Effect of Vitamin D and/or Calcium Supplementation on Pancreatic β-Cell Function in Subjects with Prediabetes: A Randomized, Controlled Trial

Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management

Polycystic Ovary Syndrome (PCOS) is a common health condition related to a woman's hormonal problems. Hormonal imbalance, metabolic disorders, and an increased insulin level mainly characterize the ailment. This detailed review focuses on dietary strategies, macromolecules, macromolecules, and herbal interventions that exception-ally work in PCOS treatment. Research has shown that Mediterranean, low-glycemic index, and ketogenic diets that are modified with individuals in mind are the best ways to resolve insulin resistance, obesity, and lack of ovulation. The other nutrients shown to affect glucose metabolism and play a role in hormone regulation are the macromolecules, such as increased protein and reduced refined carbs. Among the different micronutrients, vitamin D, omega-3 fatty acids, and inositol were shown to be the most vital supplements in the treatment of PCOS-induced oxidative damage, hyperandrogenism, and infertility. Not to mention, cinnamon, curcumin, sage, fennel, and traditional Chinese herbal medicine are among some of the herbal remedies that so far show good potential to be the perfect complementary therapy tools as they create better glycemic control, inflammation reduction, and menstrual cycle regularization. Even though the findings are promising, the current supply of clinical trials for standardizing these nutritional and herbal protocols is lacking. Overall, this report stresses the fact that a customized, holistic diet regime is the best treatment for women with PCOS to make them feel well and live a long and healthy life.

Assessing the Predictive Value of Serum Vitamin D Levels for Hip Fracture Risk in Older Adults and Identifying Associated Risk Factors

Background As the elderly population continues to grow globally, the incidence of hip fractures among this demographic is becoming an increasingly pressing public health issue. Hip fractures often result from a complex interplay of factors, including sociodemographic variables, clinical comorbidities, medication use, physical activity, and vitamin D levels. Understanding these factors is essential to mitigating the risk of hip fractures in older individuals. Objective This study aims to explore the relationship between vitamin D levels and hip fracture risk in elderly patients, identifying the clinical, demographic, and environmental factors contributing to fracture risk, with a particular focus on the role of vitamin D in bone health. Methodology This cross-sectional observational study was conducted at Mardan Medical Complex between January 2024 and February 2025. A total of 119 older adult patients (aged 50 years and above) with confirmed hip fractures were included. Demographic data, comorbidities, vitamin D levels, and relevant biomarkers were collected. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using electrochemiluminescence immunoassay. Statistical analysis, including ANOVA, Mann-Whitney U tests, and decision tree modeling, was employed to assess the relationship between vitamin D and other variables, including BMI, mobility, supplementation, and comorbidities. Results The study found a high prevalence of vitamin D deficiency among older adult patients with hip fractures, with the average serum vitamin D level measured at 15.01 ± 5.51 ng/mL, significantly lower than the recommended levels. Key factors such as Body Mass Index (BMI) (28.27 ± 5.67) and mobility status (59 patients, 49.58% using mobility aids), as well as comorbidities like diabetes (76 patients, 63.87%) and chronic kidney disease (18 patients, 15.13%), were significantly associated with lower vitamin D levels. Vitamin D supplementation, with an average intake of 505.99 ± 284.26 IU/day, was taken by 68 patients (57.14%) and showed a positive effect on serum levels, but the variability in response (ranging from non-users to varying doses) highlighted the need for personalized supplementation strategies. Additionally, age (67.53 ± 10.51 years) and gender (69 males, 57.98%, and 50 females, 42.02%) did not show a significant impact on vitamin D levels or fracture risk in this study. Conclusion This study supports the importance of vitamin D as a modifiable risk factor for hip fractures in older adult patients. It underscores the need for comprehensive public health strategies, including regular vitamin D screening, targeted supplementation, and management of comorbidities, to reduce fracture risk in aging populations.

Vitamin D supplementation alleviates high fat diet-induced metabolic associated fatty liver disease by inhibiting ferroptosis pathway

PURPOSE

Recently, a significant negative correlation has been found between vitamin D (VD) and metabolic associated fatty liver disease (MAFLD), suggesting a potential beneficial role of VD in preventing of MAFLD, while underscoring the importance of exploring its mechanisms.

