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Tip 1 Diyabetli Yetişkinlerde 25-Hidroksivitamin D Durumu Ve Glisemik Kontrol ile İlişkisi

Yıl 2024, , 284 - 288, 01.05.2024
https://doi.org/10.53394/akd.1255947

Öz

Amaç: Tip 1 diabetes mellituslu erişkinler ile sağlıklı kontrol grubu arasında D vitamini düzeylerini karşılaştırmak ve diyabetik grupta HbA1c ile D vitamini düzeyleri arasındaki ilişkiyi değerlendirmek amaçlanmıştır.
Yöntemler: Kesitsel, tanımlayıcı tipteki çalışmamıza Endokrinoloji Polikliniği'ne başvuran 18 yaş üstü, 98 tip 1 diyabetli hasta ile yaş ve cinsiyet olarak eşleştirilmiş, kronik hastalığı olmayan 95 kişi dahil edildi. İleri derecede böbrek veya karaciğer hastalığı, primer hiperparatiroidizmi, metabolik kemik hastalığı olan veya vitamin D konsantrasyonlarını değiştirebilecek ilaç kullanan hastalar çalışma dışı bırakıldı. HbA1c ve 25(OH) Vitamin-D3 düzeyleri 9 aylık dönemde 3 kez ölçüldü ve ölçümlerin ortalaması kullanıldı. Diyabetik hastalar ve kontrol grubu D vitamini düzeylerine göre; eksiklik (<12 ng/ml), yetersizlik (12-20 ng/ml) ve yeterlilik (>20 ng/ml) olmak üzere üç gruba ayrıldı.
Bulgular: Diyabetik hastaların serum 25 (OH) D vitamini düzeyleri sağlıklı bireylerden anlamlı olarak daha düşüktü (p=0,024). Ancak, diyabetik erişkinler 25(OH) D vitamini düzeylerine göre 3 gruba ayrıldığında HbA1c düzeyleri açısından anlamlı fark yoktu (p=0,905).
Sonuç: Preklinik veriler, tip 1 diabetes mellitus etiyopatogenezinde düşük serum D vitamini düzeylerinin rolünü desteklese de, düşük serum D vitamini düzeyleri ile tip 1 diyabet prevalansı veya glisemik kontrol arasındaki bağlantıyı inceleyen çalışmalar, bizim çalışmamız da dahil olmak üzere, net bir sonuca ulaşmak için yeterli değildir.

Kaynakça

  • 1.Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet 2016; 387(10035):2340-8.
  • 2. Rak K, Bronkowska M. Immunomodulatory Effect of Vitamin D and Its Potential Role in the Prevention and Treatment of Type 1 Diabetes Mellitus-A Narrative Review. Molecules 2018; 24(1):53.
  • 3. Norman AW, Frankel JB, Heldt AM, Grodsky GM. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science 1980; 209(4458):823-5.
  • 4. Littorin B, Blom P, Schölin A, Arnqvist HJ, Blohmé G, Bolinder J, Ekbom-Schnell A, Eriksson JW, Gudbjörnsdottir S, Nyström L, Ostman J, Sundkvist G. Lower levels of plasma 25-hydroxyvitamin D among young adults at diagnosis of autoimmune type 1 diabetes compared with control subjects: results from the nationwide Diabetes Incidence Study in Sweden (DISS). Diabetologia 2006; 49(12):2847-52.
  • 5. Federico G, Genoni A, Puggioni A, Saba A, Gallo D, Randazzo E, Salvatoni A, Toniolo A. Vitamin D status, enterovirus infection, and type 1 diabetes in Italian children/adolescents. Pediatr Diabetes 2018;19(5):923-9.
  • 6. Sørensen IM, Joner G, Jenum PA, Eskild A, Torjesen PA, Stene LC. Maternal serum levels of 25-hydroxy-vitamin D during pregnancy and risk of type 1 diabetes in the offspring. Diabetes 2012; 61(1):175-8.
  • 7. Jacobsen R, Moldovan M, Vaag AA, Hypponen E, Heitmann BL. Vitamin D fortification and seasonality of birth in type 1 diabetic cases: D-tect study. J Dev Orig Health Dis 2016;7(1):114-9. Erratum in: J Dev Orig Health Dis 2016; 7(4):429. 8. Svoren BM, Volkening LK, Wood JR, Laffel LM. Significant vitamin D deficiency in youth with type 1 diabetes mellitus. J Pediatr 2009; 154(1):132-4.
  • 9. Tunc O, Cetinkaya S, Kizilgun M, Aycan Z. Evaluation of the relation between vitamin D and insulin requirements and frequency of osteopenia/osteoporosis in childhood with type 1 diabetes. 49th Annual Meeting of the ESPE September 22-25,2010. Espe; 2010.
  • 10. Gogas Yavuz D, Keskin L, Kıyıcı S, Sert M, Yazıcı D, Şahin İ, Yüksel M, Deyneli O, Aydın H, Tuncel E, Akalın S. Vitamin D receptor gene BsmI, FokI, ApaI, TaqI polymorphisms and bone mineral density in a group of Turkish type 1 diabetic patients. Acta Diabetol 2011; 48(4):329-36.
  • 11. Bierschenk L, Alexander J, Wasserfall C, Haller M, Schatz D, Atkinson M. Vitamin D levels in subjects with and without type 1 diabetes residing in a solar rich environment. Diabetes Care 2009; 32(11):1977-9.
  • 12. Massé PG, Pacifique MB, Tranchant CC, Arjmandi BH, Ericson KL, Donovan SM, Delvin E, Caissie M. Bone metabolic abnormalities associated with well-controlled type 1 diabetes (IDDM) in young adult women: a disease complication often ignored or neglected. J Am Coll Nutr 2010; 29(4):419-29.
  • 13. Miettinen ME, Reinert L, Kinnunen L, Harjutsalo V, Koskela P, Surcel HM, Lamberg-Allardt C, Tuomilehto J. Serum 25-hydroxyvitamin D level during early pregnancy and type 1 diabetes risk in the offspring. Diabetologia 2012; 55(5):1291-4.
  • 14. Mutlu A, Mutlu GY, Özsu E, Çizmecioğlu FM, Hatun Ş. Vitamin D deficiency in children and adolescents with type 1 diabetes. J Clin Res Pediatr Endocrinol 2011; 3(4):179-83.
  • 15. Janner M, Ballinari P, Mullis PE, Flück CE. High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes. Swiss Med Wkly. 2010; 140:w13091.
  • 16. Giustina A, Adler RA, Binkley N, Bouillon R, Ebeling PR, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Controversies in Vitamin D: Summary Statement From an International Conference. J Clin Endocrinol Metab 2019; 104(2):234-40.
  • 17. Cooper JD, Smyth DJ, Walker NM, Stevens H, Burren OS, Wallace C, Greissl C, Ramos-Lopez E, Hyppönen E, Dunger DB, Spector TD, Ouwehand WH, Wang TJ, Badenhoop K, Todd JA. Inherited variation in vitamin D genes is associated with predisposition to autoimmune disease type 1 diabetes. Diabetes 2011; 60(5):1624-31.
  • 18. Dong JY, Zhang WG, Chen JJ, Zhang ZL, Han SF, Qin LQ. Vitamin D intake and risk of type 1 diabetes: a meta-analysis of observational studies. Nutrients 2013; 5(9):3551-62.

