Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial.

Chiara M A Cefalo, Caterina Conte, Gian Pio Sorice, Simona Moffa, Vinsin A Sun, Francesca Cinti, Enrica Salomone, Giovanna Muscogiuri, Alex A G Brocchi, Alfredo Pontecorvi, Teresa Mezza, Andrea Giaccari

Journal: Obesity (Silver Spring, Md.) 2018;26(4):651-657

PMID: 29504254

Plain Language Summary

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Vitamin D concentration has been inversely associated with impaired glucose regulation, insulin resistance and risk of metabolic dysfunction. The aim of the study was to evaluate whether Vitamin D supplementation could improve insulin sensitivity in patients with a high risk of diabetes. The study is a randomised, double-blind, placebo-controlled trial. The participants with obesity were supplemented with Vitamin D or placebo on top of a hypocaloric diet. Results indicate that Vitamin D supplementation combined with weight loss is linked with a significant improvement in insulin sensitivity in vitamin D deficient participants with obesity.

Abstract

OBJECTIVE

The aim was to investigate whether vitamin D supplementation, combined with a hypocaloric diet, could have an independent effect on insulin sensitivity in subjects with both overweight and hypovitaminosis D. Changes from baseline in anthropometric parameters, body composition, glucose tolerance, and insulin secretion were considered as secondary outcomes.

METHODS

Eighteen volunteers who were nondiabetic and vitamin D deficient and had BMI > 25 kg/m were randomized (1:1) in a double-blind manner to a hypocaloric diet + either oral cholecalciferol at 25,000 IU/wk or placebo for 3 months. Hyperinsulinemic-euglycemic clamp to measure insulin sensitivity was performed at baseline and after intervention.

RESULTS

Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Serum 25-hydroxyvitamin D levels in the vitamin D group increased considerably (from 36.7 ± 13.2 nmol/L to 74.8 ± 18.7 nmol/L; P < 0.001). Insulin sensitivity in the vitamin D group improved (from 4.6 ± 2.0 to 6.9 ± 3.3 mg·kg ·min ; P < 0.001), whereas no changes were observed in the placebo group (from 4.9 ± 1.1 to 5.1 ± 0.3 mg·kg ·min ; P = 0.84).

CONCLUSIONS

Cholecalciferol supplementation, combined with a weight loss program, significantly improves insulin sensitivity in healthy subjects with obesity and might represent a personalized approach for insulin-resistant subjects with obesity.

© 2018 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Address: Center for Endocrine and Metabolic Diseases, Gemelli University Polyclinic Foundation, Catholic University of the Sacred Heart, Rome, Italy.; Internal Medicine and Transplant Unit, San Raffaele Hospital, Milan, Italy.; Center for Diabetes and Metabolic Diseases, Association of Italian Knights of the Sovereign Military Order of Malta, Rome, Italy.; Division of Endocrinology, Department of Clinical Medicine and Surgery, Federic II University, Naples, Italy.
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