The Effects of Vitamin D, K and Calcium Co-Supplementation on Carotid Intima-Media Thickness and Metabolic Status in Overweight Type 2 Diabetic Patients With CHD

Br J Nutr. 2016 Jul;116(2):286-93. doi: 10.1017/S0007114516001847. Epub 2016 May 20.

Abstract

This study was conducted to examine the effects of vitamin D, K and Ca co-supplementation on carotid intima-media thickness (CIMT) and metabolic status in overweight diabetic patients with CHD. This randomised, double-blind, placebo-controlled trial was conducted among sixty-six diabetic patients with CHD. Participants were randomly allocated into two groups to take either 5µg vitamin D, 90 µg vitamin K plus 500 mg Ca supplements (n 33) or placebo (n 33) twice a day for 12 weeks. Fasting blood samples were obtained at the beginning of the study and after the 12-week intervention period to determine related markers. Vitamin D, K and Ca co-supplementation resulted in a significant reduction in maximum levels of left CIMT (-0·04 (sd 0·22) v. +0·04 (sd 0·09) mm, P=0·02). Changes in serum vitamin D (+6·5 (sd 7·8) v. +0·4 (sd 2·2) ng/ml, P<0·001), Ca (+0·6 (sd 0·3) v. +0·1 (sd 0·1) mg/dl, P<0·001) and insulin concentrations (-0·9 (sd 3·1) v. +2·6 (sd 7·2) µIU/ml, P=0·01), homoeostasis model for assessment of estimated insulin resistance (-0·4 (sd 1·2) v. +0·7 (sd 2·3), P=0·01), β-cell function (-2·1 (sd 9·0) v. +8·9 (sd 23·7), P=0·01) and quantitative insulin sensitivity check index (+0·007 (sd 0·01) v. -0·006 (sd 0·02), P=0·01) in supplemented patients were significantly different from those in patients in the placebo group. Supplementation resulted in significant changes in HDL-cholesterol (+2·7 (sd 7·0) v. -2·5 (sd 5·7) mg/dl, P=0·002), high-sensitivity C-reactive protein (-1320·1 (sd 3758·3) v. +464·0 (sd 3053·3) ng/ml, P=0·03) and plasma malondialdehyde concentrations (-0·4 (sd 0·5) v. -1·0 (sd 1·1) µmol/l, P=0·007) compared with placebo. Overall, vitamin D, K and Ca co-supplementation for 12 weeks among diabetic patients with CHD had beneficial effects on maximum levels of left CIMT and metabolic status. The effect of vitamin D, K and Ca co-supplementation on maximum levels of left CIMT could be a chance finding.

Keywords: CHD; CIMT carotid intima-media thickness; Carotid intima-media thickness; FPG fasting plasma glucose; HOMA-IR homoeostasis model for assessment of insulin resistance; K and calcium co-supplementation; MDA malondialdehyde; MGP matrix Gla-protein; Metabolic status; NO nitric oxide; Obesity; Type 2 diabetes mellitus; Vitamin D; hs-CRP high-sensitivity C-reactive protein.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Calcium / pharmacology*
  • Calcium / therapeutic use
  • Carotid Intima-Media Thickness*
  • Cholesterol, HDL / blood
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / pathology
  • Dietary Supplements*
  • Double-Blind Method
  • Female
  • Humans
  • Inflammation / blood
  • Insulin / blood
  • Insulin Resistance
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Obesity / complications*
  • Obesity / metabolism
  • Oxidative Stress
  • Vitamin D / blood
  • Vitamin D / pharmacology*
  • Vitamin D / therapeutic use
  • Vitamin K / pharmacology*
  • Vitamin K / therapeutic use
  • Vitamins / pharmacology
  • Vitamins / therapeutic use

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Insulin
  • Vitamins
  • Vitamin K
  • Vitamin D
  • Malondialdehyde
  • C-Reactive Protein
  • Calcium