25-Hydroxyvitamin D Status In Type 1 Diabetic Adults And Its Relationship With Glycemic Control

Yıl 2024, , 284 - 288, 01.05.2024
https://doi.org/10.53394/akd.1255947

Öz

Objective: To assess the vitamin D levels between adults with type 1 diabetes mellitus and the healthy control group and evaluate the relationship between HbA1c levels and vitamin D status in the diabetic group.
Methods: Our cross-sectional, descriptive study included 98 type 1 diabetic patients over 18 years old who applied to the Endocrinology Outpatient Clinic and 95 age- and sex-matched individuals without chronic disease. Patients with advanced renal or liver disorders, primary hyperparathyroidism, metabolic bone disorders, or using medications that might change vitamin D concentrations were excluded from the study. HbA1c and 25(OH) Vitamin-D3 levels were measured three times in 9 months, and the average of the measurements was used. Diabetic patients and control individuals were separated into three groups according to their vitamin D levels as follows: deficiency (<12 ng/ml), insufficiency (12-20 ng/ml), and sufficiency (> 20 ng/ml).
Results: Serum 25 (OH) vitamin D levels of diabetic patients were significantly lower than in healthy individuals (p=0.024). However, when diabetic adults were separated into three groups according to 25(OH) vitamin D levels, there was no significant difference regarding HbA1c levels (p=0.905).
Conclusion: Although preclinical data support the role of low serum vitamin D levels in the etiopathogenesis of type 1 diabetes mellitus, studies examining the connection between low serum vitamin D levels and the prevalence of type 1 diabetes or glycemic control are not sufficient to reach a clear conclusion, including our study.

