Effectiveness of 1,25-dihydroxyvitamin D Supplementation on Blood Pressure Reduction in a Pseudohypoparathyroidism Patient with High Renin Activity.

Kimura, Yasukazu; Kawamura, Minoru; Owada, Masahiko; Oshima, Toshikatsu; Murooka, Masako; Fujiwara, Takuya; Hiramori, Katsuhiko

doi:10.2169/internalmedicine.38.31

Cited by 60 publications

(40 citation statements)

References 18 publications

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“…In addition, vitamin D could modulate lipid levels via suppression of PTH secretion, as elevated PTH concentrations reportedly reduce lipolysis (30). Secondly, the blood pressure may be influenced by vitamin D through regulation of the renin-angiotensin system, an important regulator of blood pressure (31,32). Last, experimental studies have suggested that vitamin D may exert its beneficial effects by stimulating the expression of an insulin receptor to improve insulin responsiveness for glucose transport or by controlling calcium influx, which is essential for the insulin-mediated intracellular process in insulin-responsive tissues (33).…”

Section: Resultsmentioning

confidence: 99%

Vitamin D Deficiency in Relation to the Risk of Metabolic Syndrome in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

Pan

Guo

Mei

et al. 2016

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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Summary Vitamin D deficiency is highly prevalent all over the world and dietary intakes of vitamin D are very low in China. In this study we aimed to determine whether vitamin D deficiency is associated with increased risk of metabolic syndrome (MetS) among Chinese type 2 diabetes mellitus (T2DM) patients aged over 50 y. Vitamin D deficiency is now an increasingly recognized worldwide health concern (1) related to its nonclassical roles, such as diabetes, heart disease, autoimmune diseases and certain types of cancers. Low serum 25-hydroxyvitamin D [25(OH)D] concentrations are also deemed to be related to the high incidence of type 2 diabetes mellitus (T2DM) (2) because of existing vitamin D receptors on pancreatic b cells and the other insulin-sensitive tissue such as skeletal muscle tissue. Outcomes indicated that fasting plasma glucose (FPG) and the insulin sensitive index improved significantly in a study of vitamin D supplementation for patients with T2DM (3). The elderly are at high risk for vitamin D deficiency worldwide. And it is worth noting that the prevalence of T2DM is 11.6% with 50.1% of pre-diabetes (IGT) among adults over 18 y in China according to the latest international clinical diagnostic criteria (HbA1c $6.5%). The burden from T2DM complications and mortality is higher in worldwide.The metabolic syndrome (MetS) is commonly characterized by dyslipidemia, dysglycemia, abdominal obesity and hypertension (4). MetS is associated with an increased risk of T2DM and cardiovascular complications, and is a complex of interrelated risk factors for diabetes (5). We know that obesity is also one of the risk factors for vitamin D deficiency, because the excess fat absorbs and holds onto the vitamin D so that it cannot be used for bone building or cellular health. The elderly are at high risk for vitamin D deficiency worldwide due to reduced ability of active vitamin D synthesis. Moreover, relationships among serum 25(OH)D and dyslipidemia, abdominal obesity, and hypertension have been explored in different regions and various kinds of people (6-8), but data to support those relationships are inconsistent with only a sparse sample from Asian people with T2DM. In addition to these traditional risk factors, some blood biomarkers such as apolipoprotein (Apo) A1 and ApoB (9), C-reactive protein (CRP), fibrinogen, and homocysteine (10-12), and vitamin D status (13-15)

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Section: Resultsmentioning

confidence: 99%

Vitamin D Deficiency in Relation to the Risk of Metabolic Syndrome in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

Pan

Guo

Mei

et al. 2016

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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show abstract

“…Mice without the vitamin D-activating 1α-hydroxylase develop hyperreninaemia, independently of calcium levels [20]. The administration of calcitriol (1,25[OH] 2 D 3 ), the active hormonal metabolite of vitamin D, or its analogues, reduces plasma renin activity and angiotensin II levels in experiments and in humans [21,22]. Vitamin D status has shown inverse relationships with plasma renin activity in humans [23,24], while activated vitamin D and AT 1 receptor antagonism have synergistic beneficial effects on RAS regulation and on outcomes in diabetic nephropathy [25].…”

