Association between vitamin D and glycaemic parameters in a multi-ethnic cohort of postmenopausal women with type 2 diabetes in Saudi Arabia

Abstract Background The relationship between vitamin D (VitD) and insulin sensitivity and secretion in type 2 diabetes mellitus (T2D) has been shown to be different amongst different ethnic populations. In Saudi Arabia, where both T2D and VitD deficiency are highly prevalent health concerns, little is known about the relationship between VitD, insulin sensitivity, resistance and the relative importance of ethnicity. Our primary aim in this study was to investigate influence of ethnicity on VitD association with glycaemic profile and to measures of obesity as a secondary outcome, among multiethnic postmenopausal women with T2D in Saudi Arabia. Methods A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. Postmenopausal females (n = 173, age ≥ 50 years) with T2D were randomly selected in this study. Anthropometric measures and fasting blood samples were obtained for all study participants. Several biochemical parameters were measured including 25-hydroxyvitamin D (25(OH)D), glycosylated hemoglobin (HbA1c), insulin, glucose and c-peptide. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment 2 for insulin resistance and beta cell activity (HOMA2-IR, HOMA2-β). Results Overall, 25(OH)D was inversely associated with fasting glucose (r=-0.165, P = 0.037), insulin (r=-0.184, P = 0.02), C-peptide (r=-0.19, P = 0.015) and HOMA2- IR C-peptide (r=-0.23, P = 0.004). Additionally, serum 25 (OH)D showed a negative correlation with body weight (r=-0.173 P = 0.028), waist and hip circumferences (r=-0.167, P = 0.033; r=-0.22, P = 0.004 respectively) but not with body mass index (BMI) or waist hip ratio (WHR). In the white ethnic group but not in black or Asian population groups, 25(OH)D level was also associated with only serum fasting C-peptide and HOMA2-IR C-peptide and BMI (P < 0.05). Conclusions Insulin resistance and obesity were associated with VitD status in T2D in this cohort. Our findings also suggest that these VitD associations in women from white ethnic background are different than in those from black/Asian ethnic backgrounds. Whether VitD supplements are able to improve either obesity and/or insulin sensitivity should be further investigated in different ethnic population groups.

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Association Between Vitamin D and Glycaemic Parameters in a Multi-Ethnic Cohort of Postmenopausal Women with Type-2 Diabetes in Saudi Arabia

10.21203/rs.3.rs-285226/v1 ◽

2021 ◽

Author(s):

Shatha Alharazy ◽

Eman Alissa ◽

Susan Lanham-New ◽

Muhammad Imran Naseer ◽

Adeel G. Chaudhary ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Vitamin D ◽

Saudi Arabia ◽

Insulin Sensitivity ◽

Postmenopausal Women ◽

C Peptide ◽

Population Groups ◽

The Relationship

Abstract Background: The relationship between Vitamin D (VitD) with insulin sensitivity and secretion in Type-2 diabetes (T2D) has shown to be different amongst different ethnic populations. In Saudi Arabia, where both T2D and VitD deficiency are highly prevalent health concerns, little is known about the relationship between VitD, insulin sensitivity, resistance and the relative importance of ethnicity. Our aim in this study is to investigate influence of ethnicity on VitD association with glycaemic profile primarily and to measures of obesity secondarily, among multiethnic postmenopausal women with T2DM in Saudi Arabia.Methods: A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. Postmenopausal females (n = 173, age ≥ 50 years) with T2D were randomly selected in this study. Anthropometric measures and fasting blood samples were obtained for all study participants. Several biochemical parameters were measured including 25-hydroxyvitamin D (25(OH)D), glycosylated hemoglobin (HbA1c), insulin, glucose and c-peptide. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment 2 for insulin resistance and beta cell activity (HOMA2-IR, HOMA2-β).Results: Overall, 25(OH)D was inversely associated with fasting glucose (r=-0.165, P=0.037), insulin (r=-0.184, P=0.02), C-peptide (r=-0.19, P=0.015) and HOMA2- IR C-peptide (r=-0.23,P=0.004). Additionally, serum 25 (OH)D showed an overall a negative correlation with body weight (r=-0.173 P=0.028), waist and hip circumferences (r=-0.167, P=0.033; r=-0.22, P=0.004 respectively) but not with body mass index (BMI) or waist hip ration (WHR). In the white ethnic group but not in black or Asian population groups, 25(OH)D level was associated with only serum fasting C-peptide and HOMA2-IR C-peptide and BMI (P<0.05). Conclusions: Insulin resistance and obesity are associated with VitD status in T2D in this cohort. Our findings also suggest that these VitD associations in women from white ethnic background are different than in those from black/Asian ethnic backgrounds. Whether VitD supplements are able to improve degree of obesity and insulin sensitivity should be further investigated in different ethnic population groups.

