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Anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency: a randomized, double-blinded, placebo-controlled clinical trial



The present study aimed to investigate the anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency.


This study was a randomized, placebo-controlled, double-blinded clinical trial.

Trial registration code: IRCT20190204042621N1


Forty-eight patients with type 2 diabetes aged 40–65 (from a total of 52 volunteers in Ardabil diabetes clinic) were randomly assigned to either the vitamin D supplementation with resistance training group (VD + RT: n = 12), the resistance training group (RT: n = 12), the vitamin D supplementation group (VD: n = 12), or the control group (CON: n = 12).


The subjects in VD group took vitamin D supplements at 50000 IU per 2 weeks for 3 months; the subjects in RT group exercised 3 times per week for 12 weeks; and the subjects in VD + RT group participated in both treatments. Subjects in CON group were asked to maintain normal daily life pattern for the duration of the study.


Serum Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α) and C-reactive protein (CRP) levels were determined at pre and post-test and the data were compared among the four groups and between two tests (4 × 2) using two-way ANOVA with repeated measures.


IL-6 decreased significantly (P = 0.001) in all groups (VD + RT = % -71.73, RT = % -65.85, VD = % -61.70). TNF-α decreased significantly (P = 0.001) in VD + RT (% -44.90) and RT (% -40) groups. CRP showed no significant change in any group (P > 0.05).


Results demonstrated that vitamin D supplementation in addition to resistance training had positive effects on some inflammatory markers in T2D and vitamin D deficient men. Vitamin D supplementation was especially effective when it was complemented with exercise training.

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Fig. 1


  1. 1.

    Seshadrj KG, Tamilselvan B, Rajendran A. Role of vitamin D in diabetes. J Clin Endocrinol Metab. 2011;12:47–56.

  2. 2.

    Marmett B, Nunes RB. Resistance and aerobic training in the treatment of type 2 diabetes mellitus. J Diabetes Metab Disord Control. 2017;4:00126.

  3. 3.

    World Health Organization (WHO).Global report on diabetes. Geneva, Switzerland 2018

  4. 4.

    Guadarrama-López AL, Valdés-Ramos R, Martínez-Carrillo BE. Type 2 Diabetes, PUFAs, and Vitamin D: Their Relation to Inflammation. Hindawi Publishing Corporation. J Immunol Res. 2014, 2014:860703. https://doi.org/10.1155/2014/860703.

  5. 5.

    Stumvoll M, Goldstein B, van Haeften T. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365:1333–134.

  6. 6.

    Badawi A, Klip A, Haddad P, Cole DEC, Bailo BG, El Sohemy A, et al. Type 2 diabetes mellitus and inflammation: prospects for biomarkers of risk and nutritional intervention. Diabetes Metab Syndr Obes. 2010;26:173–86.

  7. 7.

    Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor-a in human obesity and insulin resistance. J Clin Invest. 1995;95:2409–15.

  8. 8.

    Zeggini E, Groves CJ, Parkinson JR, et al. Large-scale studies of the association between variation at the TNF/LTA locus and susceptibility to type 2 diabetes. Diabetologia. 2005;48:2013–7.

  9. 9.

    Chagas CEA, Borges MC, Martini LA, Rogero MM. Focus on vitamin D, inflammation and type 2 diabetes. Nutrients. 2012;4:52–67.

  10. 10.

    Elnasr SM, Ibrahim IM, Alkady MM. Role of vitamin D on glycemic control and oxidative stress in type 2 diabetes mellitus. J Res Med Sci. 2017;22:22. https://doi.org/10.4103/1735-1995.200278.

  11. 11.

    Zuk A, Fitz Patrick T, Roella LC. Effect of vitamin D3 supplementation on inflammatory markers and glycemic measures among overweight or obese adults: a systematic review of randomized controlled trials. PLoS One. 2016;11(4):e0154215.

  12. 12.

    Dixit S, Maiya A, Shastry BA. Effect of moderate-intensity aerobic exercise on glycosylated haemoglobin among elderly patients with type 2 diabetes & peripheral neuropathy. Indian J Med Res. 2017;145:129–32.

  13. 13.

    Kim HJ, Kang CK, Park H, Lee MG. Effects of vitamin D supplementation and circuit training on indices of obesity and insulin resistance in T2D and vitamin D deficient elderly women. J Exerc Nutr Biochem. 2014;18:249–57.

  14. 14.

    Duclos M, Oppert JM, Verges B, Coliche V, Gautier JF, Guezennec Y, et al. Physical activity and type 2 diabetes. Recommandations of the SFD (francophone diabetes society) diabetes and physical activity working group. Diabetes Metab. 2013;39(3):205–16.

  15. 15.

    Hagstrom AD, Marshall PWM, Lonsdale C, Papalia S, Cheema BS, Toben C, et al. The effect of resistance training on markers of immune function and inflammation in previously sedentary women recovering from breast cancer: a randomized controlled trial. Breast Cancer Res Treat. 2016;155(3):471–82.

  16. 16.

    Gray S, Baker G, Wright A, Fitzsimons C, Mutrie N, Nimmo M. The effect of a 12 weeks walking intervention on markers of insulin resistance and systemic inflammation. Prev Med. 2009;48(1):39–44.

  17. 17.

    Carrillo AE, Flynn MG, Pinkston C, Markofski MM, Jiang Y, Donkin SS, et al. Vitamin D supplementation during exercise training does not alter inflammatory biomarkers in overweight and obese subjects. Eur J Appl Physiol. 2012;112(8):3045–52.

  18. 18.

    American Diabetes Association (ADA). Standards of medical Care in Diabetes, Diabetes Care Volume 41, Supplement 1, January 2018.

  19. 19.

    Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010;85(8):752–8.

  20. 20.

    Whitley E, Ball J. Statistics review 4: sample size calculations. Crit Care. 2002;6:335–41.

  21. 21.

    Jackson AS, Pollock ML. Practical assessment of body composition. Phys Sportsmed. 1985;13:76–90.

  22. 22.

    Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/ exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39:2065–79.

  23. 23.

    Brzycki M. Strength testing: predicting a one – rep max from repetitions-to-fatigue. JOPERD. 1993;64:88–90.

  24. 24.

    Yazdchi R, Pourghassem Gargari B, Asghari-Jafarabadi M, Shahaf F. Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized, double-blind, placebo-controlled clinical trial. Nutr Res Pract. 2016;10(3):328–35.

  25. 25.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

  26. 26.

    Woerle HJ, Pimenta WP, Meyer C, Gosmanov NR, Szoke E, Szombathy T, et al. Diagnostic and therapeutic implications of relationships between fasting, 2-hour postchallenge plasma glucose and hemoglobin a1c values. Arch Intern Med. 2004;164:1627–32.

  27. 27.

    Das G. Vitamin D and type 2 diabetes. Pract Diabetes. 2017;34(1):19–24.

  28. 28.

    Shab-Bidar S, Neyestani TR, Djazayery A, Eshraghian MR, Houshiarrad A, Kalayi A, et al. Improvement of vitamin D status resulted in amelioration of biomarkers of systemic inflammation in the subjects with type 2 diabetes. Diabetes Metab Res Rev. 2012;28:424–30.

  29. 29.

    Miller EG, Sethi P, Nowson CA, Dunstan DW, Daly RM. Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes. Eur J Appl Physiol. 2017;117(8):1669–78.

  30. 30.

    Calton EK, Kevin N, Keane KN, Newsholm P, Soares MJ. The impact of vitamin D levels on inflammatory status: a systematic review of immune cell studies. PLoS One. 2015;10(11):e0141770.

  31. 31.

    Haussler MR, Haussler CA, Bartik L, Whitfield CK, Hsieh JC, Slater S, et al. Vitamin D receptor: molecular signaling and actions of nutritional ligands in disease prevention. Nutr Rev. 2008;66:S98–S112.

  32. 32.

    Sigmundsdottir H, Pan J, Debes GF, Alt C, Habtezion A, Soler D, et al. DCs metabolize sunlight-induced vitamin D3 to “program” T cell attraction to the epidermal chemokine CCL27. Nat Immunol. 2007;8:285–93.

  33. 33.

    Jablonski KL, Chonchol M, Pierce GL, Walker AE, Seals DR. 25-Hydroxyvitamin D deficiency is associated with inflammation-linked vascular endothelial dysfunction in middle-aged and older adults. Hypertension. 2011;57:63–9.

  34. 34.

    Zhang Z, Zhao M, Li Q, Zhao H, Wang J, LI Y. Acetyl-l-carnitine inhibits TNF-alpha-induced insulin resistance via AMPK pathway in rat skeletal muscle cells. FEBS Lett. 2009;583(2):470–4.

  35. 35.

    Nabata A, Kuroki M, Ueba H, Hashimoto S, Umemoto T, Wada H, et al. C-reactive protein induces endothelial cell apoptosis and matrix metalloproteinase-9 production in human mononuclear cells: implications for the destabilization of atherosclerotic plaque. Atherosclerosis. 2008;196:129–35.

  36. 36.

    Salamat KM, Azarbayjani MA, Yusof A, Dehghan F. The response of pre-inflammatory cytokines factors to different exercises (endurance, resistance, concurrent) in overweight men. Alex J Med. 2016;52:367–70.

  37. 37.

    Mora S, Lee IM, Buring JE, Ridker PM. Association of physical activity and body mass index with novel and traditional cardiovascular biomarkers in women. JAMA. 2006;295(12):1412–9.

  38. 38.

    Penninx BW, Kritchevsky SB, Newman AB, Nicklas BJ, Simonsick EM, Rubin S, et al. Inflammatory markers and incident mobility limitation in the elderly. J Am Geriatr Soc. 2004;52:1105–13.

  39. 39.

    Levinger I, Goodman C, Peake J, Garnham A, Hare DL, Jerums G, et al. Inflammation, hepatic enzymes and resistance training in individuals with metabolic risk factors. Diabet UK Diabet Med. 2009;26(6):220–7.

  40. 40.

    Hopps E, Canino B, Caimi G. Effects of exercise on inflammation markers in type 2 diabetic subjects. Acta Diabetol. 2011;48(3):183–9.

  41. 41.

    Christiansen T, Paulsen SK, Bruun JM, Pedersen SB, Richelsen B. Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-weeks randomized intervention study. Am J Physiol Endocrinol Metab. 2010;298(4):E824–31.

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We would like to express gratitude to Dr. Mohammad Zaefizadeh, Dr. Ahad Jafari, Dr. Nasser Shokri, Ardabil Islamic Azad University for their excellent helps in conducting the present study and Sanandaj Islamic Azad University for Funding the study. This study was performed with the approval of the Faculty of Medical Sciences of Ardabil Azad University.


Sanandaj Branch, Islamic Azad University.

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All authors equally contributed to the writing and revision of this paper.

Correspondence to Khalid Mohamadzadeh Salamat.

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Dadrass, A., Mohamadzadeh Salamat, K., Hamidi, K. et al. Anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency: a randomized, double-blinded, placebo-controlled clinical trial. J Diabetes Metab Disord 18, 323–331 (2019). https://doi.org/10.1007/s40200-019-00416-z

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  • Inflammation
  • Resistance training
  • Type 2 diabetes mellitus
  • Vitamin D