TY - JOUR
T1 - Effect of Vitamin D replacement on indexes of insulin resistance in overweight elderly individuals
T2 - A randomized controlled trial
AU - Fuleihan, Ghada El Hajj
AU - Baddoura, Rafic
AU - Habib, Robert H.
AU - Halaby, Georges
AU - Arabi, Asma
AU - Rahme, Maya
AU - Singh, Ravinder J.
AU - Kassem, Moustapha
AU - Mahfoud, Ziyad
AU - Hoteit, Maha
AU - Daher, Rose T.
AU - Kassir, Mohamed Faisal
N1 - Publisher Copyright:
© 2016 American Society for Nutrition.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). Objective: We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. Design: This double-blind, randomized, controlled multicenter trial enrolled 257 elderly overweight individuals aged ≥ 65 y with baseline 25-hydroxyvitamin D [25(OH)D] concentrations between 10 and 30 ng/mL. All subjects received 1000 mg calcium citrate/d, with vitamin D administered weekly at an equivalent dose of 600 or 3750 IU/d. The homeostasis model assessment (HOMA) of IR index at 1 y was the primary outcome.We also assessed the McAuley index. Results: In total, 222 subjects (55% women) with a mean ± SD age and body mass index (BMI; in kg/m2) of 71 ± 4 y and 30 ± 4, respectively, completed the study. Subjects' baseline characteristics, including IR indexes, were similar across groups: 69% had prediabetes, 54% had hypertension (47% were taking antihypertensive medications), and 60% had hyperlipidemia, nearly half of whom were receiving lipidlowering drugs. At 1 y, mean ± SD serum 25(OH)D increased from 20 ± 7 to 26 ± 7 ng/mL in the low-dose arm (P <0.0001) and from 21 ± 8 to 36 ± 10 ng/mL in the high-dose arm (P > 0.001). Median HOMA-IR indexes did not change compared with baseline concentrations and were similar in the high-[2.2 (IQR: 1.5, 2.9)] and low-dose [2.3 (IQR: 1.6, 3.3] treatment groups. Adjusted analyses showed that HOMA-IR was predicted by the baseline HOMA index and BMI but not by vitamin D dose, baseline serum 25(OH)D, or change in 25(OH)D. Conclusion: Vitamin D3 at 3750 IU/d did not improve HOMA-IR compared with the Institute of Medicine Recommended Dietary Allowance of 600 IU/d in elderly overweight individuals.
AB - It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). Objective: We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. Design: This double-blind, randomized, controlled multicenter trial enrolled 257 elderly overweight individuals aged ≥ 65 y with baseline 25-hydroxyvitamin D [25(OH)D] concentrations between 10 and 30 ng/mL. All subjects received 1000 mg calcium citrate/d, with vitamin D administered weekly at an equivalent dose of 600 or 3750 IU/d. The homeostasis model assessment (HOMA) of IR index at 1 y was the primary outcome.We also assessed the McAuley index. Results: In total, 222 subjects (55% women) with a mean ± SD age and body mass index (BMI; in kg/m2) of 71 ± 4 y and 30 ± 4, respectively, completed the study. Subjects' baseline characteristics, including IR indexes, were similar across groups: 69% had prediabetes, 54% had hypertension (47% were taking antihypertensive medications), and 60% had hyperlipidemia, nearly half of whom were receiving lipidlowering drugs. At 1 y, mean ± SD serum 25(OH)D increased from 20 ± 7 to 26 ± 7 ng/mL in the low-dose arm (P <0.0001) and from 21 ± 8 to 36 ± 10 ng/mL in the high-dose arm (P > 0.001). Median HOMA-IR indexes did not change compared with baseline concentrations and were similar in the high-[2.2 (IQR: 1.5, 2.9)] and low-dose [2.3 (IQR: 1.6, 3.3] treatment groups. Adjusted analyses showed that HOMA-IR was predicted by the baseline HOMA index and BMI but not by vitamin D dose, baseline serum 25(OH)D, or change in 25(OH)D. Conclusion: Vitamin D3 at 3750 IU/d did not improve HOMA-IR compared with the Institute of Medicine Recommended Dietary Allowance of 600 IU/d in elderly overweight individuals.
KW - HOMA
KW - High-dose Vitamin D
KW - IOM RDA
KW - Insulin resistance
KW - Prediabetes
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U2 - 10.3945/ajcn.116.132589
DO - 10.3945/ajcn.116.132589
M3 - Article
C2 - 27413130
AN - SCOPUS:84980373313
SN - 0002-9165
VL - 104
SP - 315
EP - 323
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 2
ER -