Study of vitamin D supplementation on selected hematological and inflammatory parameters in type 2 diabetes mellitus with vitamin D deficiency

Abstract

Introduction: Diabetes mellitus (DM) results from decreased insulin secretion and/or increased insulin resistance. Vitamin D deficiency (VDD) is linked with decreased insulin secretion, increased insulin resistance, inflammation, and complications of DM. Few studies have reported association of VDD with anemia or decreased hemoglobin level in diabetic patients. Animal studies have reported some improvement in various blood parameters such as hemoglobin (Hb), hematocrit, red blood cell (RBC) and white blood cell count, and mononuclear cell count after Vitamin D supplementation. Neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are cheap, easy, reproducible, and dynamic parameters of inflammation with high predictive value. NLR can be associated with DM and its complications. PLR is reported to be associated with cardiovascular disease, diabetic complications, end-stage renal disease, and malignancies. Both have prognostic value. Materials and Methods: Sixty-three Type 2 DM (T2DM) patients on oral hypoglycemic agents aged 30–60 years with VDD (Vitamin D level <20 ng/ml) participated in this comparative and interventional study. Vitamin D, Hb, total leukocyte count (TLC), mean corpuscular volume (MCV), platelet, red cell distribution width (RDW), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC), packed cell volume (PCV), RBC count, NLR, and PLR were determined at baseline. Participants received Vitamin D 2000 IU daily orally for 12 weeks. All the parameters were estimated again after 12 weeks. Results: We found no correlation of Vitamin D with Hb, TLC, MCV, platelet, RDW, MCH, MCHC, PCV, RBC count, NLR, and PLR at baseline. Extremely significant rise in Vitamin D; nonsignificant fall in Hb, TLC, RDW, MCH, NLR, and PLR; and nonsignificant rise in MCV, MCHC, RBC count, and PCV were reported. Conclusion: There was no association of Vitamin D with hematological and inflammatory parameters. Nonsignificant improvement in the parameters was seen with Vitamin D supplementation.