METHODS

The experiment comprised two parts: male C57BL/6J mice (6 weeks) were fed a high-fat diet (HFD) and intraperitoneally injected with vitamin D3 (VD3) (1.68 IU/g/week) for 16 weeks. Meanwhile, palmitic acid (PA)-induced HepG2 cells were treated with 1,25(OH)2D3 (10 nM). The general conditions of the mice were evaluated by measuring body weight, liver/body weight, serum biochemical parameters, and inflammation indices. Additionally, injury-associated indices and histopathology were used to assess the severity of liver injury. Furthermore, indicators of ferroptosis, including lipid peroxidation, iron aggregation, and the aberrant expression of related proteins, were determined using Prussian blue staining, ELISA assay, and Western blot.

RESULTS

Long-term VD3 administration significantly reduced body weight gain and the liver/body weight ratio of HFD-induced MAFLD mice, while also improving serum lipid metabolism dysregulation and enhancing insulin sensitivity. The changes in the expressions of liver injury indices and histological manifestations due to VD3 treatment indicated that VD3 may exerts beneficial effects on liver injury through inhibiting inflammatory cell infiltration and vacuolation. Importantly, VD3 supplementation also inhibited ferroptosis by enhancing the body's antioxidant capacity, reducing local iron aggregation, and modulating the expression levels of ferroptosis-related proteins. These findings were further confirmed in a PA-induced HepG2 steatosis cell model, highlighting the pharmacological effects of VD.

CONCLUSIONS

VD shows promise in mitigating HFD -induced liver injury by improving metabolic dysregulation and inhibiting ferroptosis, suggesting therapeutic potential in MAFLD.

Role of vitamin D in prevention of type 2 diabetes mellitus: A systematic review and meta‑analysis

The escalating prevalence of diabetes mellitus, projected to affect over 700 million by 2045, underscores the urgent need for effective management and prevention strategies, with type 2 diabetes mellitus (T2DM) constituting over 90% of these cases globally. The present meta-analysis aims to rigorously evaluate the potential of vitamin D supplementation in mitigating the onset of T2DM, amidst the backdrop of its biological plausibility yet inconclusive evidence regarding its efficacy in reducing new incidences of the disease. A comprehensive literature search up to December 2023 in MEDLINE, EMBASE and the Cochrane Library, employing a strategy focused on diabetes and vitamin D, identified randomized controlled trials (RCTs) that explore the impact of vitamin D supplementation on T2DM onset in adults with impaired glucose regulation, incorporating quality assessment via the Cochrane ROB2 tool and utilizing meta-analysis with RevMan Web to evaluate effect magnitude and heterogeneity. In a meta-analysis of 11 RCTs with 5,221 prediabetic patients, vitamin D supplementation was associated with a 10% reduction in the progression to T2DM [RR, 0.90; 95% CI, (0.81-0.99)] and a significant increase in regression to normoglycemia [RR, 1.24; 95% CI, (1.08-1.43)], with no significant heterogeneity or publication bias observed. This meta-analysis of 11 RCTs shows that vitamin D supplementation in prediabetic patients lowers the risk of T2DM and promotes regression to normoglycemia, with no significant differences in subgroup analyses or interaction with baseline vitamin D levels, ethnicity, or body mass index (BMI). Despite indications from some trials that baseline vitamin D status may influence outcomes, the present comprehensive analysis found benefits of vitamin D across diverse populations, including non-obese individuals, without conclusive evidence linking supplementation to changes in BMI or age-specific advantages.

Effects of vitamin D and/or calcium intervention on sleep quality in individuals with prediabetes: a post hoc analysis of a randomized controlled trial

PURPOSE

The aim of this study was to evaluate the effects of vitamin D and/or calcium supplementation on sleep quality in individuals with prediabetes.

METHODS

A 24-week randomized controlled trial (RCT) was conducted in a 212 Chinese population with prediabetes. Participants were randomly assigned to four groups: vitamin D + calcium group (1600 IU/day + 500 mg/day, n = 53), vitamin D group (1600 IU/day, n = 54), calcium group (500 mg/day, n = 51), and control group (placebo, n = 54). The Pittsburgh Sleep Quality Index (PSQI) was used as the primary outcome to assess sleep quality. Questionnaires and fasting blood samples were collected at baseline and post-intervention for demographic assessment and correlation index analysis.

