Effect of vitamin D on stress‐induced hyperglycaemia and insulin resistance in critically ill patients. Issue 5 (19th April 2016)

• Record Type: Journal Article
• Authors: Alizadeh, N.; Khalili, H.; Mohammadi, M.; Abdollahi, A.; Ala, S.
• Is Part Of: International journal of clinical practice. Volume 70:Issue 5(2016)
• Page Start: 396
• Page End: 405
• Publication Date: 2016-04-19
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12795
• Languages: English
• ISSNs: 1368-5031

Abstract

Summary: Aim: Effects of vitamin D supplementation on the glycaemic indices and insulin resistance in diabetic and non‐diabetic patients were studied. In this study, effects of vitamin D supplementation on stress‐induced hyperglycaemia and insulin resistance were evaluated in non‐diabetic surgical critically ill patients. Methods: Adult surgical patients with stress‐induced hyperglycaemia within the first 24 h of admission to the ICU were recruited. The patients randomly assigned to receive either vitamin D or placebo. Patients in the vitamin D group received a single dose of 600, 000 IU vitamin D3 as intramuscular injection at time of recruitment. Besides demographic and clinical characteristics of the patients, plasma glucose, insulin, 25(OH) D and adiponectin levels were measured at the time of ICU admission and day 7. Homoeostasis model assessment for insulin resistance (HOMA‐IR) and homestasis model assessment adiponectin (HOMA‐AD) ratio were considered at the times of assessment. Results: Comparing with the baseline, plasma 25(OH) D level significantly increased in the subjects who received vitamin D (p = 0.04). Improvement in fasting plasma glucose levels was detected in day 7 of the study compared with the baseline status in both groups. HOMA‐IR showed a decrement pattern in vitamin D group (p = 0.09). Fasting plasma adiponectin levels increased significantly in the vitamin D group (p = 0.007), but not in the placebo group (p = 0.38). Finally, changes in HOMA‐AD ratio were not significant in the both groups. Conclusion: Vitamin D supplementation showed positive effect on plasma adiponectin level, as a biomarker of insulin sensitivity in surgical critically ill patients with stress‐induced hyperglycaemia. However, effects of vitamin D supplementation on HOMA‐IR and HOMA‐AD as indicators of insulin resistance were not significant.