Effect of Vitamin D3 Supplementation to 25(OH)D, IL-17, and HbA1c Level in Pediatric Type 1 Diabetes Mellitus
DOI:
https://doi.org/10.11594/jtls.07.01.06Keywords:
25(OH)D, HbA1c, IL-17, type 1 diabetes mellitus, vitamin DAbstract
Type 1 Diabetes Mellitus (T1DM) is the consequence of autoimmune destruction process of β cells which associated with Th17 activity and low 25(OH)D level. This study was aimed to investigate the effect of vitamin D3 supplementation toward 25(OH)D level, Th17 activity (IL-17) and glycemic control (HbA1c) in pediatric T1DM. This study was designed as randomized clinical trials (RCT), double-blind, pre and post-test controlled study. Subject was children with T1DM who were divided into two groups: K1: subjects were treated with insulin 0.5–2 IU/day + vitamin D3 2000 IU/day for 3 months, K2: subjects were treated with insulin 0.5–2 IU/day + placebo for 3 months. Levels of 25(OH)D, IL-17 and HbA1c were evaluated after 3 months treatment using ELISA. After 3 months treatment, results showed that 25(OH)D level was significantly higher in K1 compared with K2 (p = 0.00), IL-17 level was significantly lower K1 compared with K2 (p= 0.022). Surprisingly, HbA1c level in K1 was not significantly different with K2 (p = 0.93). Furthermore, in vitamin D-treated group, 25(OH)D level was elevated significantly after 3 months treatment with vitamin D (p = 0.00), IL-17 level was reduced significantly after 3 months treatment with vitamin D (p= 0.001)  and HbA1c level was reduced insignificantly after 3 months treatment with vitamin D (p= 0.76). Correlation study showed that there was no correlation between 25(OH)D level with IL-17 level (p= 0.160, r= -0.284) and 25(OH)D with HbA1c (p= 0.62, r= -0.10). This study can be conclude that vitamin D3 supplementation may elevate the 25(OH)D and reduce IL-17 level but did not change HbA1c level in pediatric T1DM.
References
Janner M, Ballinari P, Mullis PE, Flück CE (2010) High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes. Swiss Medical Weekly 140 (3): 451–460.
Greer RM, Portelli SL, Hung BS-M et al. (2013) Serum vitamin D Levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes. Pediatric Diabetes 14 (1): 31–41. doi: 10.1111/j.1399-5448.2012.00890.x
Mitri J, Pittas AG (2014) Vitamin D and diabetes. Endocrinology and Metabolism Clinics of North America 43 (1): 205–232. doi: 10.2337/diaspect.24.2.113.
Alemzadeh R, Wyatt DT. Diabetes mellitus in children. In: Kliegman R, Stanton B, St. Geme J, Schor N, eds. (2007) Nelson textbook of Pediatrics. Philadelphia, Elsevier Saunders.
Savova R (2009) Definition, epidemiology and classification of diabetes mellitus in childhood after ‘Ispad Clinical Practice Consensus Guidelines 2009 Compendium’. Pediatriya 49: 8–13.
Holt R, Hanley N (2012) Clinical diabetes and obesity. In: Essential Endocrinology and Diabetes, Holt, R & Hanley, N (eds). Oxford, Wiley-Blackwell.
Baeke F, Korf H, Overbergh L et al. (2010) Human T lymphocytes are direct targets of 1,25-dihydroxyvitamin D3 in the immune system. The Journal of Steroid Biochemistry and Molecular Biology 121 (1–2): 221–227. doi:10.1016/j.jsbmb.2010.03.037.
Takiishi T, Gysemans C, Bouillon R, Mathieu C (2010) Vitamin D and diabetes. Endocrinology Metabolism Clinics of North America 39 (2): 419–446.
Dejkhamron P, Menon RK, Sperling M (2007) Childhood diabetes mellitus: Recent advances and future prospects. Indian Journal of Medical Research 125(3): 231–250.
Gysemans C, Van-Etten E, Overbergh L, Giulietti A, Eelen G, Waer M (2008) Unaltered diabetes presentation in NOD mice lacking the vitamin D receptor. Diabetes. 57(1): 269–75.
Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM (2001) Intake of vitamin D and risk of type 1 diabetes: A birth-cohort study. Lancet. 358(9292): 1500–1503.
Prietl B, Pilz S, Wolf M, Tomaschitz A, Obermayer-Pietsch B, Graninger W (2010) Vitamin D supplementation and regulatory T cells in apparently healthy subjects: vitamin D treatment for autoimmune diseases?. Isr Med Assoc J. 12(3): 136–139.
Dong JY, Zhang WG, Chen JJ, Zhang ZL, Han SF, Qin L-Q (2013) Vitamin D intake and risk of type 1 diabetes: a meta-analysis of observational studies. Nutrients. 5(9): 3551–3562.
