Effects of active vitamin D on insulin resistance and islet β-cell function in non-diabetic chronic kidney disease patients: a randomized controlled study.

Abstract

PURPOSE:

The purpose of the study is to observe the effects of active vitamin D supplementation on insulin resistance and islet β-cell function (HOMA-β) in patients with non-diabetic chronic kidney disease (NDCKD).

METHODS:

A total of 134 patients with NDCKD who met the inclusion criteria were enrolled in the prospective controlled study and categorized as such: 60 patients in the non-dialysis (ND) group; 36, hemodialysis (HD) group; and 38, peritoneal dialysis (PD) group. Each group was divided into two equal-numbered subgroups for vitamin D supplementation. Those in the experimental subgroups received calcitriol 0.5 ug/day orally, and were followed-up for 6 months. A total of 117 patients were followed-up, including 57 patients in the ND group; 29, HD group; and 31, PD group. Changes in the insulin resistance index (HOMA-IR) and HOMA-β index were calculated and compared at the time of enrollment and after 1, 3, and 6 months of intervention.

RESULTS:

(1) Mean HOMA-IR value: In the ND group, mean HOMA-IR value of the experimental group significantly decreased compared with that of the control group after 3 months of intervention (P = 0.02). In the HD and PD groups, there was no statistical difference between the experimental and control groups (P > 0.05). (2) Mean HOMA-β index: In the ND group, mean HOMA-β index of the experimental group was higher than that of the control group after 1 month of active vitamin D treatment (P = 0.03), and, with an extended intervention time, the index gradually increased (P < 0.001). In the HD group, mean HOMA-β index of the experimental group was higher than that of the control group after 3 months of active vitamin D treatment (P = 0.01). Among PD patients, mean HOMA-β index of the patients in the experimental group was higher than that of the control group after 6 months of active vitamin D treatment (P = 0.02).

CONCLUSIONS:

Active vitamin D supplementation improved insulin resistance and HOMA-β after 6 months in ND patients, but only improved HOMA-β in the dialysis patients, with no significant effect on insulin resistance.

• Authors: Yongxin Lu, Yi'an Wang, Yang Sun, Yongyan Li, Jingrui Wang, Yanhong Zhao, Fang Yang, Xiufang Gao, Jianqing Xu, Zongwu Tong
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 54 Issue 7 Pg. 1725-1732 (Jul 2022) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 34807347 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2021. The Author(s).

Chemical References

• Blood Glucose
• Insulin
• Vitamin D

Topics

• Blood Glucose
• Diabetic Nephropathies
• Humans
• Insulin
• Insulin Resistance
• Prospective Studies
• Renal Insufficiency, Chronic (complications, therapy)
• Vitamin D (therapeutic use)