Serum vitamin D levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes

Greer, Ristan M.; Portelli, Sharon L; Hung, B.; Cleghorn, Geoffrey J.; McMahon, Sandra; Batch, Jennifer; Conwell, Louise S.

doi:10.1111/j.1399-5448.2012.00890.x

Cited by 93 publications

(88 citation statements)

References 46 publications

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“…Our research is in line with previous research conducted in RSSA Malang, 90% of children with T1DM had low levels of 25(OH)D 3 [14]. The same result also obtained in various countries, such as in the United States, Switzerland, and Australia, where in patients with T1DM suffered from vitamin D deficiency and insufficiency [11,12,13].…”

Section: Subject Characteristicssupporting

confidence: 80%

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Levels of 25(OH)D3, IL-2, and C-peptide in Children with Type 1 Diabetes Mellitus (T1DM) Receiving Vitamin D3 Supplementation

Suryanto

Tjahjono

Widjajanto

2018

J.Trop.Life.Science

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Type 1 Diabetes Mellitus (T1DM) has become a health problem in many countries. T1DM is the consequence of autoimmune destruction process of β cells. There was relationship between vitamin D deficiency with T1DM. The destruction process was caused by an imbalance of pro-inflammatory and anti-inflammatory cytokines. One of the pro-inflammatory cytokines is IL-2. C-peptide examination to see the function of beta cells due to destruction of pancreatic beta cell. Administration of vitamin D 3 supplementation still cause controversy and give varying results. This randomized clinical trial was conducted to determine the levels of 25(OH)D 3 , IL-2, and C-peptide in people with T1DM who received vitamin D 3 supplementation. The subjects were 26 children with T1DM, divided into K1 group (received vitamin D 3 supplementation) and K2 group (received placebo). The results showed higher levels of 25(OH)D 3 in the K1 group and statistically found a significant difference (p = 0.00). Higher levels of IL-2 and lower C-peptide were obtained in the K1 group and no statistically significant differences were found (p = 0.76 and p= 0.26). The insignificant relationship and the negative correlation were found between 25(OH)D 3 and IL-2 (p = 0.71; r = -0.12), 25(OH)D 3 and C-peptide (p = 0.59; r = -0.16), also levels of IL-2 and C-peptide (p = 0.13; r = -0.44) in children with type 1 diabetes who received vitamin D3 supplementation. From this study can be concluded that administration vitamin D 3 supplementation in patients with T1DM can increase levels 25(OH)D 3 significantly. This increase has not significantly lowered levels of IL-2 and increased levels of C-peptide. However, there was an absolute decrease in the rate of slower C-peptide in the supplemented group than in the placebo group.

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Section: Subject Characteristicssupporting

confidence: 80%

“…Research in various countries, such as in the United States, Switzerland, Australia, and Indonesia mentioned that people with T1DM suffered from vitamin D deficiency and insufficiency [11,12,13,14]. Administration vitamin D3 supplementation can prevent or reduce autoimmune damage and destruction of pancreatic β cells [7].…”

Section: Introductionmentioning

confidence: 99%

Levels of 25(OH)D3, IL-2, and C-peptide in Children with Type 1 Diabetes Mellitus (T1DM) Receiving Vitamin D3 Supplementation

Suryanto

Tjahjono

Widjajanto

2018

J.Trop.Life.Science

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“…A lack of association between UV30 and 25-hydroxyvitamin D was similarly reported by Greer et al [15]. In this study, it could indicate that children and adolescents with T1D may have decreased time outdoors, as the UV30 is only a measure of ambient UV light and does not necessarily represent any individual's time spent outside or amount of skin exposed to sunlight.…”

Section: Discussionmentioning

confidence: 50%

“…A study in Qatari youth with age-matched controls reported increased 25-hydroxyvitamin D deficiency/insufficiency with T1D [14]; however this population may not be generalizable to US children due to a much higher overall prevalence of vitamin D deficiency/insufficiency reported amongst the Qatari (90.6% in subjects with T1D compared to 85.3% in control subjects). In Australia, Greer et al also reported a significant difference between groups [15]. In contrast, it has been reported in Denmark that no difference was detected between children with newly diagnosed T1D and their healthy siblings [16].…”

Section: Introductionmentioning

confidence: 86%

Vitamin D Abnormalities: More Common in US Children with T1D than in Healthy Children