Hawa MI, Valorani MG, Buckley LR, Beales PE, Afeltra A, Cacciapaglia F (2004) Lack of effect of vitamin D administration during pregnancy and early life on diabetes incidence in the non-obese diabetic mouse. Horm Metab Res. 36(9): 620–624.
Mathieu C, Decallonne B, van Etten E (2002) 1,25-dihydroxyvitamin D3: the endocrine system meets the immune system. Verh K Acad Geneeskd Belg. 64 (1): 71–82.
Svoren BM, Volkening LK, Wood JR, Laffel LMB (2009) Significant vitamin D deficiency in youth with type 1 diabetes mellitus. Journal of Pediatrics 154 (1): 132–134.
Wulandari D, Cahyono HA, Widjajanto E, Puryatni A (2014) Low levels of vitamin D correlate with hemoglobin A1c and interleukin-10 levels in pediatric type 1 diabetes mellitus patients. Journal of Tropical Life Science 4 (3): 182–186.
Honkanen J, Nieminen JK, Gao R et al. (2010) IL-17 immunity in human type 1 diabetes. The Journal of Immunology 185 (3): 1959–1967.
Marwaha AK, Crome SQ, Panagiotopoulos C et al. (2010) Cutting edge: Increased IL-17-secreting T cells in children with new-onset type 1 diabetes. The Journal of Immunology 185 (7): 3814-3818.
Arif S, Moore F, Marks K et al. (2011) Peripheral and islet interleukin-17 pathway activation characterizes human autoimmune diabetes and promotes cytokine-mediated β-Cell Death. Diabetes 60 (8): 2112-2119.
Grieco FA, Moore F, Vigneron F et al. (2014) IL-17A increases the expression of proinflammatory chemokines in human pancreatic islets. Diabetologia 57 (3): 502–511.
Bizzari C, Pitocco D, Napoli N (2010) No protective effect of calcitriol on beta-cell function in recent-onset type 1 diabetes: The IMDIAB XIII trial. Diabetes Care 33 (9): 1962–1963.
Aljabri K, Bokhari S, Khan M (2010) Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency. Annals of Saudi Medicine 30 (6): 454–458.
Jeffery LE, Burke F, Mura M et al. (2009) 1,25-Dihydroxyvitamin D3 and IL-2 combine to inhibit T cell production of inflammatory cytokines and promote development of regulatory T cells expressing CTLA-4 and FoxP3. The Journal of Immunology 183 (9): 5458–5467.
Ferraro A, Socci C, Stabilini A et al. (2011) Expansion of Th17 cells and functional defects in T regulatory cells are key features of the pancreatic lymph nodes in patients with type 1 diabetes. Diabetes 60 (11): 2903–2913.
Nwosu BU, Maranda L (2014) The effects of vitamin D supplementation on hepatic dysfunction, vitamin D status, and glycemic control in children and adolescents with vitamin D deficiency and either type 1 or type 2 diabetes mellitus. PLoS One 9 (6): e99646. doi:10.1371/journal.pone.0099646.
Branco S, Rego H, Costa C et al. (2012) Vitamin D deficiency in children and adolescents with type 1 diabetes. Pediatric Diabetes 13: 91–92.
Tunc O, Cetinkaya S, Kizilgun M, Aycan Z (2011) Vitamin D status and insulin requirements in children and adolescent with type 1 diabetes. Journal of Pediatric Endocrinology and Metabolism 24: 10377–11041.
Magee L, Mughal Z, Ehtisham S et al. (2012) The relationship between Vitamin D and HbA1C in a type 1 diabetic paediatric population. Endocrine Abstracts 28: 38–42.
Zella JB, DeLuca HF (2003) Vitamin D and autoimmune diabetes. Journal of Cellular Biochemistry 88 (2): 216–222.
Giulietti A, Gysemans C, Stoffels K et al. (2004) Vitamin D deficiency in early life accelerates Type 1 diabetes in non-obese diabetic mice. Diabetologia 47 (3): 451–462.
Baeke Fb, Takiishi T, Korf H et al. (2010) Vitamin D: Modulator of the immune system. Current Opinion in Pharmacology 10 (4): 482–496.
Zella JB, McCary LC, DeLuca HF (2003) Oral administration of 1,25-dihydroxyvitamin D3 completely protects NOD mice from insulin-dependent diabetes mellitus. Archives of Biochemistry and Biophysics 417 (1): 77–80.
van Etten E, Mathieu C (2005) Immunoregulation by 1,25-dihydroxyvitamin D3: Basic concepts. The Journal of Steroid Biochemistry and Molecular Biology 97 (1-2): 93–101.
Downloads
Published
Issue
Section
License
The work has not been published before (except in the form of an abstract or part of a published lecture or thesis) and it is not under consideration for publication elsewhere. When the manuscript is accepted for publication in this journal, the authors agree to automatic transfer of the copyright to the publisher.
Journal of Tropical Life Science is licensed under Creative Commons Attribution-NonCommercial 4.0 International License
_.png){kind=logo}
