A comparative study to determine vitamin D status in type 2 diabetes and normal subjects in south India
Abstract
Background: Vitamin D deficiency is common in general population in India in spite of adequate sunlight. We have decided to compare the prevalence of vitamin D deficiency in type 2 diabetes and normal individuals.
Methods: 370 type 2 diabetes individuals attending Karnataka Institute of endocrinology and research outpatient department and 100 normal individuals were studied. Fasting plasma glucose, post prandial plasma glucose, lipid profile, vitamin D levels, BMI, waist circumference and BP of these subjects were measured.
Results: Out of 370 type 2 diabetes subjects 67.3% were males and age group ranging from 21 to 80 years. Duration of diabetes vary from 0 to 20 years. Vitamin D deficiency was present in 83%, insufficiency in 13.8% and only 3.2% had normal vitamin D levels in type 2 diabetes. Vitamin D deficiency was common in individuals >50 years, males, BMI 25-30. Family history of diabetes was present in 60%. Hypertension was present in 47.6%. Total cholesterol, LDL, Triglycerides were lower and HDL levels were higher in type 2 diabetes individuals with vitamin D more than 20 nanograms per ml. In 100 normal individuals taken as controls 62% were males, age group ranging from 21 to 80 years. Vitamin D deficiency was present in 82% and insufficiency in 12% and 6% had normal vitamin D levels.
Conclusions: Vitamin D deficiency was present in 83% of type 2 diabetes individuals and 82% of normal individuals. So both type2 diabetes and normal controls from south India are equally deficient in vitamin D. Total cholesterol, LDL, Triglycerides were lower and HDL levels were higher in type 2 diabetes individuals with vitamin D more than 20 nanograms per ml.
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References
Zehnder D, Bland R, Williams MC, McNinch RW, Howie AJ, Stewart PM, Hewison M. Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. J Clin Endocrinol Metab.2001Feb;86(2):888-94.
Norman AW. Minireview: vitamin D receptor: new assignments for an already busy receptor. Endocrinology. 2006 Dec;147(12):5542-8. Epub 2006 Aug 31.
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, Rao PV, Yajnik CS, Prasanna Kumar KM, Nair JD; Diabetes Epidemiology Study Group in India (DESI). High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia.2001Sep;44(9):1094-101.
Chow CK, Raju PK, Raju R, Reddy KS, Cardona M, Celermajer DS, Neal BC. The prevalence and management of diabetes in rural India. Diabetes Care. 2006 Jul;29(7):1717-8.
Wild S, Roglic G, Green A, Sicree R, King H. Globalprevalence of diabetes: estimates for the year2000 and projections for 2030. Diabetes Care.2004 May;27(5):1047-53.
Ishii H, Suzuki H, Baba T, Nakamura K, Watanabe T. Seasonal variation of glycemic control in type 2 diabetic patients. Diabetes care. 2001 Aug 1;24(8):1503.
Campbell IT, Jarrett RJ, Keen H. Diurnal and seasonal variation in oral glucose tolerance: studies in the Antarctic. Diabetologia. 1975 Apr;11(2):139-45.
Pittas AG, Lau J, Hu FB, Dawson-Hughes B. Theroleofvitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab.2007 Jun;92(6):2017-29. Epub 2007 Mar 27.
Scragg R, Sowers M, Bell C; ThirdNational Health and Nutrition Examination Survey. Serum25-hydroxyvitamin D, diabetes, and ethnicity in the ThirdNational Health and Nutrition Examination Survey. Diabetes Care.2004Dec;27(12):2813-8.
Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietary calcium, vitamin D, and the prevalence of metabolicsyndrome in middle-aged and older U.S. women. Diabetes Care.2005Dec;28(12):2926-32.
Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, Hu FB. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006 Mar;29(3):650-6.
Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin Dsupplementation on blood glucose and markers of inflammation in nondiabeticadults. Diabetes Care.2007Apr;30(4):980-6. Epub 2007 Feb 2.
Di Cesar DJ, Ploutz-Snyder R, Weinstock RS, Moses AM. Vitamin D deficiency is more common in type 2 than in type 1 diabetes. Diabetes Care. 2006 Jan;29(1):174.
Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N. Prevalence and significanceoflow25-hydroxyvitamin Dconcentrations in healthy subjects in Delhi.Am J Clin Nutr.2000Aug;72(2):472-5.
Khadgawat R, Brar KS, Gahlo M, Yadav CS, Malhotra R, Guptat N, Tandon N. Highprevalence of vitamin D deficiency in Asian-Indianpatients with fragilityhip fracture: a pilot study. J Assoc Physicians India.2010 Sep;58:539-42.
Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PV, Sarma KV, Kumar EG. High prevalence of low dietary calcium, high phytate consumption, and vitamin D deficiency in healthy south Indians. The American journal of clinical nutrition. 2007 Apr 1;85(4):1062-7.
Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, Saberwal A, Bandra K. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India. 2011 Nov;59:706-9.
Lo CW, Paris PW, Holick MF. Indian and Pakistaniimmigrants have thesamecapacity as Caucasians to producevitamin D in response to ultravioletirradiation. Am J Clin Nutr.1986Nov;44(5):683-5.
Lips P, van Schoor NM, de Jongh RT. Diet, sun, and lifestyle as determinants of vitamin D status. Ann N Y Acad Sci. 2014 May;1317:92-8. doi: https://doi.org/10.1111/nyas.12443. Epub 2014 May 9.
Harinarayan CV, Joshi SR. Vitamin D status in India--its implications and remedial measures. J Assoc Physicians India. 2009 Jan;57:40-8.
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