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Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial.

Abstract

OBJECTIVES

To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, β-cell function, inflammation and metabolic markers.

DESIGN

6-month randomized, placebo-controlled trial.

PARTICIPANTS

Ninety-five adults with serum 25-hydroxyvitamin D [25(OH)D] ≤55 nmol/L at risk of type 2 diabetes (with prediabetes or an AUSDRISK score ≥15) were randomized. Analyses included participants who completed the baseline and final visits (treatment n = 35; placebo n = 45).

INTERVENTION

Daily calcium carbonate (1,200 mg) and cholecalciferol [2,000-6,000 IU to target 25(OH)D >75 nmol/L] or matching placebos for 6 months.

MEASUREMENTS

Insulin sensitivity (HOMA2%S, Matsuda index), insulin secretion (insulinogenic index, area under the curve (AUC) for C-peptide) and β-cell function (Matsuda index x AUC for C-peptide) derived from a 75 g 2-h OGTT; anthropometry; blood pressure; lipid profile; hs-CRP; TNF-α; IL-6; adiponectin; total and undercarboxylated osteocalcin.

RESULTS

Participants were middle-aged adults (mean age 54 years; 69% Europid) at risk of type 2 diabetes (48% with prediabetes). Compliance was >80% for calcium and vitamin D. Mean serum 25(OH)D concentration increased from 48 to 95 nmol/L in the treatment group (91% achieved >75 nmol/L), but remained unchanged in controls. There were no significant changes in insulin sensitivity, insulin secretion and β-cell function, or in inflammatory and metabolic markers between or within the groups, before or after adjustment for potential confounders including waist circumference and season of recruitment. In a post hoc analysis restricted to participants with prediabetes, a significant beneficial effect of vitamin D and calcium supplementation on insulin sensitivity (HOMA%S and Matsuda) was observed.

CONCLUSIONS

Daily vitamin D and calcium supplementation for 6 months may not change OGTT-derived measures of insulin sensitivity, insulin secretion and β-cell function in multi-ethnic adults with low vitamin D status at risk of type 2 diabetes. However, in participants with prediabetes, supplementation with vitamin D and calcium may improve insulin sensitivity.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12609000043235.

Links

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  • Authors+Show Affiliations

    ,

    Department of Medicine, NorthWest Academic Centre, The University of Melbourne, Western Health, Melbourne, Australia.

    ,

    Department of Medicine, NorthWest Academic Centre, The University of Melbourne, Western Health, Melbourne, Australia.

    ,

    Department of Medicine, University of Sherbrooke, Sherbrooke, Canada.

    ,

    Melbourne Pathology, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia.

    ,

    Department of Medicine, NorthWest Academic Centre, The University of Melbourne, Western Health, Melbourne, Australia.

    ,

    Melbourne Pathology, Melbourne, Australia.

    ,

    Department of Chronic Diseases Surveillance, Institut national de santé publique du Québec, Quebec City, Canada; Department of Medicine, Laval University, Quebec City, Canada.

    Department of Medicine, NorthWest Academic Centre, The University of Melbourne, Western Health, Melbourne, Australia.

    Source

    PloS one 9:10 2014 pg e109607

    MeSH

    Adiponectin
    Adult
    Aged
    Blood Glucose
    C-Peptide
    C-Reactive Protein
    Calcium, Dietary
    Cholecalciferol
    Diabetes Mellitus, Type 2
    Dietary Supplements
    Female
    Humans
    Insulin
    Insulin Resistance
    Insulin-Secreting Cells
    Interleukin-6
    Male
    Middle Aged
    Osteocalcin
    Pilot Projects
    Prediabetic State
    Tumor Necrosis Factor-alpha
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25299668

