The role of vitamin d in the metabolic homeostasis of diabetic bone

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8 Scopus citations

Abstract

Most studies across a variety of geographic locations suggest that vitamin D insufficiency is more common in individuals with type 1 diabetes (T1D) compared to the general population. In type 2 diabetes (T2D), while obesity is commonplace and lower vitamin D levels are present in obese adolescents and adults, the association between vitamin D insufficiency and T2D is less clear. Studies suggest that the relationship between T2D and vitamin D may be concurrently influenced by ethnicity, geography, BMI and age. Nonetheless, diabetic osteopathy is a significant comorbidity of both forms of diabetes and is characterized by micro-architectural changes that decrease bone quality leading to an increased risk for bone fracture in both disorders. The question remains, however, to what degree vitamin D homeostasis contributes to or exacerbates skeletal pathology in diabetes. Proposed mechanisms for vitamin D deficiency in diabetes include (1) genetic predisposition (T1D); (2) increased BMI (T2D); (3) concurrent albuminuria (T1D or T2D); or (4) exaggerated renal excretion of vitamin D metabolites or vitamin D-binding protein (T1D, T2D, animal models). The specific effects of vitamin D treatment on diabetic osteoporosis have been examined in rodents and demonstrate skeletal improvements even in the face of untreated diabetes. However, human clinical trial data examining whether vitamin D status can be directly related to or it is predictive of bone quality and fracture risk in those with diabetes are still needed. Herein, we provide a review of the literature linking vitamin D, diabetes and skeletal health.

Original languageEnglish
Pages (from-to)28-37
Number of pages10
JournalClinical Reviews in Bone and Mineral Metabolism
Volume11
Issue number1
DOIs
StatePublished - Mar 2013

Bibliographical note

Funding Information:
Acknowledgments This work was supported by grants from the Martha Ann Pugh Diabetes Research Fund (to K.M.T.), the Arkansas Biosciences Institute (to J.L.F.), and in part by a National Institutes of Health Grant R01DK055653 (to J.L.F.).

Keywords

  • Diabetic fracture
  • Diabetic osteoporosis
  • Type 1 diabetes
  • Type 2 diabetes
  • Vitamin D receptor
  • Vitamin D-binding protein

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology

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