Associations between Vitamin D and β-Cell Function and Colorectal Cancer-Associated Tumor Markers in Chinese Type 2 Diabetic Patients with Albuminuria

Clin Lab. 2019 Apr 1;65(4). doi: 10.7754/Clin.Lab.2019.181111.

Abstract

Background: This study is to investigate the protective effects of vitamin D in T2DM, as well as the associations between serum calcifediol level and β-cell function, and risk of CRC, in Chinese type 2 diabetes mellitus (T2DM) patients with albuminuria.

Methods: Serum calcifediol levels were analyzed and compared among healthy individuals and T2DM patients stratified by albumin/creatinine ratio (ACR). Relative correlation analyses were performed with β-cell function (BCF) and risk of CRC.

Results: Patients' ACR was positively associated with fasting plasma glucose and insulin, homeostasis model assessment (HOMA) of insulin resistance (IR), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen (CA)199, CA125, and Septin9 methylation, but inversely associated with HOMA-BCF and insulin secretion. Serum calcifediol level in the healthy controls was significantly higher than T2DM patients. In T2DM patients, calcifediol level was inversely associated with ACR, HOMA-IR, AFP, CEA, and Septin9 methylation, but positively associated with HOMA-BCF and insulin secretion. Multivariate stepwise principal component regression analysis indicated that calcifediol, hemoglobin A1c, and serum creatinine were independent risk factors for elevated CEA in T2DM.

Conclusions: Higher serum calcifediol level is correlated with better β-cell function, lower insulin resistance, and decreased risk of CRC. Vitamin D may have suppressive effects on T2DM-associated complications and therefore represents a potential prophylactic treatment against β-cell dysfunction and cancer development in T2DM patients with albuminuria.

MeSH terms

  • Aged
  • Albuminuria / blood*
  • Albuminuria / urine
  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / urine
  • CA-125 Antigen / blood
  • Calcifediol / blood
  • Carcinoembryonic Antigen
  • China
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / urine
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / urine
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Insulin Resistance
  • Insulin-Secreting Cells / cytology*
  • Luminescence
  • Male
  • Membrane Proteins / blood
  • Middle Aged
  • Multivariate Analysis
  • Principal Component Analysis
  • Real-Time Polymerase Chain Reaction
  • Reproducibility of Results
  • Risk Factors
  • Septins / blood
  • Vitamin D / blood*
  • alpha-Fetoproteins / chemistry

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • CA-125 Antigen
  • Carcinoembryonic Antigen
  • MUC16 protein, human
  • Membrane Proteins
  • alpha-Fetoproteins
  • carbohydrate antigen 199, human
  • Vitamin D
  • SEPTIN9 protein, human
  • Septins
  • Calcifediol