Araştırma Makalesi
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The effect of vitamin D replacement therapy on insulin resistance: a retrospective study

Yıl 2025, Cilt: 7 Sayı: 5, 647 - 651, 15.09.2025
https://doi.org/10.38053/acmj.1739961

Öz

Aims: This study retrospectively evaluated the effect of a 3-month vitamin D replacement therapy in patients diagnosed with insulin resistance (IR) and low vitamin D levels. The relationship between changes in vitamin D levels and IR was investigated.
Methods: A total of 98 patients with low serum vitamin D levels and HOMA-IR >2.5, who were admitted to the internal medicine outpatient clinic between January 1 and December 31, 2023, were included in this retrospective study. Sociodemographic characteristics and pre-and post-treatment biochemical parameters were obtained from medical records. Post-supplementation levels of vitamin D, glucose, insulin, and HOMA-IR were analyzed. Pre-and post-treatment values were compared using paired t-tests. The relationship between changes in vitamin D levels and HOMA-IR scores was assessed using Spearman correlation analysis.
Results: Of the 98 patients, 85.7% were female and 14.3% were male, with a mean age of 39.09±11.45 years. A significant reduction in HOMA-IR score was observed after vitamin D supplementation (pre: 4.54±2.05; post: 3.01±1.28; p<0.0001). A statistically significant negative correlation was found between the increase in vitamin D levels and the decrease in HOMA-IR scores (r=–0.298, p=0.0029). In addition, glucose and insulin levels significantly decreased after treatment, while no significant changes were observed in lipid profile or vitamin B12 levels.
Conclusion: The findings suggest that vitamin D replacement therapy may have a beneficial effect on IR. Vitamin D supplementation could be considered as a supportive approach in the management of IR, especially in individuals with vitamin D deficiency. The more pronounced improvement observed in female patients indicates the potential importance of considering sex-specific differences in future clinical assessments, but this should be interpreted cautiously due to the limited number of male participants.

