Effects of 1α‐Calcidol (Alfacalcidol) on Microvascular Endothelial Function, Arterial Stiffness, and Blood Pressure in Type II Diabetic Nephropathy Patients

Munisamy, Seetha; Daud, Kamaliah Mohd; Mokhtar, Siti Safiah; Rasool, Aida Hanum Ghulam

doi:10.1111/micc.12256

Cited by 12 publications

(8 citation statements)

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“…Thus, evidences on the ability of antioxidants to regulate oxidative stress in diabetes are compelling and suggests potential additional treatment strategy to reduce cardiovascular risk and complications in diabetes. In view that vitamin D supplementation is able to improve many cardiovascular biomarkers in both diabetic (78,110) and non-diabetic (111) population with vitamin D deficiency, it may be a potential measure in regulating oxidative stress underlying diabetic complications. By correcting the vitamin D levels as shown by accumulating evidences in epidemiology studies, enhanced oxidative damage and reduced antioxidant activities might be reversed or at least improved in diabetic population.…”

Section: Discussionmentioning

confidence: 99%

“…In the development of adverse cardiovascular events, especially in DM, low vitamin D level is suggested as one of the risk factors (59). This is supported by statistics showing high prevalence of vitamin D insufficiency and deficiency occurring in the diabetic population; 91.1% in India (76), 73.6% in Saudi Arabia (77) and 43% in Malaysia (78).Studies have shown that higher vitamin D levels were associated with 40% lower risk of T2DM in women while subjects that developed diabetes had lower vitamin D levels (serum 25(OH)D < 50 nmol/L) compared to non-diabetics (79). This suggested that low circulating vitamin D concentrations played a significant role in the pathogenesis of DM.…”

Section: Vitamin D Status and Diabetes Mellitusmentioning

confidence: 94%

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Vitamin D status and oxidative stress in diabetes mellitus

Lee

Mokhtar

Munisamy

et al. 2018

Cell Mol Biol (Noisy-le-grand)

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Diabetes mellitus is an epidemic that is gaining global concern. Chronic hyperglycemia in diabetes induces the excess production of free radicals. The deleterious effects of excess free radicals are encountered by endogenous antioxidant defense system. Imbalance between free radicals production and antioxidants defense mechanisms leads to a condition known as "oxidative stress". Diabetes mellitus is associated with augmented oxidative stress that induced micro-and macrovascular complications, which presents a significant risk for cardiovascular events. Low vitamin D levels in the body have also been reported to be associated with the pathogenesis of diabetes and enhanced oxidative stress. The article is to review available literature and summarize the relationship between oxidative stress and vitamin D levels in diabetes. We also review the effects of vitamin D analogs supplementation in improving oxidative stress in diabetics.

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Section: Discussionmentioning

confidence: 99%

Section: Vitamin D Status and Diabetes Mellitusmentioning

confidence: 94%

Vitamin D status and oxidative stress in diabetes mellitus

Lee

Mokhtar

Munisamy

et al. 2018

Cell Mol Biol (Noisy-le-grand)

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“…In contrast to this finding, no significant correlation between vitamin D levels and UACR has been reported by other research groups, which might be explained by the small number of study patients in these trials [ 53 , 56 ]. Several well-designed observational and interventional studies have shown a recovery of renal function after vitamin D therapy [ 27 , 56 , 62 , 63 , 64 , 65 ], which was not confirmed by others [ 25 , 53 , 66 , 67 , 68 ].…”

Section: Discussionmentioning

confidence: 87%

“…In addition to the higher risk of DN in patients with vitamin D deficiency, multiple interventional studies have shown a recovery of renal function after vitamin D therapy [ 27 , 56 , 62 , 63 , 64 , 65 ]. An RCT was performed in 48 T1DN patients to examine the effects of a 12-week paricalcitol treatment (starting dose was 1 µg daily if plasma parathyroid hormone levels were <53 pmol/L (<500 pg/mL), or, if higher, the starting dose was 2 µg paricalcitol daily) on renal function [ 62 ].…”

Section: Human Studiesmentioning

confidence: 99%

The Role of Vitamin D in Diabetic Nephropathy: A Translational Approach

Delrue

Speeckaert

Delanghe

et al. 2022

IJMS

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According to several animal and human studies, vitamin D appears to play a significant role in the development of diabetic nephropathy. However, the possible renoprotective effect of vitamin D and its influence on the reversal of already existing renal damage remains doubtful. At this moment, there are a few hypotheses concerning the underlying molecular and genetic mechanisms including the link between vitamin D and inflammation, oxidative stress, and extracellular matrix accumulation. The present review aims to investigate the potential role of vitamin D in the development of diabetic kidney disease from a translational approach.

