Diabetologia

, Volume 38, Issue 10, pp 1239–1245 | Cite as

Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in East London Asians

  • B. J. Boucher
  • N. Mannan
  • K. Noonan
  • C. N. Hales
  • S. J. W. Evans
Originals

Summary

Vitamin D deficiency reduces insulin secretion and still occurs in East London Asians in whom the prevalence of diabetes mellitus is at least four times that of Caucasians. Vitamin D status was assessed in 44 of 65 non-diabetic subjects ‘at risk’ of diabetes (spot blood glucose level >6.0 mmol/l <2 h post cibum, or >4.6 mmol/l >2 h post cibum on two separate occasions) and in 15 of 60 age and sex-matched ‘low-risk’ control subjects who attended for oral glucose tolerance test (OGTT) after screening of 877 omnivorous subjects not known to have diabetes. It was found that 95% of at-risk and 80% of low-risk subjects were vitamin D deficient (serum 25-hydroxy-vitamin D <11 ng/ml). Diabetes was present in 16, impaired glucose tolerance in 12 and normoglycaemia in 19 at-risk subjects, impaired glucose tolerance in 2, and normoglycaemia in 13 low-risk subjects. Correlations of 30-min OGTT blood glucose, specific insulin and C-peptide levels with 25-hydroxy-vitamin D concentrations in 44 at-risk subjects were −0.31 (p=0.04), 0.59 (p=0.0001) and 0.44 (p=0.006). In 15 ‘not-at-risk’ subjects 30-min OGTT specific insulin and C-peptide levels correlated with 25-hydroxy-vitamin D, r=0.39 (p=0.04) and 0.16 (p=0.43), respectively. Serum alkaline phosphatase concentration was higher in at-risk than not-at-risk subjects (59.6 vs 46.5 IU/l, p=0.012); corrected calcium concentrations were comparable (2.38 vs 2.39 mmol/l, p=0.7). Following treatment with 100,000 IU vitamin D by i.m. injection, specific insulin, C-peptide [30 min on OGTT] and 25-hydroxy-vitamin D concentrations had risen 8–12 weeks later [means±SD] from 57±62 to 96.2±82.4 mU/l [p=0.0017], 1.0±0.4 to 1.7±0.8 pmol/ml [p=0.0001] and 3.6±1.8 to 13.5±7.4 ng/ml [p=0.0001], (but not to low-risk group values of 179±89 mU/l, 2.7±1.14 pmol/ml and 8.16±6.4 ng/ml), respectively. Both total serum alkaline phosphatase and corrected calcium concentrations rose following vitamin D treatment in the at-risk subjects by 11.1±8.22 (from 44 to 55 IU/l) and 0.15±0.18, (2.43 to 2.57 mmol/l), respectively (p=0.004). Abnormal glucose tolerance was unchanged by vitamin D treatment. The value of early and sustained repletion with vitamin D in diabetes prophylaxis should be examined in communities where vitamin D depletion is common.

Key words

Non-insulin-dependent diabetes mellitus vitamin D vitamin D deficiency total insulin specific insulin proinsulin 32,33 split proinsulin C-peptide glucose intolerance 

Abbreviations

OGTT

Oral glucose tolerance test

IGT

impaired glucose tolerance

p.c.

post cibum

CV

coefficient of variation

NEFA

non-esterified fatty acids

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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • B. J. Boucher
    • 1
  • N. Mannan
    • 1
  • K. Noonan
    • 2
  • C. N. Hales
    • 3
  • S. J. W. Evans
    • 4
  1. 1.Academic Medical Unit and Cellular Mechanisms Research GroupLondon Hospital Medical CollegeLondonUK
  2. 2.Department of Clinical ChemistryRoyal London HospitalLondonUK
  3. 3.Department of Clinical BiochemistryUniversity of Cambridge, Addenbrookes HospitalCambridgeUK
  4. 4.Department of Epidemiology and Medical StatisticsThe London Hospital Medical CollegeLondonUK
  5. 5.Royal London HospitalLondonUK

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