Kaynakça

  • Liu X, Tang HY, Luo ZC. Insulin resistance and skin diseases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020;42(2):247-250. doi:10.3881/j.issn. 1000-503X.11609
  • Goh LPW, Sani SA, Sabullah MK, Gansau JA. The prevalence of insulin resistance in Malaysia and Indonesia: an updated systematic review and meta-analysis. Medicina (Kaunas). 2022;58(6):826. doi:10.3390/medicina58060826
  • Bermudez V, Salazar J, Martínez MS, et al. Prevalence and associated factors of insulin resistance in adults from Maracaibo City, Venezuela. Adv Prev Med. 2016;2016:9405105. doi:10.1155/2016/9405105
  • Qu HQ, Li Q, Rentfro AR, Fisher-Hoch SP, McCormick JB. The definition of insulin resistance using HOMA-IR for Americans of Mexican descent using machine learning. PLoS One. 2011;6(6):e21041. doi:10.1371/journal.pone.0021041
  • Penno G, Solini A, Orsi E, et al. Insulin resistance, diabetic kidney disease, and all-cause mortality in individuals with type 2 diabetes: a prospective cohort study. BMC Med. 2021;19(1):66. doi:10.1186/s12916-021-01936-3
  • Insulin Resistance & Prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases. 2018.
  • Lazear J, Kapustin J. Vitamin D deficiency and type 2 diabetes: a retrospective review. J Nurse Practitioners. 2014;10(3):175-182. doi:10. 1016/j.nurpra.2013.12.010
  • Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5):820-825. doi:10.1093/ajcn/79.5.820
  • Trimarco V, Manzi MV, Mancusi C, et al. Insulin resistance and vitamin D deficiency: a link beyond the appearances. Front Cardiovasc Med. 2022;9:859793. doi:10.3389/fcvm.2022.859793
  • Yetgin S, Ozsoylu S, Ruacan S, Tekinalp G, Sarialioğlu F. Vitamin D-deficiency rickets and myelofibrosis. J Pediatr. 1989;114(2):213-217. doi:10.1016/s0022-3476(89)80785-1
  • Tao S, Yuan Q, Mao L, Chen FL, Ji F, Cui ZH. Vitamin D deficiency causes insulin resistance by provoking oxidative stress in hepatocytes. Oncotarget. 2017;8(40):67605-67613. doi:10.18632/oncotarget.18754
  • Park S, Kim DS, Kang S. Vitamin D deficiency impairs glucose-stimulated insulin secretion and increases insulin resistance by reducing PPAR-γ expression in nonobese type 2 diabetic rats. J Nutr Biochem. 2016;27:257-265. doi:10.1016/j.jnutbio.2015.09.013
  • Alissa EM, Alnahdi WA, Alama N, Ferns GA. Insulin resistance in Saudi postmenopausal women with and without metabolic syndrome and its association with vitamin D deficiency. J Clin Transl Endocrinol. 2014;2(1):42-47. doi:10.1016/j.jcte.2014.09.001
  • Lips P, Eekhoff M, van Schoor N, et al. Vitamin D and type 2 diabetes. J Steroid Biochem Mol Biol. 2017;173:280-285. doi:10.1016/j.jsbmb.2016.11.021
  • Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-1495. doi:10.2337/diacare.27.6.1487
  • Gidding SS. Dyslipidemia in the metabolic syndrome in children. J Cardiometab Syndr. 2006;1(4):282-285. doi:10.1111/j.1559-4564.2006. 05798.x
  • Chiarelli F, Marcovecchio ML. Insulin resistance and obesity in childhood. Eur J Endocrinol. 2008;159(Suppl 1):S67-74. doi:10.1530/EJE- 08-0245
  • Mohan A, Haider R, Fakhor H, et al. Vitamin D and polycystic ovary syndrome (PCOS): a review. Ann Med Surg. 2023;85(7):3506-3511. doi: 10.1097/MS9.0000000000000879
  • Ozfirat Z, Chowdhury TA. Vitamin D deficiency and type 2 diabetes. Postgrad Med J. 2010;86(1011):18-25. doi:10.1136/pgmj.2009.078626
  • Mittendorfer B. Insulin resistance: sex matters. Curr Opin Clin Nutr Metab Care. 2005;8(4):367-372. doi:10.1097/01.mco.0000172574.64019.98
  • Gado M, Tsaousidou E, Bornstein SR, Perakakis N. Sex-based differences in insulin resistance. J Endocrinol. 2024;261(1):e230245. doi:10.1530/JOE-23-0245
  • Özdin M, Yazar H, Mundan D. Sakarya Eğitim ve Araştırma Hastanesine başvuran hastaların homeostatik model değerlendirme-insülin direnci (HOMA IR) değerlerinin yaş ve cinsiyet faktörü açısından değerlendirilmesi. MKÜ Tıp Dergisi. 2021;42(1):1-4. doi:10. 17944/mkutfd.791428
  • Sun X, Cao ZB, Tanisawa K, Ito T, Oshima S, Higuchi M. Vitamin D supplementation reduces insulin resistance in Japanese adults: a secondary analysis of a double-blind, randomized, placebo-controlled trial. Nutr Res. 2016;36(10):1121-1129. doi:10.1016/j.nutres.2016.07.006
  • Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5):820-825. doi:10.1093/ajcn/79.5.820
  • Trummer C, Theiler-Schwetz V, Kollmann M, et al. Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: a randomized controlled trial. Clin Nutr. 2020; 39(3):718-726. doi:10.1016/j.clnu.2019.03.007
  • von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient-a randomised, placebo-controlled trial. Br J Nutr. 2010;103(4):549-555. doi:10.1017/S 0007114509992017
  • Ziyab AH, Mohammad A, Almousa Z, Mohammad T. Sex differences in the association between vitamin D and prediabetes in adults: a cross-sectional study. Nutr Diabetes. 2024;14(1):49. doi:10.1038/s41387-024-00311-4
  • Ciarambino T, Crispino P, Guarisco G, Giordano M. Gender differences in insulin resistance: new knowledge and perspectives. Curr Issues Mol Biol. 2023;45(10):7845-7861. doi:10.3390/cimb45100496

D vitamini replasman tedavisinin insülin direnci üzerine etkisi

Yıl 2025, Cilt: 7 Sayı: 5, 647 - 651, 15.09.2025
https://doi.org/10.38053/acmj.1739961

Öz

Giriş Bu çalışmada, D vitamini düzeyi düşük ve insülin direnci (IR) tanısı almış hastalarda 3 aylık D vitamini replasman tedavisinin HOMA-IR skoruna etkisi retrospektif olarak değerlendirilmiş, ayrıca D vitamini düzeyindeki değişimin insülin direnciyle ilişkisi incelenmiştir.

