The effects of vitamin D3 supplementation on some metabolic and inflammatory markers in diabetic nephropathy patients with marginal status of vitamin D: A randomized double blind placebo controlled clinical trial

AIMS

Diabetic nephropathy is known to be an independent risk factor in the progression of renal and cardiovascular disorders. Due to the association between vitamin D deficiency and diabetic nephropathy, vitamin D deficiency in the diabetic nephropathy population, this study conducted to examine the effects of Vitamin D₃ on metabolic and inflammatory parameters in patients with diabetic nephropathy.

METHODS

This eight-week, randomized, double-blind, placebo-controlled trial was carried out on 50 diabetic nephropathy patients with marginal status of vitamin D. Participants were randomly assigned to two groups: control and intervention. Participants received a vitamin D3 (50000 IU) supplement weekly on a specific day. Fasting blood samples were collected from all patients at their entry to the study, and eight weeks after intervention.

RESULTS

Analyses showed significance differences in physical activity between the intervention and placebo groups (P = 0.018). There were no significant differences between the percentage changes of HbA1c, insulin and, inflammatory parameters such as TNF-α and IL-6 (P > 0.05), while the percentage change of FBS was significantly higher in the placebo group compared to the treatment one (P < 0.0001). Lower levels of FBS (P < 0.0001), insulin (P < 0.069), HOMA-IR (P < 0.001), TNF-α (P< 0.002) and IL-6 (P < 0.037) were found after supplementation in treatment group. However, the phosphorous and protein percentage change in urine were lower (P = 0.07) and higher (P = 0.003) between groups.

CONCLUSIONS

It was found that vitamin D supplementation can be regarded as an effective way to prevent the progression of diabetic nephropathy by reducing levels of proteinuria, and inflammatory markers such as TNF-α and IL-6.

THE RELATIONSHIP BETWEEN THYROID HORMONES, ANTITHYROID ANTIBODIES, ANTI-TISSUE TRANSGLUTAMINASE AND ANTI-GLIADIN ANTIBODIES IN PATIENTS WITH HASHIMOTO'S THYROIDITIS

BACKGROUND

Hashimoto's thyroiditis is in coexistence with many autoimmune disorders, especially celiac disease. There are a limited number of studies evaluating the prevalence of celiac-related antibodies in patients with Hashimoto's thyroiditis.

OBJECTIVE

This study aimed to further investigate the prevalence of undiagnosed celiac disease in patients with Hashimoto's thyroiditis and the relationship between these two autoimmune disorders in these patients.

SUBJECTS AND METHODS

This study was performed on 82 women aged 20-50 years including 40 patients with Hashimoto's thyroiditis and 42 healthy age-matched individuals. Anthropometric assessments were performed and biochemical parameters including thyroid hormones (TSH, T3 and T4), antithyroid antibodies, anti-tissue transglutaminase and anti-gliadin antibodies were measured by enzyme linked immunosorbent assay (ELISA).

RESULTS

The prevalence of IgG and IgA anti-tissue transglutaminase antibodies and IgA anti-gliadin antibody was higher in Hashimoto's thyroiditis patients compared with control group (15% vs. 7%, 22.5% vs. 17% and 15% vs. 12% respectively). In ordinal regression model, serum IgG anti-tissue transglutaminase and IgA anti-gliadin antibodies were significant predictors of antithyroid antibodies in patients with Hashimoto's thyroiditis (P < 0.05). A significant relationship between serum TSH and IgG anti-gliadin antibody were also found (P = 0.003).

CONCLUSION

To our findings, a high prevalence of anti-tissue transglutaminase and IgA anti-gliadin antibodies and their positive relationship with antithyroid antibodies in patients with Hashimoto's thyroiditis were reported. These findings further warrant the need for interventions to reduce the prevalence of these antibodies in Hashimoto's thyroiditis for preventing the occurrence of celiac disease in these patients.

EFFECT OF PROBIOTIC FERMENTED MILK (KEFIR) ON SERUM LEVEL OF INSULIN AND HOMOCYSTEINE IN TYPE 2 DIABETES PATIENTS

Background

Probiotic fermented milk is one of the most beneficial foods. The main purpose of this study was to investigate the effect of probiotic fermented milk on the serum level of insulin and homocysteine in the type 2 diabetes patients.

Methods

This study was done in 60 patients with type 2 diabetes. The intervention group received 600 mL of probiotic fermented milk (kefir) daily and control group received 600 mL of conventional fermented milk daily for 8 weeks. Food intake, anthropometric indices, serum parameters were assessed at the beginning and at the end of the study. The statistical analysis was done by the use of SPSS software (Ver.13).

Results

The mean of serum insulin level did not reduce significantly after the intervention in probiotic fermented milk group, and there was no significant difference between the two groups. The mean of HOMA-IR decreased significantly in probiotic fermented milk group after intervention and there was a significant difference between the two groups after intervention. The mean of quickie increased in probiotic fermented milk group, but this increase was not significant. Also, there was not significant difference between the two groups after intervention. The mean of homocysteine level decresead significantly in patients with probiotic fermented milk and conventional fermented milk consumption.

Conclusions

By considering the effect of probiotic fermented milk on some risk factors of cardiovascular disease in diabetic patients, probiotic foods may be useful as an adjuvant therapy in diabetic patients.

Effect of a long-term regular physical activity on hypertension and body mass index in type 2 diabetes patients

AIM

Hypertension and overweight are prevalent problems in type 2 diabetic patients. The purpose of this study was to assess the effects of long term regular aerobic exercise training on blood pressure (BP) as well as body mass index (BMI) in type 2 diabetes mellitus (T2DM).

METHODS

In a randomized, controlled trial, 60 patients with T2DM aged 40-65 years were randomly divided in two groups (30 subjects in exercise group and 30 subjects in control group). Supervised exercise program was performed three times per week for 3 years. Finally, 28 patients who completed the optimal sessions, entered in statistical analysis.

RESULTS

Systolic and diastolic blood pressure (SBP, DBP) had no significant changes in control group (respectively 127.48±12.79 to 129.28±8.52 and 78.90±8.06 to 77.55±5.95). These changes were statistically significant in the exercise group (respectively 132.57±14.82 to 118.00±12.48 and 82.89±9.19 to 74.00±6.57; P<0.001). Furthermore, the BMI of exercise group reduced significantly (28±5.26 to 26.42±4.36; P<0.001) in comparison with control group that showed a significant increase in terms of this variable (30.02±4.79 to 31.05±4.84; P<0.05).

CONCLUSION

The present study suggests that long term aerobic exercise has positive effects on systolic and diastolic blood pressure as well as heart rate of T2DM patients. We observed significant differences in levels of BMI in two groups after intervention.