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Association of Vitamin D with Type 2 Diabetes in Postmenopausal Females in Saudi Arabia

Proceedings of The Nutrition Society ◽

10.1017/s0029665120005789 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Shatha Alharazy ◽

Eman Alissa ◽

Mohammed Ardawi ◽

Susan Lanham-New ◽

M. Denise Robertson

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Vitamin D ◽

Saudi Arabia ◽

Insulin Sensitivity ◽

Postmenopausal Women ◽

Cell Activity ◽

Study Cohort ◽

Model Assessment

AbstractVitamin D (vitD) deficiency has been suspected as a risk factor for type 2 diabetes mellitus (T2DM). It has been reported that an inverse relationship exists between vitD status and risk of T2DM. The aim of this study was to investigate whether there is an association between vitD status and glycemic profile and other metabolic parameters among postmenopausal women with T2DM (living in Saudi Arabia). A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. One thirty six (n = 136) postmenopausal females (age ≥ 50 years) living in Jeddah city, Saudi Arabia, with T2DM were randomly recruited in this study. Anthropometric measures, blood pressure readings and fasting blood samples were obtained fro all study participants. Several biochemical parameters were estimated in fasting serum samples including total 25(OH)D, HbA1c, insulin, glucose, c-peptide and lipid profile. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment for insulin resistance and beta cell activity (HOMA-IR, HOMA-β), Quantitative insulin sensitivity check index (QUICK-I) and McAuley's index. VitD deficiency was defined as serum total 25(OH)D level below 20 ng/ml.The Mean (± SD) serum levels of total 25(OH)D were 13.8 ± 8.6 ng/ml with 79% of the study cohort being vitD deficient. Furthermore, serum total 25(OH)D levels were found to be inversely correlated with fasting insulin (r = -0.24, p = 0.029), HOMA-IR (r = -0.24, p = 0.03), and positively correlated with McAuley's index (r = 0.22, p = 0.048) and QUICK-I (r = 0.25, p = 0.024). In conclusion, vitD deficiency is highly prevalent among postmenopausal women with T2DM living in Jeddah, Saudi Arabia. VitD was found to be associated with insulin resistance. Whether vitD supplements are able to improve insulin sensitivity and other parameters in T2DM postmenopausal women should be further investigated.

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In middle-aged siblings of patients with type 2 diabetes mellitus normal glucose tolerance is associated with insulin resistance and with increased insulin secretion. The SPIDER study

Acta Endocrinologica ◽

10.1530/eje.0.1430681 ◽

2000 ◽

pp. 681-686 ◽

Cited By ~ 7

Author(s):

AE Pontiroli ◽

LD Monti ◽

S Costa ◽

PE Sandoli ◽

A Pizzini ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Insulin Sensitivity ◽

