ISSN 1301-109X | e-ISSN 2147-8325
Do Low Serum 25-Hydroxyvitamin D Levels Affect Progression of Prediabetes to Type 2 Diabetes? [TJI]
TJI. 2015; 3(1): 1-5 | DOI: 10.5606/tji.2015.359

Do Low Serum 25-Hydroxyvitamin D Levels Affect Progression of Prediabetes to Type 2 Diabetes?

Alev Kural1, Nilgün Işıksaçan1, Şebnem Neijmann Tekin1, Asuman Gedikbaşı1, Murat Koşer2, Nursel Kocamaz3
1Department of Biochemistry, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
2Department of Biochemistry, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
3Department of Internal Medicine, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey

Objectives: This study aims to investigate 25-hydroxyvitamin D (25(OH)D) levels in patients with glucose and glycated hemoglobin (HbA1c) defined prediabetes and type 2 diabetes mellitus (T2DM). Patients and methods: Eighty-nine prediabetic patients (44 males, 45 females; mean age 48.9±6.1 years) with impaired fasting glisemia (IFG) with glucose levels between 100-125 mg/dL (5.55-6.98 mmol/L) and HbA1c levels lower than 6.4% (46 mmol/mol), and 78 type 2 diabetic patients (40 males, 38 females; mean age 50.1±6.9 years) with HbA1c levels higher than 6.5% (48 mmol/mol) and glucose levels higher than 126 mg/dL (6.99 mmol/L) were included in the study. All patients were kept under strict control and were allowed to use their oral antidiabetics. Serum levels of glucose, insulin, HbA1c and 25(OH)D were measured in all patients. Insulin resistance was calculated by homeostasis model assessment formula. Results: While high density lipoprotein cholesterol (p=0.0001), insulin (p=0.013), insulin resistance (p=0.014), and vitamin D levels (p=0.0001) of T2DM patients were significantly lower compared to the IFG group, their HbA1c levels were higher (p=0.0001). There was a negative correlation between vitamin D and HbA1c (r=-0.327, p=0.006), but a positive correlation between vitamin D and insulin (r=0.215, p=0.006), and vitamin D and HOMA-IR (r=0.236, p=0.002). Glycated hemoglobin levels were significantly higher in the T2DM group than in the IFG group (p=0.0001). In the T2DM group, 25(OH)D levels were lower compared to the IFG group (p<0.0001). 25-hydroxy vitamin D levels were inversely associated with HbA1c levels in the T2DM group (p=0.0001, r=0.215). Conclusion: Vitamin D levels were lower in T2DM group than in IFG group. Our findings indicate that vitamin D supplementation to T2DM patients may improve glycemic control.

Keywords: Adaptive immunity; diabetes mellitus; innate immunity; type 2; vitamin D.

Düşük Serum 25 Hidroksi Vitamin D Düzeyleri Prediyabetin Tip 2 Diyabete Geçişini Etkiliyor mu?

Alev Kural1, Nilgün Işıksaçan1, Şebnem Neijmann Tekin1, Asuman Gedikbaşı1, Murat Koşer2, Nursel Kocamaz3
1Department of Biochemistry, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
2Department of Biochemistry, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
3Department of Internal Medicine, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey

Amaç: Bu çalışmada glikoz ve glikozillenmiş hemoglobine (HbA1c) göre prediyabetli ve tip 2 diabetes mellituslu (T2DM) hastaların 25 hidroksi vitamin D (25(OH)D) düzeyleri araştırıldı. Hastalar ve yöntemler: Glikoz düzeyleri 100-125 mg/dL arasında (5.55-6.98 mmol/L) ve HbA1c düzeyleri %6.4’ten düşük (46 mmol/mol), bozulmuş açlık glisemisi (BAG) olan 89 prediyabetik hasta (44 erkek, 45 kadın; ort. yaş 48.9±6.1 yıl) ve HbA1c düzeyleri %6.5’ten yüksek (48 mmol/mol) ve glikoz düzeyleri 126 mg/dL’den yüksek (6.99 mmol/L) 78 tip 2 diyabetik hasta (40 erkek, 38 kadın; ort. yaş 50.1±6.9 yıl) çalışmaya alındı. Tüm hastalar sıkı kontrol altında tutuldu ve hastaların oral antidiyabetiklerini kullanmalarına izin verildi. Tüm hastaların glikoz, insülin, HbA1c ve 25(OH)D serum düzeyleri ölçüldü. İnsülin direnci, hemostaz model değerlendirmesi formülü ile hesaplandı. Bulgular: Tip 2 diabetes mellituslu hastaların BAG grubuna göre yüksek yoğunluklu lipoprotein kolesterol (p=0.0001), insülin (p=0.013), insülin direnci (p=0.014) ve D vitamini (p=0.0001) düzeyleri anlamlı derecede düşük iken, HbA1c düzeyleri yüksek idi (p=0.0001). D vitamini ile HbA1c arasında negatif (r= -0.327, p=0.006), D vitamini ile insülin (r=0.215, p=0.006) ve D vitamini ile HOMA-IR arasında ise pozitif bir ilişki (r=0.236, p=0.002) vardı. Glikozillenmiş hemoglobin düzeyleri T2DM grubunda BAG grubuna göre anlamlı derecede yüksek idi (p=0.0001). T2DM grubunda 25(OH)D düzeyleri BAG grubuna göre daha düşük idi (p<0.0001). 25 hidroksi vitamin D düzeyleri T2DM grubunda HbA1c düzeyleri ile ters ilişkiliydi (p=0.0001, r=0.215). Sonuç: D vitamini seviyeleri T2DM grubunda BAG grubundan daha düşük idi. Bulgularımız T2DM hastalarına D vitamini takviyesi yapılmasının glisemik kontrolü iyileştirebileceğine işaret etmektedir.

Anahtar Kelimeler: Edinsel immünite; diabetes mellitus; doğal immünite; tip 2; D vitamini.

Alev Kural, Nilgün Işıksaçan, Şebnem Neijmann Tekin, Asuman Gedikbaşı, Murat Koşer, Nursel Kocamaz. Do Low Serum 25-Hydroxyvitamin D Levels Affect Progression of Prediabetes to Type 2 Diabetes?. TJI. 2015; 3(1): 1-5
Manuscript Language: English
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