title: The effects of vitamin D supplementation on hepatic dysfunction, vitamin D status, and glycemic control in children and adolescents with vitamin D deficiency and either type 1 or type 2 diabetes mellitus.
abstract: BACKGROUND
  The effects of vitamin D supplementation on mild hepatic dysfunction and glycemic control are unclear in children and adolescents with either type 1 (T1D) or type 2 diabetes (T2D).
  
  
  OBJECTIVE
  Vitamin D supplementation will improve hepatic dysfunction and glycemic control.
  
  
  OBJECTIVE
  To determine the effect of vitamin D supplementation on alanine transaminase (ALT), hemoglobin A1c (HbA1c), and serum 25-hydroxyvitamin D [25(OH)D] concentration.
  
  
  METHODS
  A retrospective study of 131 subjects with either T1D (n = 88 ∶ 46 females, 42 males), or T2D (n = 43 ∶ 26 females, 17 males) of ages 3-18 years between 2007-2013. All subjects had (1) a diagnosis of diabetes for > 12 mo, (2) received vitamin D supplementation for the management of vitamin D deficiency (3) had baseline and subsequent simultaneous measurements of HbA1c, ALT, and 25(OH)D. Vitamin D deficiency was defined as 25(OH)D concentration of < 50 nmol/L (20 ng/mL).
  
  
  RESULTS
  At baseline, vitamin D deficiency occurred in 72.1% of patients with T2D and in 37.5% of T1D patients (p < 0.001). Patients with T2D had significantly higher values for BMI SDS (p < 0.001), alanine transaminase (ALT) (p = 0.001), but lower 25(OH)D p < 0.001), and no difference in HbA1c (p = 0.94), and total daily dose (TDD) of insulin per kg body weight (p = 0.48) as compared to T1D patients. After 3 months of vitamin D supplementation, there was a significant increase in 25(OH)D in both T2D (p = 0.015), and T1D patients (p < 0.001); significant reduction in BMI SDS (p = 0.015) and ALT (p = 0.012) in T2D, but not in T1D. There was a clinically-significant decrease in HbA1c in T2D from 8.5 ± 2.9% at baseline to 7.7 ± 2.5 at 3 mo, but not in T1D, 8.5 ± 1.2 to 8.53 ± 1.1%.
  
  
  CONCLUSIONS
  Vitamin D supplementation in subjects with T2D was associated with statistically significant decreases in BMI SDS, ALT, and a clinically-significant decrease in HbA1c.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Benjamin Udoka
authors.initials: BU
authors.lastname: Nwosu
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Louise
authors.initials: L
authors.lastname: Maranda
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000378:metabolism; D001786:Blood Glucose / Q000187:drug effects*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D019587:Dietary Supplements; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology
chemical_list: D000410:Alanine Transaminase; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D014807:Vitamin D; C517652:hemoglobin A1c protein, human; C104450:25-hydroxyvitamin D