Glucose Tolerance ◽

Normal Glucose Tolerance ◽

C Peptide ◽

Type 2 Dm ◽

Normal Glucose

OBJECTIVES: To evaluate the frequency of impaired glucose tolerance (IGT) and of Type 2 diabetes mellitus (Type 2 DM) in siblings of patients with Type 2 DM, and to assess insulin release and insulin sensitivity in siblings with normal glucose tolerance (NGT), compared with NGT spouses of probands without family history of Type 2 DM. DESIGN AND METHODS: We evaluated 87 families including 103 Type 2 DM patients (87 probands), and we carried out an oral glucose tolerance test (OGTT) in 130 siblings and in 60 spouses. Among NGT subjects, 12 siblings and 16 spouses underwent a low-dose insulin-glucose infusion test (LDIGIT) to evaluate C-peptide release and insulin sensitivity. RESULTS: After the OGTT, 24 siblings were classified as having Type 2 DM, 31 as IGT, and only 14 spouses as IGT (P=0.0012 vs siblings). NGT siblings (n=75) showed higher insulin levels at 120 min than NGT spouses (n=46) at OGTT, in spite of identical blood glucose levels; at LDIGIT, NGT siblings secreted more C-peptide and showed a lower insulin sensitivity than NGT spouses. CONCLUSIONS: These data indicate that middle-aged siblings of probands with Type 2 DM have a high frequency of IGT and Type 2 DM, and that NGT siblings have increased insulin resistance and increased insulin secretion when compared with adequate controls.

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The Relationship between Serum 25-Hydroxy Vitamin D and Insulin Sensitivity and β-Cell Function in Newly Diagnosed Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2015/636891 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Yuan Gao ◽

Xinchi Wu ◽

Qi Fu ◽

Yanyun Li ◽

Tao Yang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Vitamin D ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Cell Function ◽

Newly Diagnosed ◽

25 Hydroxy Vitamin D ◽

The Relationship ◽

Diabetes Patients

The aim of this study was to investigate the relationship between serum 25-hydroxy vitamin D (25-OHD) and insulin sensitivity andβ-cell function in newly diagnosed type 2 diabetes. 395 newly diagnosed type 2 diabetes patients were enrolled in this study. Venous blood samples were collected at 0 min, 30 min, and 120 min of OGTT to measure serum glucose and insulin. Matsuda ISI and HOMA-IR were used to determine insulin sensitivity. The ratio of 0–120 min area under curve of insulin to glucose (insulin release index, INSR) was calculated as surrogate index ofβ-cell insulin secretion function. The products of insulin secretion indices multiplied by Matsuda insulin sensitivity index were used as disposition indices. Patients were divided into three groups according to tertiles (T1, T2, and T3) of 25-OHD concentration. There was significant difference among three groups for HOMA-IR, Matsuda ISI, and INSR. HOMA-IR, Matsuda ISI, INSR, and DI were undifferentiated among three groups in male patients. But HOMA-IR, Matsuda ISI, and INSR were significantly different among three groups in female patients after being adjusted by confounding factors. In conclusion, serum 25-OHD is associated with insulin sensitivity andβ-cell function for female newly diagnosed type 2 diabetes patients, and the association is ambiguous in males.

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Hyperglucagonemia Does Not Explain the β-Cell Hyperresponsiveness and Insulin Resistance in Dysglycemic Youth Compared With Adults: Lessons From the RISE Study

10.2337/figshare.14474022 ◽

2021 ◽

Author(s):

Steven E. Kahn ◽

Kieren J. Mather ◽

Silva A. Arslanian ◽

Elena Barengolts ◽

Thomas A. Buchanan ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Steady State ◽

