Abstract
BackgroundEndothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.MethodsSubjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n1 = 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n2 = 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.ResultsThe intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (P < 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, P = 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, P = 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, P < 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (P = 0.009 and P = 0.005, respectively) but disappeared for E-selectin (P = 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(P = 0.066) and MMP-9 (P = 0.277) but still remained significant for E-selectin (P = 0.011).ConclusionsAmeliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.Trial registrationClinicalTrials.gov: NCT01236846
Highlights
Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes
It is hypothesized that endothelial dysfunction is the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease (CVD) [4]
Subjects A total of 100 known patients with type 2 diabetes (T2D) (57 women and 43 men) 52.5 ± 7.4 years old were randomly selected from our original study population [12], all recruited from the Iranian Diabetes Society or Gabric Diabetes Society, both located in Tehran
Summary
Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. Accounting for more than 80% of all premature deaths, CVD has been known as the major cause of mortality in T2D [2]. Diabetes may affect both small and large vessels, leading to micro- and macro-angiopathy, respectively. Hyperinsulinemia and augmented oxidative stress, usually both present in diabetes, are known as two major contributing factors of the long-term complications, including micro- and macro-angiopathy [3]. It is hypothesized that endothelial dysfunction is the underlying cause of diabetic angiopathy that eventually leads to CVD [4]. The endothelial function may be the focus of preventive efforts against both diabetes and its fatal complications
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