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“…After intervention, SBP and DBP in vitamin D group (n=30, BP from 121/80.5 to 110/76.3 mm Hg) was significantly decreased compared with those in placebo group (n=30). Munisamy et al [86] randomly assigned 70 normotensive type 2 diabetes patients receiving either 0.25 μg α-calcidol daily (n=34) or placebo (n=36) for 6 months. In the end of the study, α-calcidol (n=28) significantly reduced central SBP.…”

Section: Effect Of Vitamin D Administration On Bp In Vitamin D-deficimentioning

confidence: 99%

Effect of Vitamin D on the Treatment and Prevention of Essential Hypertension

Chen¹

2017

Drug Des

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The vast majority of epidemiological studies have consistently shown that vitamin D levels are inversely related to blood pressure (BP) and the incidence of hypertension (HTN). Animal studies from diet-induced or genetic models of vitamin D deficiency suggest that vitamin D deficiency directly causes HTN. Based on basic and clinical studies, modestly increased renin expression in genetic mouse models of vitamin D deficiency is associated with, but not causally linked to vitamin D deficiency-induced HTN. Our mechanistic studies indicate that overexpression of a novel target gene seems to play a critical role in vitamin D-deficient HTN, and that vitamin D signaling defect in vascular smooth muscle cells and CD4+ T lymphocytes seems predominantly be responsible for vitamin D deficiencymediated HTN. The data from many clinical trials have consistently demonstrated a minimal or no effect of shortterm vitamin D supplementation on BP in normotensive healthy individuals, but long-term vitamin D supplementation should prevent the development of essential HTN (EH) at high-risk susceptible people. More than 13 randomized controlled trials have shown that vitamin D repletion significantly reduces BP in vitamin D-deficient EH patients, which appears to be more effective in those with type 2 diabetes or impaired glucose tolerance. Short-term administration of active vitamin D or its analogue has a better antihypertensive role than natural vitamin D in the treatment of vitamin D-deficient EH. While these promising data from relatively small trials have displayed potential beneficial vitamin D effect on EH, it is urgently needed to comprehensively elucidate molecular mechanisms of vitamin D deficiency-induced HTN, which will provide a solid theoretical basis to well design large randomized controlled trials to further address the antihypertensive role of vitamin D in vitamin D-deficient EH patients. Currently, EH is lacking an etiology-specific therapy. Identification of vitamin D deficiency as an environmental stressor that triggers the development of EH at vulnerable individuals will make a great advance in the field of EH research.Keywords: Vitamin D; Deficiency; Blood pressure; Essential hypertension; Molecular mechanisms; Clinical trials Etiology-Specific Treatment for EH is a Knowledge GapMore than 95% hypertensive patients suffer from EH, a chronic disease that displays an elevated BP phenotype with unknown etiology. EH can lead to stroke, coronary artery disease, peripheral artery disease, heart failure, renal failure and increased mortality if it is not well controlled [1]. Although there are several classes of antihypertensive medications available, in America, 50% of hypertensive patients do not have their BP well-controlled and about 5 million patients are resistant to antihypertensive treatment with a combination of at least three antihypertensive medications [2]. One of critical problems is lacking an etiology-specific effective therapy for EH. Currently, treatment of EH is largely empiric, and the lesseff...

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Effects of 1α‐Calcidol (Alfacalcidol) on Microvascular Endothelial Function, Arterial Stiffness, and Blood Pressure in Type II Diabetic Nephropathy Patients

Abstract: Alfacalcidol did not have an effect on microvascular endothelial function in DN patients. Alfacalcidol significantly improved CSBP with trends of improvement in arterial stiffness and peripheral BP. Alfacalcidol appears to be more beneficial in vitamin D-deficient patients.

Cited by 12 publications

References 54 publications

Vitamin D status and oxidative stress in diabetes mellitus

Vitamin D status and oxidative stress in diabetes mellitus

The Role of Vitamin D in Diabetic Nephropathy: A Translational Approach

Effect of Vitamin D on the Treatment and Prevention of Essential Hypertension

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