Insulin Sensitivity ◽

Cell Function ◽

Age Groups ◽

Β Cell ◽

C Peptide ◽

Drug Naïve

Objective: To determine whether β-cell hyperresponsiveness and insulin resistance in youth versus adults in the Restoring Insulin Secretion (RISE) Study are related to increased glucagon release. Research Design and Methods: In 66 youth and 350 adults with IGT or drug-naïve, recently diagnosed type 2 diabetes, we performed hyperglycemic clamps and OGTTs. From clamps we quantified insulin sensitivity (M/I), plasma fasting glucagon and C-peptide, steady-state glucagon and C-peptide at glucose of 11.1 mmol/L and arginine-stimulated glucagon (AGR) and C-peptide (ACPR) responses at glucose >25 mmol/L. Results: Fasting (7.63±3.47 vs 8.55±4.47 pmol/L; mean±SD; p=0.063) and steady-state glucagon (2.24±1.46 vs 2.49±1.96 pmol/L, p=0.234) were not different in youth and adults, while AGR was lower in youth (14.1±5.2 vs 16.8±8.8 pmol/L, p=0.001). Significant age group differences in M/I, fasting C-peptide, steady-state C-peptide and ACPRmax were not related to glucagon. Fasting glucose and glucagon were positively correlated in adults (r=0.133, p=0.012), and negatively correlated in youth (r= -0.143, p=0.251). In both age groups, higher fasting glucagon was associated with higher fasting C-peptide (youth r=0.209, p=0.091; adults r=0.335, p<0.001) and lower M/I (youth r= -0.228, p=0.066; adults r= -0.324, p<0.001). With comparable fasting glucagon, youth had greater C-peptide and lower insulin sensitivity. OGTT suppression of glucagon was greater in youth. Conclusions: Youth with IGT or drug-naïve, recently diagnosed type 2 diabetes have hyper-responsive β-cells and lower insulin sensitivity, but their glucagon concentrations are not increased compared to adults. Thus, α-cell dysfunction does not appear to explain the difference in β-cell function and insulin sensitivity in youth versus adults.

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Hyperglucagonemia Does Not Explain the β-Cell Hyperresponsiveness and Insulin Resistance in Dysglycemic Youth Compared With Adults: Lessons From the RISE Study

10.2337/figshare.14474022.v1 ◽

2021 ◽

Author(s):

Steven E. Kahn ◽

Kieren J. Mather ◽

Silva A. Arslanian ◽

Elena Barengolts ◽

Thomas A. Buchanan ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Steady State ◽

Insulin Sensitivity ◽

Cell Function ◽

Age Groups ◽

Β Cell ◽

C Peptide ◽

Drug Naïve

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Determining the relationship between dietary carbohydrate intake and insulin resistance

Nutrition Research Reviews ◽

10.1079/nrr2005109 ◽

2005 ◽

Vol 18 (2) ◽

pp. 222-240 ◽

Cited By ~ 22

Author(s):

Neville H. McClenaghan

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Insulin Sensitivity ◽

Intervention Studies ◽

Dietary Carbohydrate ◽

High Carbohydrate ◽

The Metabolic Syndrome ◽

Fat Diets ◽

The Relationship

Insulin resistance underlies type 2 diabetes, CVD and the metabolic syndrome, driven by changes in diet, lifestyle, energy over–consumption and obesity. Nutritional recommendations for insulin resistance remain an area of controversy, particularly the quantity and types of dietary carbohydrate. The present review gives an overview of insulin resistance, its relationship to impaired insulin secretion and the metabolic syndrome, research methodologies used to measure insulin action and the epidemiological and intervention studies on the relationship between dietary carbohydrate and insulin resistance. Epidemiological studies provide little evidence to suggest that total dietary carbohydrate predicts risk of type 2 diabetes, and high–carbohydrate, high–fibre diets with low–glycaemic index (GI) may even contribute to diabetes prevention. Despite inherent limitations associated with techniques used to measure insulin resistance and dietary assessment, most intervention studies reveal an increase in glucose tolerance or insulin sensitivity with high–carbohydrate, low–fat diets in non–diabetic and diabetic individuals. When energy is restricted the source or reduced content of carbohydrate does not appear to be as important as fat for body weight. Thus, low energy intake is key to weight loss and augmentation of insulin sensitivity. Given this, widespread adoption of popular low–carbohydrate high–fat diets highlights the necessity to evaluate dietary interventions regarding safety and metabolic effects. While current evidence supports FAO/WHO recommendations to maintain a high–carbohydrate diet with low–GI foods, the relationships between carbohydrate and insulin sensitivity remains an important research area. Emerging technologies should further enhance understanding of gene–diet interactions in insulin resistance, providing useful information for future nutrition policy decisions.

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