Kaynakça

  • 1.Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet 2016; 387(10035):2340-8.
  • 2. Rak K, Bronkowska M. Immunomodulatory Effect of Vitamin D and Its Potential Role in the Prevention and Treatment of Type 1 Diabetes Mellitus-A Narrative Review. Molecules 2018; 24(1):53.
  • 3. Norman AW, Frankel JB, Heldt AM, Grodsky GM. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science 1980; 209(4458):823-5.
  • 4. Littorin B, Blom P, Schölin A, Arnqvist HJ, Blohmé G, Bolinder J, Ekbom-Schnell A, Eriksson JW, Gudbjörnsdottir S, Nyström L, Ostman J, Sundkvist G. Lower levels of plasma 25-hydroxyvitamin D among young adults at diagnosis of autoimmune type 1 diabetes compared with control subjects: results from the nationwide Diabetes Incidence Study in Sweden (DISS). Diabetologia 2006; 49(12):2847-52.
  • 5. Federico G, Genoni A, Puggioni A, Saba A, Gallo D, Randazzo E, Salvatoni A, Toniolo A. Vitamin D status, enterovirus infection, and type 1 diabetes in Italian children/adolescents. Pediatr Diabetes 2018;19(5):923-9.
  • 6. Sørensen IM, Joner G, Jenum PA, Eskild A, Torjesen PA, Stene LC. Maternal serum levels of 25-hydroxy-vitamin D during pregnancy and risk of type 1 diabetes in the offspring. Diabetes 2012; 61(1):175-8.
  • 7. Jacobsen R, Moldovan M, Vaag AA, Hypponen E, Heitmann BL. Vitamin D fortification and seasonality of birth in type 1 diabetic cases: D-tect study. J Dev Orig Health Dis 2016;7(1):114-9. Erratum in: J Dev Orig Health Dis 2016; 7(4):429. 8. Svoren BM, Volkening LK, Wood JR, Laffel LM. Significant vitamin D deficiency in youth with type 1 diabetes mellitus. J Pediatr 2009; 154(1):132-4.
  • 9. Tunc O, Cetinkaya S, Kizilgun M, Aycan Z. Evaluation of the relation between vitamin D and insulin requirements and frequency of osteopenia/osteoporosis in childhood with type 1 diabetes. 49th Annual Meeting of the ESPE September 22-25,2010. Espe; 2010.
  • 10. Gogas Yavuz D, Keskin L, Kıyıcı S, Sert M, Yazıcı D, Şahin İ, Yüksel M, Deyneli O, Aydın H, Tuncel E, Akalın S. Vitamin D receptor gene BsmI, FokI, ApaI, TaqI polymorphisms and bone mineral density in a group of Turkish type 1 diabetic patients. Acta Diabetol 2011; 48(4):329-36.
  • 11. Bierschenk L, Alexander J, Wasserfall C, Haller M, Schatz D, Atkinson M. Vitamin D levels in subjects with and without type 1 diabetes residing in a solar rich environment. Diabetes Care 2009; 32(11):1977-9.
  • 12. Massé PG, Pacifique MB, Tranchant CC, Arjmandi BH, Ericson KL, Donovan SM, Delvin E, Caissie M. Bone metabolic abnormalities associated with well-controlled type 1 diabetes (IDDM) in young adult women: a disease complication often ignored or neglected. J Am Coll Nutr 2010; 29(4):419-29.
  • 13. Miettinen ME, Reinert L, Kinnunen L, Harjutsalo V, Koskela P, Surcel HM, Lamberg-Allardt C, Tuomilehto J. Serum 25-hydroxyvitamin D level during early pregnancy and type 1 diabetes risk in the offspring. Diabetologia 2012; 55(5):1291-4.
  • 14. Mutlu A, Mutlu GY, Özsu E, Çizmecioğlu FM, Hatun Ş. Vitamin D deficiency in children and adolescents with type 1 diabetes. J Clin Res Pediatr Endocrinol 2011; 3(4):179-83.
  • 15. Janner M, Ballinari P, Mullis PE, Flück CE. High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes. Swiss Med Wkly. 2010; 140:w13091.
  • 16. Giustina A, Adler RA, Binkley N, Bouillon R, Ebeling PR, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Controversies in Vitamin D: Summary Statement From an International Conference. J Clin Endocrinol Metab 2019; 104(2):234-40.
  • 17. Cooper JD, Smyth DJ, Walker NM, Stevens H, Burren OS, Wallace C, Greissl C, Ramos-Lopez E, Hyppönen E, Dunger DB, Spector TD, Ouwehand WH, Wang TJ, Badenhoop K, Todd JA. Inherited variation in vitamin D genes is associated with predisposition to autoimmune disease type 1 diabetes. Diabetes 2011; 60(5):1624-31.
  • 18. Dong JY, Zhang WG, Chen JJ, Zhang ZL, Han SF, Qin LQ. Vitamin D intake and risk of type 1 diabetes: a meta-analysis of observational studies. Nutrients 2013; 5(9):3551-62.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Burak Andaç 0000-0001-8680-0313

Buket Yılmaz Bülbül 0000-0003-2651-0036

Mehmet Oğulcan Tezel 0000-0001-9761-4479

Mine Okur 0000-0001-7768-3979

Serpil Yanık Çolak 0000-0003-3602-7697

Buse Ekici 0000-0001-5353-4354

Mehmet Celik 0000-0001-7364-370X

Erken Görünüm Tarihi 10 Mayıs 2024
Yayımlanma Tarihi 1 Mayıs 2024
Gönderilme Tarihi 24 Şubat 2023
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

Vancouver Andaç B, Yılmaz Bülbül B, Tezel MO, Okur M, Yanık Çolak S, Ekici B, Celik M. 25-Hydroxyvitamin D Status In Type 1 Diabetic Adults And Its Relationship With Glycemic Control. Akd Tıp D. 2024;10(2):284-8.