title: Role of vitamin D in energy and bone metabolism in postmenopausal women with type 2 diabetes mellitus: A 6-month follow-up evaluation.
abstract: OBJECTIVE
  Resting energy expenditure was associated with a serum bone turnover marker in postmenopausal women with type 2 diabetes (T2DMPW) in the present cross-sectional study. To clarify the fundamental pathological factor for the correlation of bone metabolism and basal metabolism in type 2 diabetes, a 6-month prospective follow-up study was carried out with supplementation of vitamin D.
  
  
  METHODS
  A total of 44 T2DMPW were enrolled. The following factors were evaluated at the beginning and the end of the summer: procollagen type 1 N-terminal propeptide, carboxy-terminal collagen crosslinks-1, intact parathyroid hormone and 25-hydroxyvitamin D (25[OH]D), as well as diabetic complications, body composition, respiratory quotient and resting energy expenditure. A total of 23 patients with low 25(OH)D levels (˂20 ng/mL) were instructed to increase vitamin D levels by lifestyle change. Among them, 15 patients with osteoporosis were also administered alfacalcidol.
  
  
  RESULTS
  Serum 25(OH)D increased in 25 patients and decreased in 19 patients. Patients who did not receive the study intervention at the start tended to have a decreased 2525(OH)D level; therefore, the average 25(OH)D level of all patients was not changed. Changes in resting energy expenditure were positively correlated with those of procollagen type 1 N-terminal propeptide/carboxy-terminal collagen crosslinks-1. Changes in the respiratory quotient correlated with the mean glycated hemoglobin levels; procollagen type 1 N-terminal propeptide levels positively correlated with serum 25(OH)D after the intervention. These correlations were prominent in patients with increased 25(OH)D and those with alfacalcidol supplementation.
  
  
  CONCLUSIONS
  Restoration of vitamin D level might be a prerequisite for a normal correlation between bone and basal metabolism in T2DMPW. Lifestyle intervention for retention of vitamin D level is important even in summer, in T2DMPW.
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.|Department of Nutrition, Faculty of Nursing and Nutrition, Shukutoku University, Chiba, Japan.
authors.forename: Makiko
authors.identifier: http://orcid.org/0000-0002-4883-7673
authors.initials: M
authors.lastname: Ogata
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Iwasaki
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Ide
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Takizawa
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Mizuho
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Tamaki
authors.initials: T
authors.lastname: Tetsuo
authors.affiliation: Clinical Laboratory, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Sato
authors.affiliation: Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000378:metabolism*; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000209:etiology; D017698:Postmenopause; D011446:Prospective Studies; D014807:Vitamin D / Q000097:blood*
chemical_list: D015415:Biomarkers; D014807:Vitamin D
keywords: Basal metabolism; Bone metabolism; Vitamin D