Insulin secretion and sensitivity in healthy adults with low vitamin D are not affected by high-dose ergocalciferol administration: a randomized controlled trial.

Deborah M Mitchell, Benjamin Z Leder, Enrico Cagliero, Natalia Mendoza, Maria P Henao, Douglas L Hayden, Joel S Finkelstein, Sherri-Ann M Burnett-Bowie

Journal: The American journal of clinical nutrition 2015;102(2):385-92

PMID: 26156733

Plain Language Summary

plain language summary logo

Type 2 diabetes is a highly prevalent multifactorial disease associated with comorbidities and mortalities. Several epidemiological studies showed an association between low levels of vitamin D and incidence of type 2 diabetes. This double-blinded, randomized controlled trial aims to examine the effects of ergocalciferol (vitamin D2) on glucose and insulin metabolism. Healthy subjects with low vitamin D were weekly administered either a high dose of ergocalciferol or placebo for 12 weeks. The researchers found no significant difference in the first phase insulin secretion and sensitivity and concluded that supplementation with ergocalciferol doesn’t promote metabolic markers that could lead to decreased risk of type 2 diabetes. Future trials should address the effect of vitamin D administration in high-risk populations.

Abstract

BACKGROUND

Epidemiologic data suggest that low serum 25-hydroxyvitamin D [25(OH)D] increases insulin resistance and the risk of type 2 diabetes. Few interventional trials have assessed the effect of vitamin D on insulin metabolism, and published results are discordant.

OBJECTIVE

The goal of this study was to perform a detailed assessment of the effect of ergocalciferol administration on glucose and insulin metabolism in healthy people with low total 25(OH)D(total).

DESIGN

This was a 12-wk, double-blinded, randomized controlled trial. We enrolled 90 healthy volunteers aged 18-45 y with serum 25(OH)D ≤20 ng/mL (by immunoassay) and administered 50,000 IU ergocalciferol/wk or placebo for 12 wk. Primary endpoints were change in first-phase insulin response and insulin sensitivity as measured by intravenous glucose tolerance test. Secondary endpoints included change in homeostasis model assessment of insulin resistance; fasting glucose, insulin, and lipids; body mass index (BMI); and blood pressure.

RESULTS

On-study 25(OH)D(total) was assessed by liquid chromatography-tandem mass spectrometry. In the treated group, 25(OH)D(total) rose from 18 ± 7 to 43 ± 12 ng/mL (P < 0.001) with no change in the placebo group. Despite this increase, at 12 wk, there were no between-group differences in either insulin response or insulin sensitivity; nor were there differences in any measured secondary endpoints. There was no evidence of effect modification by sex, race, glucose tolerance status, baseline 25(OH)D(total), or BMI.

CONCLUSION

In healthy persons with low 25(OH)D(total), ergocalciferol administration for 12 wk normalizes 25(OH)D(total) but does not improve insulin secretion, insulin sensitivity, or other markers of metabolic health.

© 2015 American Society for Nutrition.

Address: Endocrine Unit, Pediatric Endocrine Unit, [email protected].; Endocrine Unit.; Diabetes Center, and.; Biostatistics Center, Massachusetts General Hospital, Boston, MA.
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