Evaluation of Vitamin D Metabolism in Patients with Type 1 Diabetes Mellitus in the Setting of Cholecalciferol Treatment

• Main Authors: Alexandra Povaliaeva, Ekaterina Pigarova, Artem Zhukov, Viktor Bogdanov, Larisa Dzeranova, Olga Mel’nikova, Elena Pekareva, Natalya Malysheva, Vitaliy Ioutsi, Larisa Nikankina, Liudmila Rozhinskaya
• Format: Article
• Language: English
• Published: MDPI AG 2020-12-01
• Series: Nutrients
• Subjects: vitamin D; type 1 diabetes mellitus; cholecalciferol; vitamin D-binding protein
• Online Access: https://www.mdpi.com/2072-6643/12/12/3873

In this prospective controlled study, we examined 25 adults with adequately controlled (HbA1c level < 8.0%) type 1 diabetes mellitus (T1DM) and 49 conditionally healthy adults, intending to reveal the diversity of vitamin D metabolism in the setting of cholecalciferol intake at a therapeutic dose. All patients received a single dose (150,000 IU) of cholecalciferol aqueous solution orally. Laboratory assessments including serum vitamin D metabolites (25(OH)D₃, 25(OH)D₂, 1,25(OH)₂D₃, 3-epi-25(OH)D₃ and 24,25(OH)₂D₃), free 25(OH)D, vitamin D-binding protein (DBP) and parathyroid hormone (PTH) as well as serum and urine biochemical parameters were performed before the intake and on Days 1, 3 and 7 after the administration. The studied groups had no significant differences in baseline parameters except that the patients with diabetes showed higher baseline levels of free 25(OH)D (<i>p</i> < 0.05). They also lacked a correlation between the measured and calculated free 25(OH)D in contrast to the patients from the control group (r = 0.41, <i>p</i> > 0.05 vs. r = 0.88, <i>p</i> < 0.05), possibly due to the glycosylation of binding proteins, which affects the affinity constant for 25(OH)D. The elevation of vitamin D levels after the administration of cholecalciferol was comparable in both groups, with slightly higher 25(OH)D₃ levels observed in the diabetes group throughout the study since Day 1 (<i>p</i> < 0.05). Overall, our data indicate that in patients with adequately controlled T1DM 25(OH)D₃ levels and the therapeutic response to cholecalciferol is similar to that in healthy individuals.