Correlation of vitamin D and E plasma levels with the pathophysiology of type 2 diabetes mellitus among adults in Selangor, Malaysia
Poor glycemic status instigated by derangement of insulin signalling mechanism is the leading cause of Type 2 Diabetes Mellitus (T2DM) pathophysiology. Classical risk factors such as obesity, increasing age, sedentary lifestyle and metabolic syndromes have strong association with T2DM. Recent...
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| Format: | Thesis |
| Language: | English |
| Published: |
2018
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| Online Access: | http://psasir.upm.edu.my/id/eprint/68483/1/fpsk%202018%209%20ir.pdf http://psasir.upm.edu.my/id/eprint/68483/ |
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| Summary: | Poor glycemic status instigated by derangement of insulin signalling mechanism is
the leading cause of Type 2 Diabetes Mellitus (T2DM) pathophysiology. Classical
risk factors such as obesity, increasing age, sedentary lifestyle and metabolic
syndromes have strong association with T2DM. Recent evidence indicates plasma
level of vitamin D and E may alter insulin sensitivity to the cells, but its
pathophysiology to diabetes remains unclear. The study was aimed to investigate the
potential correlation of plasma level of vitamin D and E with glycemic status in
T2DM pathophysiology. A cross-sectional study involved 50 DM and 50 non-DM
respondents were recruited through convenient sampling. Socio-demographic,
medical background, anthropometric measurement and lifestyle behaviours were the
risk factors of diabetes and association of plasma level vitamin D and E were the
new risk factors that proposed in the current study. SPSS version 22.0 was adopted
for the statistical analysis and significant value was set at P<0.05. The outcome of
study highlighted poor glycemic status in DM group (9.32±2.61%) with significant
different with non-DM (6.67±2.01%) group. The association of poor glycemic status
with gender, level of education, ethnicity and family history who is having diabetes
were statistically significant (P<0.05) in DM group. Glycemic status [(haemoglobin
A1c (HbA1c) and fasting blood glucose (FBG)] and lipid profiles status [high
density lipoprotein (HDL), low density lipoprotein (LDL) and total cholesterol (TC)]
were significantly different between DM and non-DM groups. Most of the
respondent were deficient of plasma vitamin D with mean value 3.43±2.95 ng/mL in
non-DM group and 4.44±5.86 ng/mL in DM group which accounted about 82% and
84% respondent in respective groups. Further bivariate analysis with the group of
deficiency of vitamin D (<20 ng/mL) with glycemic status (<7% and >7% of HbA1c level) revealed strong association (P<0.05) of deficiency of vitamin D with poor
glycemic status (HbA1c and FBG) in DM groups. Lipid profile status (LDL, HDL
and TC) were significantly higher (P<0.05) in non-DM group. The calcium level in
non-DM was 8.11 mg/dL and DM group was 9.57 mg/dL. Glycemic status (HbA1c,
FBG and C-Peptide) and lipid profile status (LDL and HDL) were significantly
associated (P<0.05) with calcium plasma level. The distribution of total vitamin E
(VE) in plasma was evidently higher in DM group (4.9±4.3 μg/mL) compared to
non-DM group (3.97±3.33 μg/mL). Furthermore, the relationship of total VE with
deficiency of vitamin D has significantly associated in poor glycemic status (P<0.05)
in DM group. At higher level of total VE (>4.9 μg/mL), there was poor glycemic
status in DM group. Concurrently, lipid profiles status suggested LDL, HDL and TC
were also significantly higher (P<0.05) in DM group at high level of total VE (>4.9
μg/mL). In conclusion, the present study suggested that predisposing of multiple risk
factors of T2DM which predominate in poor glycemic status have strong association
with deficiency of vitamin D and elevated plasma vitamin E amongst diabetic
respondents. Thus, the elucidation of association of vitamin D and E in current study
define the involvement of vitamin D in insulin signalling and the role of vitamin E in
quenching free radical which both are interplay in T2DM pathophysiology. |
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