The Impact of Vitamin D Levels on Glycemic Control and Bone Mineral Density in Postmenopausal Women with Type 2 Diabetes

Overview

Journal J Endocrinol Invest

Publisher Springer

Specialty Endocrinology

Date 2015 Oct 19

PMID 26476727

Citations 13

Authors

I Perez-Diaz

G Sebastian-Barajas

Z G Hernandez-Flores

R Rivera-Moscoso

H K Osorio-Landa

A Flores-Rebollar

Affiliations

Soon will be listed here.

Abstract

Objectives: Whether glycemic control contributes to a decreased number of fractures or favorably impacts bone density in patients with type 2 diabetes mellitus (T2DM)has not been well established. Vitamin D (25 (OH) D3) deficiency appears to be related to glycemic control in patients with T2DM. The aim of this study was to determine the relationship between 25 (OH) D3 levels, glycemic control, bone mineral density (BMD), and the development of osteoporotic fractures (OPF) in postmenopausal women with T2DM.

Methods: We reviewed the charts of 110 postmenopausal women diagnosed with T2DM. Glycosylated hemoglobin A1c (HbA1c) values over the previous 5 years were recorded and an average was obtained. Based on these values,the patients were divided into three groups: optimal,suboptimal, and poor control. Bone mineral density and 25(OH) D3 levels were also recorded.

Results: In the group of patients with poorly controlled T2DM, 25 (OH) D3 levels were not significantly lower in comparison with the optimal control group 19.29 ± 7.70 vs 17.26 ± 6.93 (p = 0.53). No statistically significant linear relationship between HbA1c and 25 (OH) D3 levels( r(s) = −0.17, p = 0.06) was established. The frequency of osteoporosis and osteopenia was not significantly different between groups. The group with optimal glycemic control had an increased number of OPF events (p = 0.04).

Conclusions: We do not appreciate a significant relationship between 25 (OH) D3 levels and glucose control or OPF. Therefore, more studies are needed to identify the specific effect of 25 (OH) D3 in T2DM physiopathology.

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References

Pittas A, Lau J, Hu F, Dawson-Hughes B . The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007; 92(6):2017-29. PMC: 2085234. DOI: 10.1210/jc.2007-0298. View

Farr J, Drake M, Amin S, Melton 3rd L, McCready L, Khosla S . In vivo assessment of bone quality in postmenopausal women with type 2 diabetes. J Bone Miner Res. 2013; 29(4):787-95. PMC: 3961509. DOI: 10.1002/jbmr.2106. View

Abdulameer S, Syed Sulaiman S, Hassali M, Subramaniam K, Sahib M . Osteoporosis and type 2 diabetes mellitus: what do we know, and what we can do?. Patient Prefer Adherence. 2012; 6:435-48. PMC: 3393120. DOI: 10.2147/PPA.S32745. View

Kositsawat J, Freeman V, Gerber B, Geraci S . Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey. Diabetes Care. 2010; 33(6):1236-8. PMC: 2875430. DOI: 10.2337/dc09-2150. View

Holick M . Vitamin D deficiency. N Engl J Med. 2007; 357(3):266-81. DOI: 10.1056/NEJMra070553. View

Melton 3rd L . How many women have osteoporosis now?. J Bone Miner Res. 1995; 10(2):175-7. DOI: 10.1002/jbmr.5650100202. View

Watts N, Bilezikian J, Camacho P, Greenspan S, Harris S, Hodgson S . American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract. 2011; 16 Suppl 3:1-37. PMC: 4876714. DOI: 10.4158/ep.16.s3.1. View

Shu A, Yin M, Stein E, Cremers S, Dworakowski E, Ives R . Bone structure and turnover in type 2 diabetes mellitus. Osteoporos Int. 2011; 23(2):635-41. PMC: 3690650. DOI: 10.1007/s00198-011-1595-0. View

Bellan M, Guzzaloni G, Rinaldi M, Merlotti E, Ferrari C, Tagliaferri A . Altered glucose metabolism rather than naive type 2 diabetes mellitus (T2DM) is related to vitamin D status in severe obesity. Cardiovasc Diabetol. 2014; 13:57. PMC: 3995712. DOI: 10.1186/1475-2840-13-57. View

10.

Leslie W, Rubin M, Schwartz A, Kanis J . Type 2 diabetes and bone. J Bone Miner Res. 2012; 27(11):2231-7. DOI: 10.1002/jbmr.1759. View

11.

Mathew C, Dominic M, Isaac R, Jacob J . Prevalence of depression in consecutive patients with type 2 diabetes mellitus of 5-year duration and its impact on glycemic control. Indian J Endocrinol Metab. 2012; 16(5):764-8. PMC: 3475901. DOI: 10.4103/2230-8210.100671. View

12.

Zhukouskaya V, Eller-Vainicher C, Ellen-Vainicher C, Gaudio A, Privitera F, Cairoli E . The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients. Osteoporos Int. 2015; 27(1):49-56. DOI: 10.1007/s00198-015-3212-0. View

13.

Landrier J, Marcotorchino J, Tourniaire F . Lipophilic micronutrients and adipose tissue biology. Nutrients. 2012; 4(11):1622-49. PMC: 3509510. DOI: 10.3390/nu4111622. View

14.

Sealand R, Razavi C, Adler R . Diabetes mellitus and osteoporosis. Curr Diab Rep. 2013; 13(3):411-8. DOI: 10.1007/s11892-013-0376-x. View

15.

Gagnon C, Lu Z, Magliano D, Dunstan D, Shaw J, Zimmet P . Low serum 25-hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study (The Australian Diabetes, Obesity and Lifestyle Study: AusDiab). J Clin Endocrinol Metab. 2012; 97(6):1953-61. DOI: 10.1210/jc.2011-3187. View

16.

Wortsman J, Matsuoka L, Chen T, Lu Z, Holick M . Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72(3):690-3. DOI: 10.1093/ajcn/72.3.690. View

17.

Schwartz A, Margolis K, Sellmeyer D, Vittinghoff E, Ambrosius W, Bonds D . Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial. Diabetes Care. 2012; 35(7):1525-31. PMC: 3379596. DOI: 10.2337/dc11-2184. View

18.

Mathieu C, Gysemans C, Giulietti A, Bouillon R . Vitamin D and diabetes. Diabetologia. 2005; 48(7):1247-57. DOI: 10.1007/s00125-005-1802-7. View

19.

Chiu K, Chu A, Go V, Saad M . Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5):820-5. DOI: 10.1093/ajcn/79.5.820. View

20.

Mitri J, Muraru M, Pittas A . Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr. 2011; 65(9):1005-15. PMC: 4066381. DOI: 10.1038/ejcn.2011.118. View