2010)
  39. von Hurst PR, "Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial", Br J Nutr, 103, pp.549~555 (2010)
  40. Madar AA, "Effect of vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, serum lipids, and body mass index: a randomized, double-blinded, placebo-controlled trial among healthy immigrants living in Norway", BMJ Open Diabetes Res Care, 2, pp.e000026~ (2014)
  41. Patel P, "Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes:A pilot prospective randomized trial", J Diabetes, 2, pp.36~40 (2010)
  42. Muñoz-Aguirre P, "The effect of vitamin D supplementation on serum lipids in postmenopausal women with diabetes: a randomized controlled trial", Clin Nutr, 34, pp.799~804 (2015)
  43. Rahimi-Ardabili H, "Effects of vitamin D on cardiovascular disease risk factors in polycystic ovary syndrome women with vitamin D deficiency", J Endocrinol Invest, 36, pp.28~32 (2013)
  44. Lakshman LR, "Comparison of vitamin D levels in obese and nonobese patients with polycystic ovarian syndrome in a South Indian population", Int J Reprod Contracept Obstet Gynecol, 2, pp.336~343 (2013)
  45. Asemi Z, "Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome", Clin Nutr, 34, pp.586~592 (2015)
  46. Chen N, "Effect of vitamin D supplementation on the level of circulating high-sensitivity C-reactive protein: a meta-analysis of randomized controlled trials", Nutrients, 6, pp.2206~2216 (2014)
  47. Sadiya A, "Vitamin D supplementation in obese type 2diabetes subjects in Ajman, UAE: a randomized controlled doubleblinded clinical trial", Eur J Clin Nutr, 69, pp.707~711 (2015)
  48. Yiu YF, "Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes", Atherosclerosis, 227, pp.140~146 (2013)
  49. Asemi Z, "Vitamin D supplementation affects serum high-sensitivity C-reactive protein, insulin resistance, and biomarkers of oxidative stress in pregnant women", J Nutr, 143, pp.1432~1438 (2013)
  50. Beilfuss J, "Effects of a 1-year supplementation with cholecalciferol on interleukin-6, tumor necrosis factor-alpha and insulin resistance in overweight and obese subjects", Cytokine, 60, pp.870~874 (2012)

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