Yöntem Çalışmaya 1 Ocak-31 Aralık 2023 tarihleri arasında D vitamini düzeyi düşük ve HOMA-IR >2.5 olan 98 hasta dahil edilmiştir. Hastaların sosyodemografik verileri ile tedavi öncesi ve sonrası biyokimyasal parametreleri dosya kayıtlarından elde edilmiştir. D vitamini takviyesi sonrası ölçülen D vitamini, glukoz, insülin düzeyleri ve HOMA-IR skorları değerlendirilmiş; öncesi ve sonrası değerler eşleştirilmiş t-testi ile karşılaştırılmıştır. Ayrıca D vitamini düzeyindeki değişim ile HOMA-IR skorundaki değişim arasındaki ilişki Spearman korelasyon analizi ile analiz edilmiştir.

Bulgular Çalışmaya dahil edilen 98 hastanın %85.7’si kadın, %14.3’ü erkek olup yaş ortalaması 39.09±11.45 yıldır. D vitamini takviyesi sonrası HOMA-IR skorunda anlamlı bir azalma saptanmıştır (öncesi: 4.54±2.05; sonrası: 3.01±1.28; p<0.0001). D vitamini düzeyindeki artış ile HOMA-IR skorundaki azalma arasında istatistiksel olarak anlamlı negatif bir korelasyon bulunmuştur (r = –0.298, p = 0.0029). Ayrıca glukoz ve insülin düzeylerinde de anlamlı düşüş gözlenmiştir. Lipid profili ve B12 düzeylerinde anlamlı bir değişiklik saptanmamıştır.

Sonuç Elde edilen bulgular, D vitamini replasman tedavisinin insülin direnci üzerinde olumlu etkiler oluşturabileceğini göstermektedir. D vitamini eksikliği bulunan bireylerde bu takviyenin, insülin direnci tedavisinde destekleyici bir yaklaşım olarak değerlendirilmesi önerilebilir. Özellikle kadın hastalarda gözlenen daha belirgin iyileşme, cinsiyete özgü farklılıkların da dikkate alınmasını gerekli kılmaktadır.

