title: Insulin secretion and sensitivity in healthy adults with low vitamin D are not affected by high-dose ergocalciferol administration: a randomized controlled trial.
abstract: BACKGROUND
  Epidemiologic data suggest that low serum 25-hydroxyvitamin D [25(OH)D] increases insulin resistance and the risk of type 2 diabetes. Few interventional trials have assessed the effect of vitamin D on insulin metabolism, and published results are discordant.
  
  
  OBJECTIVE
  The goal of this study was to perform a detailed assessment of the effect of ergocalciferol administration on glucose and insulin metabolism in healthy people with low total 25(OH)D(total).
  
  
  METHODS
  This was a 12-wk, double-blinded, randomized controlled trial. We enrolled 90 healthy volunteers aged 18-45 y with serum 25(OH)D ≤20 ng/mL (by immunoassay) and administered 50,000 IU ergocalciferol/wk or placebo for 12 wk. Primary endpoints were change in first-phase insulin response and insulin sensitivity as measured by intravenous glucose tolerance test. Secondary endpoints included change in homeostasis model assessment of insulin resistance; fasting glucose, insulin, and lipids; body mass index (BMI); and blood pressure.
  
  
  RESULTS
  On-study 25(OH)D(total) was assessed by liquid chromatography-tandem mass spectrometry. In the treated group, 25(OH)D(total) rose from 18 ± 7 to 43 ± 12 ng/mL (P < 0.001) with no change in the placebo group. Despite this increase, at 12 wk, there were no between-group differences in either insulin response or insulin sensitivity; nor were there differences in any measured secondary endpoints. There was no evidence of effect modification by sex, race, glucose tolerance status, baseline 25(OH)D(total), or BMI.
  
  
  CONCLUSIONS
  In healthy persons with low 25(OH)D(total), ergocalciferol administration for 12 wk normalizes 25(OH)D(total) but does not improve insulin secretion, insulin sensitivity, or other markers of metabolic health.
authors.affiliation: Endocrine Unit, Pediatric Endocrine Unit, dmmitchell@mgh.harvard.edu.
authors.forename: Deborah M
authors.identifier: http://orcid.org/0000-0003-0364-9107
authors.initials: DM
authors.lastname: Mitchell
authors.affiliation: Endocrine Unit.
authors.forename: Benjamin Z
authors.initials: BZ
authors.lastname: Leder
authors.affiliation: Diabetes Center, and.
authors.forename: Enrico
authors.initials: E
authors.lastname: Cagliero
authors.affiliation: Endocrine Unit.
authors.forename: Natalia
authors.initials: N
authors.lastname: Mendoza
authors.affiliation: Endocrine Unit.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Henao
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Boston, MA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Hayden
authors.affiliation: Endocrine Unit.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Finkelstein
authors.affiliation: Endocrine Unit.
authors.forename: Sherri-Ann M
authors.identifier: http://orcid.org/0000-0002-0064-096X
authors.initials: SA
authors.lastname: Burnett-Bowie
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001900:Boston / Q000453:epidemiology; D002112:Calcifediol / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004872:Ergocalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008137:Longitudinal Studies; D008297:Male; D012306:Risk; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000097:blood / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004872:Ergocalciferols; D007328:Insulin; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol
keywords: diabetes; ergocalciferol; glucose; insulin; insulin resistance; vitamin D