title: The effects of vitamin D, K and calcium co-supplementation on carotid intima-media thickness and metabolic status in overweight type 2 diabetic patients with CHD.
abstract: This study was conducted to examine the effects of vitamin D, K and Ca co-supplementation on carotid intima-media thickness (CIMT) and metabolic status in overweight diabetic patients with CHD. This randomised, double-blind, placebo-controlled trial was conducted among sixty-six diabetic patients with CHD. Participants were randomly allocated into two groups to take either 5µg vitamin D, 90 µg vitamin K plus 500 mg Ca supplements (n 33) or placebo (n 33) twice a day for 12 weeks. Fasting blood samples were obtained at the beginning of the study and after the 12-week intervention period to determine related markers. Vitamin D, K and Ca co-supplementation resulted in a significant reduction in maximum levels of left CIMT (-0·04 (sd 0·22) v. +0·04 (sd 0·09) mm, P=0·02). Changes in serum vitamin D (+6·5 (sd 7·8) v. +0·4 (sd 2·2) ng/ml, P<0·001), Ca (+0·6 (sd 0·3) v. +0·1 (sd 0·1) mg/dl, P<0·001) and insulin concentrations (-0·9 (sd 3·1) v. +2·6 (sd 7·2) µIU/ml, P=0·01), homoeostasis model for assessment of estimated insulin resistance (-0·4 (sd 1·2) v. +0·7 (sd 2·3), P=0·01), β-cell function (-2·1 (sd 9·0) v. +8·9 (sd 23·7), P=0·01) and quantitative insulin sensitivity check index (+0·007 (sd 0·01) v. -0·006 (sd 0·02), P=0·01) in supplemented patients were significantly different from those in patients in the placebo group. Supplementation resulted in significant changes in HDL-cholesterol (+2·7 (sd 7·0) v. -2·5 (sd 5·7) mg/dl, P=0·002), high-sensitivity C-reactive protein (-1320·1 (sd 3758·3) v. +464·0 (sd 3053·3) ng/ml, P=0·03) and plasma malondialdehyde concentrations (-0·4 (sd 0·5) v. -1·0 (sd 1·1) µmol/l, P=0·007) compared with placebo. Overall, vitamin D, K and Ca co-supplementation for 12 weeks among diabetic patients with CHD had beneficial effects on maximum levels of left CIMT and metabolic status. The effect of vitamin D, K and Ca co-supplementation on maximum levels of left CIMT could be a chance finding.
authors.affiliation: 1Research Center for Biochemistry and Nutrition in Metabolic Diseases,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Zatollah
authors.initials: Z
authors.lastname: Asemi
authors.affiliation: 2Department of Cardiology,School of Medicine,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Raygan
authors.affiliation: 1Research Center for Biochemistry and Nutrition in Metabolic Diseases,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Bahmani
authors.affiliation: 2Department of Cardiology,School of Medicine,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Rezavandi
authors.affiliation: 3Department of Radiology,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Talari
authors.affiliation: 3Department of Radiology,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Motahereh
authors.initials: M
authors.lastname: Rafiee
authors.affiliation: 3Department of Radiology,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Somayyeh
authors.initials: S
authors.lastname: Poladchang
authors.affiliation: 1Research Center for Biochemistry and Nutrition in Metabolic Diseases,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Manijeh
authors.initials: M
authors.lastname: Darooghegi Mofrad
authors.affiliation: 1Research Center for Biochemistry and Nutrition in Metabolic Diseases,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Taheri
authors.affiliation: 1Research Center for Biochemistry and Nutrition in Metabolic Diseases,Kashan University of Medical Sciences,Kashan,Islamic Republic of Iran.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Mohammadi
authors.affiliation: 4Food Security Research Center,Isfahan University of Medical Sciences,Isfahan,Islamic Republic of Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000494:pharmacology* / Q000627:therapeutic use; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D018384:Oxidative Stress; D014807:Vitamin D / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D014812:Vitamin K / Q000494:pharmacology* / Q000627:therapeutic use; D014815:Vitamins / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014815:Vitamins; D014812:Vitamin K; D014807:Vitamin D; D008315:Malondialdehyde; D002097:C-Reactive Protein; D002118:Calcium
keywords: CHD; CIMT carotid intima-media thickness; Carotid intima-media thickness; FPG fasting plasma glucose; HOMA-IR homoeostasis model for assessment of insulin resistance; K and calcium co-supplementation; MDA malondialdehyde; MGP matrix Gla-protein; Metabolic status; NO nitric oxide; Obesity; Type 2 diabetes mellitus; Vitamin D; hs-CRP high-sensitivity C-reactive protein