Fasting Vitamin D

doi: 10.3892/br.2018.1074. Epub 2018 Mar 9.

Effect of vitamin D supplementation on fasting plasma glucose, insulin resistance and prevention of type 2 diabetes mellitus in non-diabetics: A systematic review and meta-analysis

Affiliations

PMID: 29725526
PMCID: PMC5920274
DOI: 10.3892/br.2018.1074

Free PMC article

Effect of vitamin D supplementation on fasting plasma glucose, insulin resistance and prevention of type 2 diabetes mellitus in non-diabetics: A systematic review and meta-analysis

Sitian He et al. Biomed Rep. 2018 May .

Free PMC article

Abstract

Increasing epidemiological studies suggest that there is an association between vitamin D deficiency and risk of type 2 diabetes mellitus (T2DM). Therefore, randomized clinical trials (RCTs) have been performed to observe the effect of vitamin D supplementation on preventing T2DM, decreasing fasting plasma glucose (FPG) and improving insulin resistance to confirm the association between vitamin D and T2DM. However, the results of RCTs on controlling FPG level, improving insulin resistance and preventing T2DM in non-diabetics are inconsistent. In the present study, a systematic meta-analysis considering individual variation and intervention strategy was conducted to establish an objective and definitive conclusion. The results suggested that vitamin D supplementation had no significant effect on controlling FPG level, improving insulin resistance or preventing T2DM in non-diabetics in a pooled meta-analysis of 23 articles (containing 28 RCTs). However, stratified analysis indicated that supplementation of vitamin D had differential effects on FPG control, insulin sensitivity improvement and T2DM prevention in individuals with different baseline states: FPG was decreased for those with BMI <25 (P=0.048) or 20≤ 25(OH)D <30 ng/ml (P=0.002); insulin resistance was improved for those with 25(OH)D ≥30 ng/ml (P=0.021); and risk of T2DM was lower for pre-diabetic individuals (P=0.047) or for those with 25≤ BMI <30 (P=0.032). Additionally, the effect on T2DM prevention was improved when the supplement dose was >2,000 IU/day (P=0.047) and with intervention without calcium (P=0.047). Thus, further trials should focus on individual baselines and the supplementation strategy of vitamin D in the prevention of T2DM.

Keywords: fasting plasma glucose; insulin resistance; meta-analysis; type 2 diabetes mellitus; vitamin D.

Figures

**Figure 1.**
Flow chart of literature screening process. A total of 1,684 literatures were retrieved following exclusion of the repeated reports. Of these, 23 articles were included in the meta-analysis according to the inclusion and exclusion criteria.

**Figure 2.**
Forest plot of vitamin D supplementation effect on FPG. The pooled results suggested that there was no statistically significant difference in FPG levels in non-diabetics following vitamin D intervention or control treatments. FPG, fasting plasma glucose; WMD, weighted mean difference; 95% CI, 95% confidence interval. (a), (b) and (c) indicate the first, second and third trial in the reference, respectively.

**Figure 3.**
Forest plot of vitamin D supplementation effect on insulin resistance. It was indicated that vitamin D supplementation had no significant effect on insulin resistance improvement in non-diabetics. SMD, standardized mean difference; 95% CI, 95% confidence interval. (a) and (b) indicate the first and second trial in the reference, respectively.

**Figure 4.**
Forest plot of vitamin D supplementation effect on T2DM prevention. The pooled results revealed that vitamin D supplementation had no significant effect on T2DM prevention in the non-diabetic population. T2DM, type 2 diabetes mellitus; RR, relative risk; 95% CI, 95% confidence interval.

**Figure 5.**
Funnel plots with pseudo 95% confidence limits for (A) fasting plasma glucose (Begg's test: P=0.086; Egger's test: P=0.800), (B) insulin resistance (Begg's test: P=0.125; Egger's test: P=0.080) and (C) type 2 diabetes mellitus prevention (Begg's test: P=1.00; Egger's test; P=0.421). s.e.; standard error; MD, mean difference; SMD, standardized mean difference; RR, relative risk.

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Fasting Vitamin D

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