Sheedy¹,

Xu²,

Saville³

et al. 2014

JDM

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Background: Pediatric patients with type 1 diabetes (T1D) have increased risk for low bone mineral density, which may be due in part to low 25-hydroxyvitamin D levels. Vitamin D levels are influenced by sunlight exposure and thus display geographical variation. We hypothesize that the prevalence of 25-hydroxyvitamin D deficiency (<20 ng/mL) and insufficiency (20 -29 ng/mL) in children with T1D living in the United States is higher than in healthy children and that diabetes duration, HbA1c, and insulin dose/kg are inversely associated with 25-hydroxyvitamin D levels. Methods: Medical records of patients with T1D being followed in Tennessee were reviewed for demographics, medical information, and 25-hydroxyvitamin D levels during the previous 2 years. Control subjects were obtained from a de-identified database of healthy pediatric subjects living in a similar geographical area. Chi squared tests and multivariable linear regression were performed. Results: Children and adolescents with T1D (n = 276; median age 14 years) have a significantly higher percentage of vitamin D deficiency and insufficiency compared with healthy pediatric controls (n = 100; median age 11.2 years) (68% versus 44%; p < 0.001). The median 25-hydroxyvitamin D level is 24 ng/mL versus 31 ng/mL, respectively. After adjusting for age, race, gender, UV light exposure, BMI, and multivitamin supplementation, children and adolescents with T1D have a serum 25-hydroxyvitamin D level 6.7 ng/mL lower than the control population [CI (4.11, 9.21), p < 0.0001]. Within the T1D population, there is no clear association between diabetes duration, HbA1c, or insulin dose/kg and 25-hydroxyvitamin D levels. Conclusions: There is an increased prevalence of 25-hydroxyvitamin D deficiency and insufficiency in US. children with T1D compared with geographically similar children without diabetes. Further research is needed to determine whether decreased serum 25-hydroxyvitamin D can be alleviated via dietary or behavioral modifications in this population. C. Sheedy et al.325

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“…These mechanisms explain how the balance resulting from calcitriol-VDR interaction finally results in a controlled activation of T-cell differentiation and effector function, allowing proper response against infections or cancer after antigen presentation, meanwhile avoiding excessive autoimmune activation [11]. This is also indirectly proven by the association found between low serum levels of vitamin D and development of autoimmune diseases, indeed known to be latitude dependent (due to the low exposure to sunlight at higher degrees of latitude) [12,13], and by the link between low serum levels of 25(OH)D and higher susceptibility to various infections [14][15][16].…”

mentioning

confidence: 96%

The Link Between Calcitriol and Anticancer Immunotherapy: Vitamin D as the Possible Balance Between Inflammation and Autoimmunity in the Immune-Checkpoint Blockade

2017

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" We are thus inclined to hypothesize a proportionally better prognostic role respectively for normal basal vitamin D levels and for recovering levels after proper repletion in advanced cancer patients, compared with the worse prognosis of vitamin D deficient patients who are unable to raise their levels. Similarly, the possible predictive role of vitamin D status for response to CKI might follow this proportional strength " First draft submitted: 5 September 2017; Accepted for publication: 25 September 2017; Published online: 25 October 2017The advent of the new immunotherapy with immune-checkpoint inhibitors (CKI) is currently revolutionizing the world of oncology, both in the advanced and early cancer setting.After the approval of the anti-CTLA-4 antibody ipilimumab for the systemic treatment of metastatic melanoma, a cascade of subsequent therapeutic indications of further CKI took place for several advanced cancers during the last decade [1,2]. Likewise, anti-CTLA-4, anti-PD-1 and anti-PD-L1 antibodies are currently in study for the adjuvant setting in several cancer types after the first positive data still coming from melanoma [2,3].The great challenge of immune-checkpoint blockade is still represented by the lack of consistent predictive factors. Despite the evidence of conditions favoring response to CKI, for instance mismatch repair deficiency [4], PD-L1 expression, high mutational burden, loss of function of genes involved in antigen presentation and IFN-γ signaling among many others [5,6], each of these represents an imperfect marker, whose negativity does not exclude a good response to immunotherapy. Several studies are still investigating potentially predictive biomarkers.The role of vitamin D blood levels (25[OH]D, calcidiol) has been largely explored in the field of cancer, ranging from the assessment of hypovitaminosis D in cancer patient populations to the investigation of the possible prophylactic role of vitamin D supplementation to prevent cancer, basing on the preclinical evidence of an antiproliferative effect of calcitriol [7,8]. On the other hand, it is well known that the role of the active form of vitamin D (1,25[OH] 2 D, calcitriol) and of vitamin D receptor (VDR) is crucial for the proper activation of the immune system, particularly for T-cell differentiation and their effector function [9]. This evidence, in our opinion, constitutes the rationale for a possible pivotal link between vitamin D and the new anticancer immunotherapy with CKI, whose main goal is T-cell activation (Figure 1).Interestingly, most of immune cells express VDR and hold enzyme CYP27B1, used for the internal conversion of circulating 25(OH)D to the active VDR-ligand calcitriol. In fact, circulating levels of vitamin D are too low to affect immune responses in vivo and immune upregulation by calcitriol is dose dependent [9,10]. Not only antigen presenting cells such as monocytes, macrophages and dendritic cells, but also activated T cells are capable to produce 1,25(OH) 2 D in sufficiently high concentrations to ...

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Serum vitamin D levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes

Cited by 93 publications

References 46 publications

Levels of 25(OH)D3, IL-2, and C-peptide in Children with Type 1 Diabetes Mellitus (T1DM) Receiving Vitamin D3 Supplementation

Levels of 25(OH)D3, IL-2, and C-peptide in Children with Type 1 Diabetes Mellitus (T1DM) Receiving Vitamin D3 Supplementation

Vitamin D Abnormalities: More Common in US Children with T1D than in Healthy Children

The Link Between Calcitriol and Anticancer Immunotherapy: Vitamin D as the Possible Balance Between Inflammation and Autoimmunity in the Immune-Checkpoint Blockade

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