Section: -Hydroxyvitamin D (25[oh]dmentioning

confidence: 99%

Modulation of hypovitaminosis D-induced islet dysfunction and insulin resistance through direct suppression of the pancreatic islet renin–angiotensin system in mice

2012

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Aims/hypothesis Vitamin D is necessary for normal insulin action and suppresses renin production. Increased renin-angiotensin system (RAS) activity causes islet damage, including reduced insulin secretion. We therefore sought to determine whether hypovitaminosis D-induced upregulation of islet RAS in vivo impairs islet cell function and increases insulin resistance, and whether pharmacological suppression of the RAS during continuing vitamin D deficiency might correct this. Methods C57BL/6 mice were rendered vitamin D-deficient by diet, and glucose and insulin tolerance was assessed. The expression and translation of islet functional, and islet RAS, genes were measured and the effects of pharmacological renin suppression examined. Results Mice with diet-induced hypovitaminosis D developed impaired glucose tolerance, increased RAS component expression and impaired islet function gene transcription. Treatment with pharmacological renin inhibition (aliskiren), without vitamin D status correction, reduced islet RAS overreactivity, islet dysfunction and insulin resistance, and improved glucose tolerance. Conclusions/interpretation Upregulation of islet RAS genes can contribute to hypovitaminosis D-induced impairment of islet function and increase insulin resistance independently of vitamin D status. Thus, our findings support the use of RAS inhibitors in impaired glucose homeostasis or early diabetes. They also suggest that combining RAS inhibition with correction of hypovitaminosis D might be useful in treating impaired glycaemic control and also in type 2 diabetes prevention. However, the use of aliskiren in established diabetes is contraindicated due to the increased risk of side effects such as hyperkalaemia, so other more suitable RAS blockers need to be identified.

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“…Calcitriol is known to be a negative endocrine regulator of the RAAS [31]. In several cases, calcitriol treatment was shown to reduce the plasma renin activity, angiotensin II levels, blood pressure, and myocardial hypertrophy [32,33]. In VDR receptor knockout mice, the developing hypertension can be corrected by angiotension converting enzyme inhibitors and angiotensin I receptor antagonists [31].…”

Section: Vitamin D Insufficiency: a Contributing Factor In The Pathogmentioning

confidence: 99%

Vitamin D insufficiency in congestive heart failure: Why and what to do about it?

2006

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This article gives an overview of the current knowledge on vitamin D status in patients with congestive heart failure (CHF). A serum 25-hydroxyvitamin D level below 50 nmol/l (20 ng/ml) is generally regarded as insufficient. Available data indicate that the majority of CHF patients have 25-hydroxyvitamin D levels in the insufficiency range. Skin synthesis of vitamin D after solar ultraviolet B exposure is the most important vitamin D source for humans. However, CHF patients have relatively low outdoor activities. Consequently, a disease-related sedentary lifestyle is an important cause for the insufficient vitamin D status in CHF patients. There is also evidence from a recently performed case-controlled study that indicators of ultraviolet B exposure are already reduced in CHF patients during childhood, adolescence, and early adulthood compared to healthy controls. We present results indicating that an insufficient vitamin D status may contribute to the etiology/pathogenesis of CHF. Data include a vitamin D-mediated reduction of elevated blood pressure as well as a vitamin D-mediated prevention of enhanced parathyroid hormone levels, a pathophysiological state that contributes to cardiovascular disease. Based on population attributable risks, hypertension and cardiovascular disease have a high impact, accounting for the majority of CHF events.Theoretically, vitamin D status can be improved by adequate skin synthesis of vitamin D and/or adequate oral vitamin D intake. At present, daily oral intake of 50-100 microg vitamin D seems to be the most effective way to improve vitamin D status in CHF patients.

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Effectiveness of 1,25-dihydroxyvitamin D Supplementation on Blood Pressure Reduction in a Pseudohypoparathyroidism Patient with High Renin Activity.

Cited by 60 publications

References 18 publications

Vitamin D Deficiency in Relation to the Risk of Metabolic Syndrome in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

Vitamin D Deficiency in Relation to the Risk of Metabolic Syndrome in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

Modulation of hypovitaminosis D-induced islet dysfunction and insulin resistance through direct suppression of the pancreatic islet renin–angiotensin system in mice

Vitamin D insufficiency in congestive heart failure: Why and what to do about it?

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