Kaynakça

  • Liu X, Tang HY, Luo ZC. Insulin resistance and skin diseases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020;42(2):247-250. doi:10.3881/j.issn. 1000-503X.11609
  • Goh LPW, Sani SA, Sabullah MK, Gansau JA. The prevalence of insulin resistance in Malaysia and Indonesia: an updated systematic review and meta-analysis. Medicina (Kaunas). 2022;58(6):826. doi:10.3390/medicina58060826
  • Bermudez V, Salazar J, Martínez MS, et al. Prevalence and associated factors of insulin resistance in adults from Maracaibo City, Venezuela. Adv Prev Med. 2016;2016:9405105. doi:10.1155/2016/9405105
  • Qu HQ, Li Q, Rentfro AR, Fisher-Hoch SP, McCormick JB. The definition of insulin resistance using HOMA-IR for Americans of Mexican descent using machine learning. PLoS One. 2011;6(6):e21041. doi:10.1371/journal.pone.0021041
  • Penno G, Solini A, Orsi E, et al. Insulin resistance, diabetic kidney disease, and all-cause mortality in individuals with type 2 diabetes: a prospective cohort study. BMC Med. 2021;19(1):66. doi:10.1186/s12916-021-01936-3
  • Insulin Resistance & Prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases. 2018.
  • Lazear J, Kapustin J. Vitamin D deficiency and type 2 diabetes: a retrospective review. J Nurse Practitioners. 2014;10(3):175-182. doi:10. 1016/j.nurpra.2013.12.010
  • Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5):820-825. doi:10.1093/ajcn/79.5.820
  • Trimarco V, Manzi MV, Mancusi C, et al. Insulin resistance and vitamin D deficiency: a link beyond the appearances. Front Cardiovasc Med. 2022;9:859793. doi:10.3389/fcvm.2022.859793
  • Yetgin S, Ozsoylu S, Ruacan S, Tekinalp G, Sarialioğlu F. Vitamin D-deficiency rickets and myelofibrosis. J Pediatr. 1989;114(2):213-217. doi:10.1016/s0022-3476(89)80785-1
  • Tao S, Yuan Q, Mao L, Chen FL, Ji F, Cui ZH. Vitamin D deficiency causes insulin resistance by provoking oxidative stress in hepatocytes. Oncotarget. 2017;8(40):67605-67613. doi:10.18632/oncotarget.18754
  • Park S, Kim DS, Kang S. Vitamin D deficiency impairs glucose-stimulated insulin secretion and increases insulin resistance by reducing PPAR-γ expression in nonobese type 2 diabetic rats. J Nutr Biochem. 2016;27:257-265. doi:10.1016/j.jnutbio.2015.09.013
  • Alissa EM, Alnahdi WA, Alama N, Ferns GA. Insulin resistance in Saudi postmenopausal women with and without metabolic syndrome and its association with vitamin D deficiency. J Clin Transl Endocrinol. 2014;2(1):42-47. doi:10.1016/j.jcte.2014.09.001
  • Lips P, Eekhoff M, van Schoor N, et al. Vitamin D and type 2 diabetes. J Steroid Biochem Mol Biol. 2017;173:280-285. doi:10.1016/j.jsbmb.2016.11.021
  • Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-1495. doi:10.2337/diacare.27.6.1487
  • Gidding SS. Dyslipidemia in the metabolic syndrome in children. J Cardiometab Syndr. 2006;1(4):282-285. doi:10.1111/j.1559-4564.2006. 05798.x
  • Chiarelli F, Marcovecchio ML. Insulin resistance and obesity in childhood. Eur J Endocrinol. 2008;159(Suppl 1):S67-74. doi:10.1530/EJE- 08-0245
  • Mohan A, Haider R, Fakhor H, et al. Vitamin D and polycystic ovary syndrome (PCOS): a review. Ann Med Surg. 2023;85(7):3506-3511. doi: 10.1097/MS9.0000000000000879
  • Ozfirat Z, Chowdhury TA. Vitamin D deficiency and type 2 diabetes. Postgrad Med J. 2010;86(1011):18-25. doi:10.1136/pgmj.2009.078626
  • Mittendorfer B. Insulin resistance: sex matters. Curr Opin Clin Nutr Metab Care. 2005;8(4):367-372. doi:10.1097/01.mco.0000172574.64019.98
  • Gado M, Tsaousidou E, Bornstein SR, Perakakis N. Sex-based differences in insulin resistance. J Endocrinol. 2024;261(1):e230245. doi:10.1530/JOE-23-0245
  • Özdin M, Yazar H, Mundan D. Sakarya Eğitim ve Araştırma Hastanesine başvuran hastaların homeostatik model değerlendirme-insülin direnci (HOMA IR) değerlerinin yaş ve cinsiyet faktörü açısından değerlendirilmesi. MKÜ Tıp Dergisi. 2021;42(1):1-4. doi:10. 17944/mkutfd.791428
  • Sun X, Cao ZB, Tanisawa K, Ito T, Oshima S, Higuchi M. Vitamin D supplementation reduces insulin resistance in Japanese adults: a secondary analysis of a double-blind, randomized, placebo-controlled trial. Nutr Res. 2016;36(10):1121-1129. doi:10.1016/j.nutres.2016.07.006
  • Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5):820-825. doi:10.1093/ajcn/79.5.820
  • Trummer C, Theiler-Schwetz V, Kollmann M, et al. Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: a randomized controlled trial. Clin Nutr. 2020; 39(3):718-726. doi:10.1016/j.clnu.2019.03.007
  • von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient-a randomised, placebo-controlled trial. Br J Nutr. 2010;103(4):549-555. doi:10.1017/S 0007114509992017
  • Ziyab AH, Mohammad A, Almousa Z, Mohammad T. Sex differences in the association between vitamin D and prediabetes in adults: a cross-sectional study. Nutr Diabetes. 2024;14(1):49. doi:10.1038/s41387-024-00311-4
  • Ciarambino T, Crispino P, Guarisco G, Giordano M. Gender differences in insulin resistance: new knowledge and perspectives. Curr Issues Mol Biol. 2023;45(10):7845-7861. doi:10.3390/cimb45100496
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıbbi Farmakoloji
Bölüm Araştırma Makalesi
Yazarlar

Bahar Arıcan Tarım 0000-0002-6017-3259

Tuğçe Uskur 0000-0001-6626-4859

Yayımlanma Tarihi 15 Eylül 2025
Gönderilme Tarihi 11 Temmuz 2025
Kabul Tarihi 3 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 7 Sayı: 5

Kaynak Göster

AMA Arıcan Tarım B, Uskur T. The effect of vitamin D replacement therapy on insulin resistance: a retrospective study. Anatolian Curr Med J / ACMJ / acmj. Eylül 2025;7(5):647-651. doi:10.38053/acmj.1739961

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