RESULTS

After a 24-week intervention, a significant difference was observed in serum 25(OH)D concentration among the four groups (P < 0.05), and the total PSQI score in vitamin D + calcium group was lower compared to the preintervention levels. Subgroup analyses revealed improved sleep quality with calcium supplementation (P < 0.05) for specific groups, including women, individuals with a low baseline 25(OH)D level (< 30 ng/mL), and individuals in menopause. Moreover, correlation analysis revealed a negative correlation between the extent of change in sleep efficiency scores before and after the calcium intervention and the degree of change in insulin efficiency scores (r = - 0.264, P = 0.007), as well as the magnitude of change in islet beta cell function (r = - 0.304, P = 0.002).

CONCLUSIONS

The combined intervention of vitamin D and calcium, as well as calcium interventions alone, exhibits substantial potential for improving sleep quality in individuals with prediabetes.

CLINICAL TRIAL REGISTRATION

The trial was registered in August 2019 as ChiCTR190002487.

Nutritional therapy bridges the critical cut-off point for the closed-loop role of type 2 diabetes and bone homeostasis: A narrative review

Currently, osteoporosis-related fractures become the most cutting-edge problem of diabetes-related complications. Rational diet is not only the basis of glycemic management in type 2 diabetes patients, but also the direction of diabetic bone health. This review highlights the importance of micronutrient supplementation (including calcium, magnesium, zinc, vitamin D, vitamin K, and vitamin C) for patients with T2DM, as well as describing the constructive intermediary role of gut flora between T2DM and bone through nutrients predominantly high in dietary fiber. In addition, it is recommended to combine the Mediterranean dietary pattern with other diversified management approaches to prevent OP. Therefore, this provides a theoretical basis for the potential role of islet β-cells in promoting bone health.

Prediabetes in rural adolescent girls from DERVAN cohort: data from the KONKAN region of the state of Maharashtra, India (DERVAN-4)

Background

India is witnessing an epidemic of type 2 diabetes. Overweight/obesity, overnutrition, physical inactivity, and family history are well-known risk factors for diabetes. We investigated the role of undernutrition in the development of diabetes among rural adolescent girls.

Methods

DERVAN cohort study was set up in the KONKAN region of the western Indian state of Maharashtra. It enrolled 1,520 adolescent girls (16-18 years old at the time of enrollment). We measured glycemic parameters (glucose, insulin, and HbA1C) and body size using anthropometry and body composition using bioimpedance. Prediabetes was diagnosed using the American Diabetic Association (ADA) criteria. We also calculated various HOMA indices for insulin resistance (HOMA-IR), β-cell function (HOMA-β), insulin sensitivity (HOMA-S), and compensatory β-cell response using a homeostasis model. BMI, body fat%, and waist circumferences were treated as exposures and all the glycemic parameters and indices as outcomes.

Results

The median age of the subjects was 16.6 years. The median weight, height, and BMI were 40.7 kg, 151.7 cm, and 17.5 kg/m2, respectively. Prevalence of underweight was 28.8%, and stunting was observed in 30.4%. Thinness and obesity using BMI were observed in 58.4% and 4.2%, respectively. The median body fat% was 22.5, and excess body fat (>35%) was observed in 5.7%. The prevalence of prediabetes was 39.4%. Fasting insulin concentrations, HOMA-IR, and HOMA-β showed a positive trend across body composition quartiles (p < 0.001). HOMA-S and compensatory β-cell response showed an inverse trend (p < 0.001). Compared with prediabetic girls in the overweight/obese group, girls most undernourished group had lower median insulin concentrations (8.1 μIU/ml vs. 17.1 μIU/ml), lower HOMA-IR (1.1 vs. 2.3), and lower HOMA-β (75.6 vs. 129.2) but higher sensitivity (87.4 vs. 43.7) (p < 0.001) for all.

Conclusion

We have reported a high prevalence of prediabetes among rural adolescent girls with a very low prevalence of obesity. Prediabetes in obesity is driven by hyperinsulinemia and overworking of the pancreas while poor β-cell function and poor insulin secretion are major drivers in the undernourished group. The high-risk diabetes screening programs are much needed for the undernourished populations. Caution should be exercised for planning the interventions as overfeeding (or overnutrition) is likely to put the populations at risk of development of obesity and insulin resistance.