ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Effect of Vitamin D Treatment on Glycemic Control, Diastolic Functions, and Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus
Tip 2 Diabetes Mellitus Hastalarında Vitamin D Replasmanının Glisemik Kontrol, Diyastolik Fonksiyon ve Katoris İntima-Media Kalınlığı Üzerine Etkisi
Doi: 10.25179/tjem.2018-63768 - Makale Dili: EN
Turk J Endocrinol Metab 2019;23:97-104
ABSTRACT
Objective: The purpose of this study was to investigate the influence of 25(OH)D3 levels on glycemic control, diastolic functions, and carotid intima-media thickness in patients with Type 2 diabetes mellitus. Material and Methods: Patients admitted to the endocrinology department, with the diagnosis of Type 2 diabetes mellitus, who were under follow-up for at least six months and also had 25(OH)D3 deficiency [25(OH)D3 levels <20 ng/mL] were included in this study. D3 supplement (50.000 IU) was administered to the patients every month up to six months. Carotid intima-media thickness was measured using the B-mode ultrasonography. Diastolic function was evaluated using the tissue doppler imaging by measuring tissue e wave/tissue a wave (e’/a’) and annular E wave/tissue e wave (E/e’) ratios. All the evaluations were made at baseline and at six months after vitamin D3 supplementation. Results: A total of 45 (27 females, 18 males; mean age: 56.2±7.8 years) patients were included in this study. The mean duration of diabetes was 8.5±6.8 (ranging from 7.0 to 9.0 years) years. It was found that even after D3 supplementation, fasting plasma glucose and Hemoglobin A1C levels did not change, yet, the carotid intimamedia thickness reduced (788±100 μm vs. 745±116.8 μm; p=0.009). Diastolic function parameters e’/a’ (0.79±0.21 vs. 0.89±0.26; p=0.03) and E/e’ (7.27±1.81 vs. 6.52±1.65; p=0.048) also improved significantly after the therapy. Conclusion: Vitamin D supplementation, in patients with Type 2 diabetes mellitus, who are also having vitamin D deficiency, seems to be beneficial in reducing the thickness of carotid intima-media, which is a well-known cardiovascular risk predictor, and in improving diastolic functions by vitamin D repletion. Further prospective well-designed studies with a larger patient population are needed to lead a firm conclusion in this regard.
ÖZET
Amaç: Çalışmamızda Tip 2 diabetes mellitus tanısı ile takip ettiğimiz hastalarda 25(OH)D3 düzeyleri ve bunun glisemik kontrol, diyastolik fonksiyon ve karotis intima-media kalınlığı üzerine etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya endokrinoloji bölümüne başvuran ve en az altı ay boyunca Tip 2 diabetes mellitus tanısı ile takip edilen ve 25(OH)D3 eksikliği [25(OH)D3 seviyesi <20 ng/mL] olan hastalar dâhil edildi. Hastalara altı ay boyunca aylık D3 desteği (50.000 IU) uygulandı. Karotis intima media kalınlığı B-mod ultrasonografi ile ölçüldü. Diyastolik fonksiyon doku e dalgası/doku a dalgası (e’/a’) ve anüler E dalgası/doku e dalgası (E/e’) oranları ölçülerek doku Doppler görüntüleme ile değerlendirildi. Tüm değerlendirmeler başlangıçta ve vitamin D3 takviyesinden altı ay sonra yapıldı. Bulgular: Çalışmamıza toplam 45 (27 kadın, 18 erkek; ortalama yaş: 56.2±7.8 yıl) hasta alındı. Ortalama diyabet süresi 8.5±6.8 yıl’dı (7.0-9.0). Vitamin D3 takviyesi sonrası açlık plazma glukozu ve Hemoglobin A1C düzeyleri değişmedi, ancak karotis intima-media kalınlığı azaldı (788±100 μm vs 745±16,8 μm; p=0,009). Diyastolik fonksiyon parametrelerinde e’/a’ (0,79±0,21’e karşı 0,89±0,26; p=0,03) ve E/e’ (7,27±1,81’e karşı 6,52±1,65; p=0,048) tedaviden sonra önemli ölçüde iyileşme görüldü. Sonuç: Vitamin D eksikliği olan Tip 2 diabetes mellituslu hastalarda Vitamin D takviyesi, iyi bilinen bir kardiyovasküler risk prediktörü olan karotis intima-media kalınlığının azaltılmasında ve diyastolik fonksiyonların iyileştirilmesinde yararlı görünmektedir. Daha kesin sonuçlar için daha büyük hasta populasyonu ile daha iyi tasarlanmış prospektif çalışmalar gereklidir
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