    Citation

    Gagnon, Claudia, et al. "Effects of Combined Calcium and Vitamin D Supplementation On Insulin Secretion, Insulin Sensitivity and Β-cell Function in Multi-ethnic Vitamin D-deficient Adults at Risk for Type 2 Diabetes: a Pilot Randomized, Placebo-controlled Trial." PloS One, vol. 9, no. 10, 2014, pp. e109607.
    Gagnon C, Daly RM, Carpentier A, et al. Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial. PLoS ONE. 2014;9(10):e109607.
    Gagnon, C., Daly, R. M., Carpentier, A., Lu, Z. X., Shore-Lorenti, C., Sikaris, K., ... Ebeling, P. R. (2014). Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial. PloS One, 9(10), pp. e109607. doi:10.1371/journal.pone.0109607.
    Gagnon C, et al. Effects of Combined Calcium and Vitamin D Supplementation On Insulin Secretion, Insulin Sensitivity and Β-cell Function in Multi-ethnic Vitamin D-deficient Adults at Risk for Type 2 Diabetes: a Pilot Randomized, Placebo-controlled Trial. PLoS ONE. 2014;9(10):e109607. PubMed PMID: 25299668.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial. AU - Gagnon,Claudia, AU - Daly,Robin M, AU - Carpentier,André, AU - Lu,Zhong X, AU - Shore-Lorenti,Catherine, AU - Sikaris,Ken, AU - Jean,Sonia, AU - Ebeling,Peter R, Y1 - 2014/10/09/ PY - 2014/06/10/received PY - 2014/08/30/accepted PY - 2014/10/10/entrez PY - 2014/10/10/pubmed PY - 2015/12/22/medline SP - e109607 EP - e109607 JF - PloS one JO - PLoS ONE VL - 9 IS - 10 N2 - OBJECTIVES: To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, β-cell function, inflammation and metabolic markers. DESIGN: 6-month randomized, placebo-controlled trial. PARTICIPANTS: Ninety-five adults with serum 25-hydroxyvitamin D [25(OH)D] ≤55 nmol/L at risk of type 2 diabetes (with prediabetes or an AUSDRISK score ≥15) were randomized. Analyses included participants who completed the baseline and final visits (treatment n = 35; placebo n = 45). INTERVENTION: Daily calcium carbonate (1,200 mg) and cholecalciferol [2,000-6,000 IU to target 25(OH)D >75 nmol/L] or matching placebos for 6 months. MEASUREMENTS: Insulin sensitivity (HOMA2%S, Matsuda index), insulin secretion (insulinogenic index, area under the curve (AUC) for C-peptide) and β-cell function (Matsuda index x AUC for C-peptide) derived from a 75 g 2-h OGTT; anthropometry; blood pressure; lipid profile; hs-CRP; TNF-α; IL-6; adiponectin; total and undercarboxylated osteocalcin. RESULTS: Participants were middle-aged adults (mean age 54 years; 69% Europid) at risk of type 2 diabetes (48% with prediabetes). Compliance was >80% for calcium and vitamin D. Mean serum 25(OH)D concentration increased from 48 to 95 nmol/L in the treatment group (91% achieved >75 nmol/L), but remained unchanged in controls. There were no significant changes in insulin sensitivity, insulin secretion and β-cell function, or in inflammatory and metabolic markers between or within the groups, before or after adjustment for potential confounders including waist circumference and season of recruitment. In a post hoc analysis restricted to participants with prediabetes, a significant beneficial effect of vitamin D and calcium supplementation on insulin sensitivity (HOMA%S and Matsuda) was observed. CONCLUSIONS: Daily vitamin D and calcium supplementation for 6 months may not change OGTT-derived measures of insulin sensitivity, insulin secretion and β-cell function in multi-ethnic adults with low vitamin D status at risk of type 2 diabetes. However, in participants with prediabetes, supplementation with vitamin D and calcium may improve insulin sensitivity. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12609000043235. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25299668/Effects_of_combined_calcium_and_vitamin_D_supplementation_on_insulin_secretion_insulin_sensitivity_and_β_cell_function_in_multi_ethnic_vitamin_D_deficient_adults_at_risk_for_type_2_diabetes:_a_pilot_randomized_placebo_controlled_trial_ L2 - http://dx.plos.org/10.1371/journal.pone.0109607 DB - PRIME DP - Unbound Medicine ER -