Abstract

Rationale. The impact of vitamin D3 deficiency on the risk and prognosis of numerous chronic diseases has been actively studied for years. Recent research has demonstrated that vitamin D is not merely involved in the control of calcium-phosphorus metabolism, but can also enhance insulin sensitivity, decrease the incidence of type 2 diabetes mellitus (T2DM), obesity and autoimmune destruction of pancreatic β-cells. The influence of vitamin D3 on some cardiometabolic risk factors and cardiovascular disease (CVD) was described. Thus studying the role of vitamin D3 in the development of arteries wall changes in T2DM and IR, and their relationship with biology telomere seems to be quite relevant.Aim. To study the relationship between vitamin D3 deficiency and vascular wall condition, telomere biology in patients with varying insulin sensitivity.Materials and methods. The cross-sectional study involved 305 patients (106 men and 199 women) aged 51.5 ± 13.3 y.o. All patients underwent laboratory and instrumental research methods, study of morphofunctional state vascular wall. Telomere length and telomerase activity were determined using polymerase chain reaction.Results. Totally, 18 patients out of 248 (7.2%) were found to have normal vitamin D3 level (more than 30 ng/ml). In 92.8% of those studied Vitamin D3 insufficiency or deficiency was determined. As increase in vitamin D3 deficiency, an increase in fasting glucose was noted, HbA1c and its elevated concentration, HOMA index, glucose disorders up to T2DM, higher vascular stiffness. Telomerase activity in group with vitamin D3 deficiency was significantly lower than in groups with vitamin D3 insufficiency and normal content. Multiple linear regression analysis revealed that they are independently associated with vitamin D3 in T2DM (B=1.43; st. OR. 0.106; p=0.0001), vascular stiffness (B=0.075; st. OR. 2.11; p=0.017), fasting glucose (B=0.169; st. OR 1.62; p=0.004), HbA1c level (B=0.062; st. OR. 7.4; p=0.001) and the presence of “short” telomeres (B=0.09; st. OR. 1.154; p=0.001). ROC analysis revealed relationships between BMI (0.634, p=0.001), duration of T2DM (0.651, p=0.022), high intima media thickness (0.614, p=0.004), vascular stiffness (0.605, p<0.001), HbA1c (0.588, p=0.022) and presence of vitamin D3 deficiency.Conclusion. In persons with varying insulin sensitivity — from insulin resistance up T2DM is advisable assess vitamin D3 levels for effective prevention of arterial wall changes in addition to traditional CVD risk factors. Availability Vitamin D3 deficiency requires active prevention metabolic disorders and vascular changes.

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