Hasan Qader Sofihussein, Abdulqader Azeez Al-Naqshabandi, Hawri Fatih Sami, Mudhafar Mohamed M. Saeed
Hasan Qader Sofihussein1, Abdulqader Azeez Al-Naqshabandi2, Hawri Fatih Sami3, Mudhafar Mohamed M. Saeed4*
1Polytechnic University of Sulaimani, Technical Institute of Sulaimani, Department of Pharmacy, Sulaimani, Kudistan Region, Iraq.
2Hawler Medical University, College of pharmacy, Hawler, Kudistan Region, Iraq.
3Cihan University, College of Science, Hawler, Kudistan Region, Iraq.
4Polytechnic University of Sulaimani, Technical Institute of Sulaimani, Department of Pharmacy, Sulaimani, Kudistan Region, Iraq.
Volume - 13,
Issue - 9,
Year - 2020
Bachground: Hypovitaminosis D has been observed in all ethnicities and age groups worldwide. Beyond its role in bone metabolism and calcium homeostasis, there is abundant evidence showing that there is a link between vitamin D and major pathological conditions such as cancer, type II diabetes mellitus, autoimmune disease, and various inflammatory disorders. Decreasing risks of these diseases involve the supplementation of vitamin D3 on daily doses at its normal level. This research focused on the role of vitamin D3 supplement on the level of glycated hemoglobin and hs-CRP and its impact on reducing risks of cardiovascular disease in type-2 diabetic vitamin D deficient patients. Methods:The study sample consisted of 91 patients (17 males and 74 females). For a period of 14 weeks, they received daily supplementation with 5000 IU added to their other treatment regimens. Before and after supplementation with vitamin D3, data on the patients’ anthropometric characteristics were collected and analyzed. Body mass index was measured. Afterwards, fasting venous blood samples were taken from the patients for investigation of, HbA1c, FBS, lipid profile, fasting serum insulin (mU/L), amylin (pg/ml), C-peptide (ng/ml), TNF-a,IL6, and hs-CRP. TG/HDL-c, and the homeostasis model of assessments of insulin resistance (HOMA-IR) were calculated. Results:The current study was carried out on 91 patients withtype-2 diabetes. Fourteen weeks of supplementation with vitamin D resulted in sharp amelioration in vitamin D level which in turn led to a significant decrease in the level of HbA1c, fasting blood glucose, IL-6, TNF-a, hs-CRP, waist circumference (WC), BMI, TG and TG/HDL-c ratio. While, a non-significant drop in HOMA-IR, Total cholesterol, and LDL-c. It also resulted in significant improvement in the level of fasting insulin, C-peptide, and HDL-c, and non-significant improvement in amylin. Conclusion: Vitamin D supplementation significantly decreased percentage of glycated hemoglobin as well as the level of hs-CRP, which in turn results in reducing cardiovascular disease risks in type-2 diabetic vitamin D deficient patients.
Cite this article:
Hasan Qader Sofihussein, Abdulqader Azeez Al-Naqshabandi, Hawri Fatih Sami, Mudhafar Mohamed M. Saeed. Effect of Vitamin D supplement on the risks of Cardiovascular disease in patients with type 2 diabetes in the Kurdistan Region of Iraq. Research J. Pharm. and Tech 2020; 13(9):4125-4129. doi: 10.5958/0974-360X.2020.00728.3
1. Mortality, G. B. D. and Causes of Death, C. 2015. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385, 117-171.
2. Nichols, M., Townsend, N., Scarborough, P. and Rayner, M. 2014. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J, 35, 2950-9.
3. Dusso, A. S., Brown, A. J. and Slatopolsky, E. 2005. Vitamin D. Am J Physiol Renal Physiol, 289, F8-28.
4. Calvo, M. S., Whiting, S. J. and Barton, C. N. 2005. Vitamin D intake: a global perspective of current status. J Nutr, 135, 310-6.
