Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya

Abstract Serum vitamin D status exerts effects on glucose-insulin-homeostatic states underlying Diabetes-Mellitus, Type 2 (T2DM). This has been described in white and Asian population where low Vitamin D levels predicted future impairments in beta cell function and worsening of insulin resistance. T...

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Autores principales:	Jamil Said, David Lagat, Allan Kimaina, Chrispine Oduor
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c270d03037b14c4381ff65d75566c52e
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spelling	oai:doaj.org-article:c270d03037b14c4381ff65d75566c52e2021-12-02T12:11:28ZBeta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya10.1038/s41598-021-83302-02045-2322https://doaj.org/article/c270d03037b14c4381ff65d75566c52e2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83302-0https://doaj.org/toc/2045-2322Abstract Serum vitamin D status exerts effects on glucose-insulin-homeostatic states underlying Diabetes-Mellitus, Type 2 (T2DM). This has been described in white and Asian population where low Vitamin D levels predicted future impairments in beta cell function and worsening of insulin resistance. This study aimed to examine the relationship between serum vitamin D, insulin resistance and beta cell function in a sub population of black Kenyan T2DM patients. The primary objective was to determine the levels of serum 25 hydroxy (25-OH) vitamin D, and estimate the insulin resistance, and beta cell function among T2DM patients at Moi Teaching and Referral Hospital (MTRH). This was a cross sectional study. 124 T2DM patients attending the MTRH Diabetes clinic between February and May 2016 were enrolled. Patients on insulin therapy and/or thiazolidinediones were excluded. Anthropometric, clinical and demographic data was obtained. Samples were drawn for estimation of serum 25-OH vitamin D, fasting insulin levels and fasting blood glucose levels. HOMA (Homeostatic model of assessment) model was used to estimate Beta cell secretion (HOMA-B) and insulin resistance (HOMA-IR); while the Disposition index {(DI) hyperbola product of insulin sensitivity (1/HOMA-IR) and beta cell secretion} was used to estimate the beta cell function. The relationships between serum vitamin D, insulin resistance and beta cell function were explored using a linear regression model. The study participants had a mean age of 56.2 (± 9.2) years, and a mean BMI of 26.9 kg/m2 (4.3). Forty nine percent (n = 61) were males. Vitamin D deficiency was present in 71.1% (n = 88) of the respondents. Relatively low levels of insulin resistance and higher levels of beta cell dysfunction were observed {median HOMA-IR of 2.3 (0.7, 6.5) and Disposition Index (DI) of 25.5 (14.3, 47.2)}. Vitamin D levels exhibited a low positive correlation with DI [r = 0.22 (95% CI: 0.03, 0.37)], but was not significantly correlated with HOMA-IR [r = 0.07(95% CI: − 0.11, 0.25)]. These results indicate that beta cell dysfunction rather than insulin resistance as the predominant defect among black T2DM patients seeking care at the MTRH diabetes clinic. Vitamin D deficiency is also prevalent among them and exhibits a low positive correlation with beta cell dysfunction. There was no correlation observed between Vitamin D deficiency and insulin resistance.Jamil SaidDavid LagatAllan KimainaChrispine OduorNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jamil Said David Lagat Allan Kimaina Chrispine Oduor Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
description	Abstract Serum vitamin D status exerts effects on glucose-insulin-homeostatic states underlying Diabetes-Mellitus, Type 2 (T2DM). This has been described in white and Asian population where low Vitamin D levels predicted future impairments in beta cell function and worsening of insulin resistance. This study aimed to examine the relationship between serum vitamin D, insulin resistance and beta cell function in a sub population of black Kenyan T2DM patients. The primary objective was to determine the levels of serum 25 hydroxy (25-OH) vitamin D, and estimate the insulin resistance, and beta cell function among T2DM patients at Moi Teaching and Referral Hospital (MTRH). This was a cross sectional study. 124 T2DM patients attending the MTRH Diabetes clinic between February and May 2016 were enrolled. Patients on insulin therapy and/or thiazolidinediones were excluded. Anthropometric, clinical and demographic data was obtained. Samples were drawn for estimation of serum 25-OH vitamin D, fasting insulin levels and fasting blood glucose levels. HOMA (Homeostatic model of assessment) model was used to estimate Beta cell secretion (HOMA-B) and insulin resistance (HOMA-IR); while the Disposition index {(DI) hyperbola product of insulin sensitivity (1/HOMA-IR) and beta cell secretion} was used to estimate the beta cell function. The relationships between serum vitamin D, insulin resistance and beta cell function were explored using a linear regression model. The study participants had a mean age of 56.2 (± 9.2) years, and a mean BMI of 26.9 kg/m2 (4.3). Forty nine percent (n = 61) were males. Vitamin D deficiency was present in 71.1% (n = 88) of the respondents. Relatively low levels of insulin resistance and higher levels of beta cell dysfunction were observed {median HOMA-IR of 2.3 (0.7, 6.5) and Disposition Index (DI) of 25.5 (14.3, 47.2)}. Vitamin D levels exhibited a low positive correlation with DI [r = 0.22 (95% CI: 0.03, 0.37)], but was not significantly correlated with HOMA-IR [r = 0.07(95% CI: − 0.11, 0.25)]. These results indicate that beta cell dysfunction rather than insulin resistance as the predominant defect among black T2DM patients seeking care at the MTRH diabetes clinic. Vitamin D deficiency is also prevalent among them and exhibits a low positive correlation with beta cell dysfunction. There was no correlation observed between Vitamin D deficiency and insulin resistance.
format	article
author	Jamil Said David Lagat Allan Kimaina Chrispine Oduor
author_facet	Jamil Said David Lagat Allan Kimaina Chrispine Oduor
author_sort	Jamil Said
title	Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
title_short	Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
title_full	Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
title_fullStr	Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
title_full_unstemmed	Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya
title_sort	beta cell function, insulin resistance and vitamin d status among type 2 diabetes patients in western kenya
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c270d03037b14c4381ff65d75566c52e
work_keys_str_mv	AT jamilsaid betacellfunctioninsulinresistanceandvitamindstatusamongtype2diabetespatientsinwesternkenya AT davidlagat betacellfunctioninsulinresistanceandvitamindstatusamongtype2diabetespatientsinwesternkenya AT allankimaina betacellfunctioninsulinresistanceandvitamindstatusamongtype2diabetespatientsinwesternkenya AT chrispineoduor betacellfunctioninsulinresistanceandvitamindstatusamongtype2diabetespatientsinwesternkenya
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Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya

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