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Open Access Highly Accessed Original investigation

Vitamin D supplementation as an adjuvant therapy for patients with T2DM: an 18-month prospective interventional study

Nasser M Al-Daghri123*, Khalid M Alkharfy124, Abdulaziz Al-Othman5, Emad El-Kholie1, Osama Moharram6, Majed S Alokail123, Yousef Al-Saleh37, Shaun Sabico13, Sudhesh Kumar8 and George P Chrousos19

Author Affiliations

1 Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Kingdom of Saudi Arabia

2 Center of Excellence in Biotechnology Research Center, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia

3 Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia

4 Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia

5 College of Applied Medical Sciences, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia

6 King Abdulaziz University Hospital, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia

7 College of Medicine, King Saud University for Health Sciences, Riyadh, 11426, Kingdom of Saudi Arabia

8 Clinical Sciences Research Institute, Diabetes and Metabolism Unit, Coventry, CV47AL, UK

9 First Department of Pediatrics, Athens University Medical School, Athens, 11527, Greece

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Cardiovascular Diabetology 2012, 11:85  doi:10.1186/1475-2840-11-85

Published: 18 July 2012

Abstract

Background

Vitamin D deficiency has been associated with impaired human insulin action, suggesting a role in the pathogenesis of diabetes mellitus type 2 (T2DM). In this prospective interventional study we investigated the effects of vitamin D3 supplementation on the metabolic profiles of Saudi T2DM subjects pre- and post-vitamin D supplementation over an 18-month period.

Methods

T2DM Saudi subjects (men, N = 34: Age: 56.6 ± 8.7 yr, BMI, 29.1 ± 3.3 kg/m2; women, N = 58: Age: 51.2 ± 10.6 yr, BMI 34.3 ± 4.9 kg/m2;) were recruited and given 2000 IU vitamin D3 daily for 18 months. Anthropometrics and fasting blood were collected (0, 6, 12, 18 months) to monitor serum 25-hydroxyvitamin D using specific ELISA, and to determine metabolic profiles by standard methods.

Results

In all subjects there was a significant increase in mean 25-hydroxyvitamin D levels from baseline (32.2 ± 1.5 nmol/L) to 18 months (54.7 ± 1.5 nmol/L; p  < 0.001), as well as serum calcium (baseline = 2.3 ± 0.23 mmol/L vs. 18 months = 2.6 ± 0.1 mmol/L; p = 0.003). A significant decrease in LDL- (baseline = 4.4 ± 0.8 mmol/L vs. 18 months = 3.6 ± 0.8 mmol/L, p  < 0.001] and total cholesterol (baseline = 5.4 ± 0.2 mmol/L vs. 18 months = 4.9 ± 0.3 mmol/L, p < 0.001) were noted, as well as a significant improvement in HOMA-β function ( p  = 0.002). Majority of the improvements elicited were more prominent in women than men.

Conclusion

In the Saudi T2DM population receiving oral Vitamin D3 supplementation (2000 IU/day), circulating 25-hydroxyvitamin D levels remained below normal 18 months after the onset of treatment. Yet, this “suboptimal” supplementation significantly improved lipid profile with a favorable change in HDL/LDL ratio, and HOMA-β function, which were more pronounced in T2DM females.

Keywords:
Vitamin D; Diabetes mellitus; Saudi; Supplementation