5. Rosen, C. J. 2011. Clinical practice. Vitamin D insufficiency. N Engl J Med, 364, 248-54.
6. Holick, M. F. 2007. Vitamin D deficiency. N Engl J Med, 357, 266-81.
7. Chonchol, M. and SCRAGG, R. 2007. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey. Kidney Int, 71, 134-9.
8. Duplancic, D., Cesarik, M., Poljak, N. K., Radman, M., Kovacic, V., RADIC, J. and ROGOSIC, V. 2013. The influence of selective vitamin D receptor activator paricalcitol on cardiovascular system and cardiorenal protection. Clinical Interventions in Aging, 8, 149-156.
9. Gotsman, I., Shauer, A., Zwas, D. R., Hellman, Y., Keren, A., Lotan, C. and Admon, D. 2012. Vitamin D deficiency is a predictor of reduced survival in patients with heart failure; vitamin D supplementation improves outcome. Eur J Heart Fail, 14, 357-66.
10. DE Metrio, M., Milazzo, V., Rubino, M., Cabiati, A., Moltrasio, M., Marana, I., Campodonico, J., Cosentino, N., Veglia, F., Bonomi, A., Camera, M., Tremoli, E. and Marenzi, G. 2015. Vitamin D plasma levels and in-hospital and 1-year outcomes in acute coronary syndromes: a prospective study. Medicine (Baltimore), 94, e857.
11. Aleksova, A., Belfiore, R., Carriere, C., Kassem, S., LA Carrubba, S., Barbati, G. and Sinagra, G. 2015. Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study. Int J Vitam Nutr Res, 85, 23-30.
12. Wolpowitz, D. and Gilchrest, B. A. 2006. The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol, 54, 301-17.
13. AL-Shoumer, K. A. and AL-Essa, T. M. 2015. Is there a relationship between vitamin D with insulin resistance and diabetes mellitus? World journal of diabetes, 6, 1057-1064.
14. Song, B. M., Kim, H. C., Choi, D. P., OH, S. M. and SUH, I. 2014. Association between serum 25-hydroxyvitamin D level and insulin resistance in a rural population. Yonsei medical journal, 55, 1036-1041
15. Hossein-Nezhad, A. and Holick, M. F. 2013. Vitamin D for health: a global perspective. Mayo Clinic proceedings, 88, 720-755.
16. Upadhyay, R. K. 2015. Emerging risk biomarkers in cardiovascular diseases and disorders. Journal of lipids, 2015, 971453-971453.
17. Judd, S. E. and Tangpricha, V. 2009. Vitamin D deficiency and risk for cardiovascular disease. The American journal of the medical sciences, 338, 40-44.
18. Stevens, R. J., Kothari, V., Adler, A. I. and Stratton, I. M. 2001. The UKPDS risk engine: a model for the risk ofcoronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond), 101, 671-9.
19. G. Pearson, R., Terence, T. P. and LIU, C. 2004. Modelling species distributions in Britain: Ahierarchical integration of climate and land-cover data.
20. Razzaghi, R., Pourbagheri, H., Momen-Heravi, M., Bahmani, F., Shadi, J., Soleimani, Z. and Asemi, Z. 2017. The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial. J Diabetes Complications, 31, 766-772.
21. Talaei, A., Mohamadi, M. and Adgi, Z. 2013. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetology and Metabolic Syndrome, 5, 8.
22. Sun, X., Cao, Z. B., Tanisawa, K., Ito, T., Oshima, S. and Higuchi, M. 2016. Vitamin D supplementation reduces insulin resistance in Japanese adults: a secondary analysis of a double-blind, randomized, placebo-controlled trial. Nutr Res, 36, 1121-1129.
23. Karamali, M., Beihaghi, E., Mohammadi, A. A. and Asemi, Z. 2015. Effects of High-Dose Vitamin D Supplementation onMetabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia. Horm Metab Res, 47, 867-72.
