A randomised controlled trial evaluating the impact of targeted vitamin D supplementation on endothelial function in type 2 diabetes mellitus: The DIMENSION trial

Diab Vasc Dis Res. 2016 May;13(3):192-200. doi: 10.1177/1479164115621667. Epub 2016 Jan 27.

Abstract

We sought to determine if vitamin D supplementation, to target 25(OH)D concentrations of 30-40 ng/mL, improves endothelial function in Singapore's multi-ethnic type 2 diabetes mellitus population. We randomised 64 type 2 diabetes mellitus patients with hypovitaminosis D to cholecalciferol 4000 International Unit/matching placebo [baseline 25(OH)D < 20 ng/mL] or cholecalciferol 2000 International Unit/matching placebo [baseline 25(OH)D: 20-30 ng/mL] daily for 16 weeks with a down titration at 8 weeks if 25(OH)D > 30 ng/mL. Endothelial function was assessed by peripheral tonometry (reactive hyperaemia index-endothelial peripheral arterial tonometry) and vascular biomarkers: E-selectin, von-Willebrand factor and high-sensitivity C-reactive protein. We compared the change from baseline parameters in the two groups using Student's t-test or Kruskal-Wallis test. A log-normal multivariate regression analysis was used to adjust for relevant baseline variables. The median reactive hyperaemia index in the vitamin D group increased from 0.65 (interquartile range: 0.42) to 0.73 (interquartile range: 0.36), whereas it decreased from 0.73 (interquartile range: 0.65) to 0.65 (interquartile range: 0.38) (p = 0.02) in the placebo group. After adjustment for baseline variables, the change was not statistically significant for reactive hyperaemia index (p = 0.07) and for other vascular biomarkers (p > 0.05). Targeted vitamin D supplementation for 16 weeks resulted in a small but non-significant improvement in endothelial function in a type 2 diabetes mellitus cohort.

Keywords: Vitamin D; cholecalciferol; endothelial function; type 2 diabetes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cholecalciferol / adverse effects
  • Cholecalciferol / therapeutic use*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetic Angiopathies / diagnosis
  • Diabetic Angiopathies / drug therapy*
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / physiopathology
  • Dietary Supplements* / adverse effects
  • Double-Blind Method
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Hyperemia / physiopathology
  • Male
  • Middle Aged
  • Singapore
  • Tertiary Care Centers
  • Time Factors
  • Treatment Outcome
  • Vasodilation / drug effects*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy*

Substances

  • Biomarkers
  • Vitamin D
  • Cholecalciferol
  • 25-hydroxyvitamin D