24. DE Medeiros Cavalcante, I. G., Silva, A. S., Costa, M. J., Persuhn, D. C., Issa, C. T., DE Luna Freire, T. L. and DA Conceicao Rodrigues Goncalves, M. 2015. Effect of vitamin D3 supplementation and influence of BsmI polymorphism of the VDR gene of the inflammatory profile and oxidative stress in elderly women with vitamin D insufficiency: Vitamin D3 megadose reduces inflammatory markers. Exp Gerontol, 66, 10-6.
25. Wu, S., Liao, A. P., Xia, Y., Li, Y. C., Li, J. D., Sartor, R. B. and Sun, J. 2010. Vitamin D receptor negatively regulates bacterial-stimulated NF-kappaB activity in intestine. Am J Pathol, 177, 686-97.
26. Chen, C.-D., Sloane, J., Li, H., Aytan, N., Giannaris, E., Zeldich, E., Hinman, J., Dedeoglu, A., Rosene, D., Bansal, R., Luebke, J., Kuro-O, M. and R Abraham, C. 2013. Chen et al., 2013.
27. Sun, J., Kong, J., Duan, Y., Szeto, F. L., Liao, A., Madara, J. L. and LI, Y. C. 2006. Increased NF-kappaB activity in fibroblasts lacking the vitamin D receptor. Am J Physiol Endocrinol Metab, 291, E315-22.
28. DE Souza, W. N., Norde, M. M., Oki, E., Rogero, M. M., Marchioni, D. M., Fisberg, R. M. and Martini, L. A. 2016. Association between 25-hydroxyvitamin D and inflammatory biomarker levels in a cross-sectional population-based study, Sao Paulo, Brazil. Nutr Res, 36, 1-8
29. Sharifi N., Amani R, Hajiani E, Cheraghian B. Does Vitamin D Improve Liver Enzymes, Oxidative Stress, and Inflammatory Biomarkers in Adults With Non-Alcoholic Fatty Liver Disease? A Randomized Clinical Trial , Endocrino, 47 (1), 70-80 , Sep 2014. DOI: 10.1007/s12020-014-0336-5
30. Raftery, T., Martineau, A. R., Greiller, C. L., Ghosh, S., Mcnamara, D., Bennett, K., Meddings, J. and O'sullivan, M. 2015. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn's disease: Results from a randomised double-blind placebo-controlled study. United European Gastroenterol J, 3, 294-302.
31. Munoz-Aguirre, P., Flores, M., Macias, N., Quezada, A. D., Denova-Gutierrez, E. and Salmeron, J. 2015. The effect of vitamin D supplementation on serum lipids in postmenopausal women with diabetes: A randomized controlled trial. Clin Nutr, 34, 799-804.
32. Calvo-Romero, J. M. and Ramiro-Lozano, J. M. 2016. Metabolic effects of supplementation with vitamin D intype 2 diabetic patients with vitamin D deficiency. Diabetes Metab Syndr, 10, 72-4.
33. Yang, S. H., Du, Y., Li, X. L., Zhang, Y., Li, S., Xu, R. X., Zhu, C. G., Guo, Y. L., Wu, N. Q., Qing, P., Gao, Y., Cui, C. J., Dong, Q., Sun, J. and LI, J. J. 2017. Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Cardiovascular Events in Diabetics With Coronary Artery Disease. Am J Med Sci, 354, 117-124.
34. Wang, H., Xia, N., Yang, Y. and Peng, D.-Q. 2012. Influence of vitamin D supplementation on plasma lipid profiles: A meta-analysis of randomized controlled trials. Lipids in Health and Disease, 11, 42-42.
35. Reid, I. R. 2004. Effects of calcium supplementation on circulating lipids: potential pharmacoeconomic implications. Drugs Aging, 21, 7-17.
36. Rajpathak, S. N., Xue, X., Wassertheil-Smoller, S., Van Horn, L., Robinson, J. G., Liu, S., Allison, M., Martin, L. W., HO, G. Y. and Rohan, T. E. 2010. Effect of 5 y of calcium plus vitamin D supplementation on change in circulating lipids: results from the Women's Health Initiative. Am J Clin Nutr, 91, 894-9.