Association between Hypovitaminosis D3 and Type II Diabetes Mellitus of Iraqi Patients


  • Shaymaa M. Hadi Department of Pharmaceutical Chemistry, College of Pharmacy, University of Kerbala, Kerbala, Iraq.
  • Fadhil J. Al-Tu’ma Department of Chemistry and Biochemistry, College of Medicine, University of Kerbala, Kerbala, Iraq.
  • Riyadh D. Al-Zubaidi Department of Internal Medicine, College of Medicine, University of Kerbala, Kerbala, Iraq.



Objective: This research has been carried out to evaluate the levels of [25(OH)D3] as well as the correlation between the deficiency levels with the risk of experiencing T2DM in sample of Iraqi population.

Methods: The levels regarding the 25-hydroxy vitamin D3 and the fasting blood sugar (FBG) have been estimated in group of 58 T2DM patients and 31 control subjects of age between (25 - 65 year). The 25-hydroxy vitamin D3 has been estimated via ELISA and fasting blood sugar (FBG) was measured spectrophotometrically.

Results: The levels of 25-hydroxy vitamin D3 have been considerably lower in individuals experiencing T2DM (9.465 ± 3.567 ng/ml) than in the control group (14.146 ± 11.045 ng/ml), (P = 0.02) whereas FBG levels were considerably higher in patients experiencing T2DM (218 ± 66 mg/dl) widespread in comparison to control group (89.8 ± 9 mg/dl), (P = 0.009). The levels related to the 25-hydroxy vitamin D3 are inversely related to FBG in both diabetic and control group (P = 0.01, r2 = 0.1), (P < 0.01, r2 = 0.2) respectively. VDD is considered to be related to the hazard of experiencing T2DM; also it is highly prevalent in subjects of Iraqi nationality.

Conclusion: VDD is associated to the risk of experiencing T2DM. hypovitaminosis D is very prevalent among the study participants and its percent was higher in female and have a therapeutic implications as cautious supplementation of vitamin D could enhance glycemic control in T2DM.


1. Hadi, SM.; Al-Tu’ma, FJ. and Al-Zubaidi, RD. Genotyping of Vitamin D Receptor FOKI Polymorphism as a predictor for Type 2 diabetes Mellitus by a Tetra primer-ARMS-PCR Assay. Gene Rep. (2019), 15 : 100365.
2. Zisser H, Gong P, Kelley CM, Seidman JS, Riddell MC. Exercise and diabetes. Int J Clin Pract Suppl. 2011 ;170 : 71–5.
3. Prokopenko I, McCarthy MI, Lindgren CM. Type 2 diabetes: new genes, new understanding. Trends Genet. 2008 ; 24 : 613–21.
4. Pilz S, Tomaschitz A, Ritz E, Pieber TR. Vitamin D status and arterial hypertension: a systematic review. Nat Rev Cardiol. 2009 Oct ; 6(10) :621–30.
5. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008 Jan 29 ;117(4) : 503–11.
6. Targher G, Bertolini L, Padovani R, Zenari L, Scala L, Cigolini M, et al. Serum 25-hydroxyvitamin D3 concentrations and carotid artery intima-media thickness among type 2 diabetic patients. Clin Endocrinol (Oxf ). 2006 Nov ; 65(5) : 593–97.
7. Demay MB, Kiernan MS, DeLuca HF, Kronenberg HM. Sequences in the human parathyroid hormone gene that bind the 1,25-dihydroxy vitamin D3 receptor and mediate transcriptional repression in response to 1,25-dihydroxy vitamin D3. Proc Natl Acad Sci USA. 1992 ; 89 : 8097–101.
8. Al-Tu’ma, FJ. and Yosuf, LMZ. Vitamin D deficiency and hypertension in type 2 diabetic Iraqi patients. J Contemp Med Sci. , 2015, 1(1) : 17–20
9. Melamed, M.L., Michos, E.D., Post, W. and Astor, B.. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Archives of internal medicine, 2008, 168(15) :1629-37.
10. Palomer, X., González‐Clemente, J.M., Blanco‐Vaca, F. and Mauricio, D.. Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes, Obesity and Metabolism, 2008, 10(3) :185-197.
11. Martin, T. and Campbell, R.K., 2011. Vitamin D and diabetes. Diabetes spectrum, 2011, 24(2) : 113-118.
12. Reis AF, Hauache OM, Velho G. Vitamin D endocrine system and the genetic susceptibility to diabetes, obesity and vascular disease. A review of evidence. Diabetes Metab. 2005 ; 31 : 318–25.
13. Lips, P., Eekhoff, M., van Schoor, N., Oosterwerff, M., de Jongh, R., Krul-Poel, Y. and Simsek, S., Vitamin D and type 2 diabetes. The Journal of steroid biochemistry and molecular biology, 2016, 173 : 280 – 285.
14. Nakashima, A., Yokoyama, K., Yokoo, T. and Urashima, M. Role of vitamin D in diabetes mellitus and chronic kidney disease. World journal of diabetes, 2016, 7(5) : 89 – 100.
15. Al-Tu’ma, F.J. ; Mohammed, A.M. and Al-Saraf, H. H. Role of Vitamin D3 and Apo-B/ApoA-1 ratio in patients with unstable angina in Kerbala Province : Iraq. J. of Contemp. Medical Sci. , 2017 , 3(10) : 224 – 28.
16. Rahi, S.A.Z. ; Al-Tu’ma, F.J. and Al-Ganabi, AM and Al-Tu’ma, J.F. Polymorphism of Vitamin D receptor (re2228570) in sera of coronary artery diseases and biochemical parameters. Al-Qadisiyah Medical Journal , 2018, 14(25) : 1-8.
17. Rosen, C., Adams, J., Bikle, D., Black, D., Demay, M., Manson, J. et al.The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. Endocr Rev , 2012, 33 : 456–492.
18. Weiss, S. Bacterial components plus vitamin D: the ultimate solution to the asthma (autoimmune disease) epidemic? J Allergy Clin Immunol , 2011, 127: 1128–1130.
19. Weinstock-Guttman, B., Mehta, B., Ramanathan, M., Karmon, Y., Henson, L., Halper, J. et al. Vitamin D and multiple sclerosis. Neurologist , 2012, 18 : 179–183.
20. Haga, H., Schmedes, A., Naderi, Y., Moreno, A. and Peen, E. Severe deficiency of 25-hydroxyvitamin D(3) (25(OH)D3) is associated with high disease activity of rheumatoid arthritis. Clin Rheumatol , 2013, 32: 629–633.
21. Hyppönen, E., Lärä, E., Reunanen, A., Järvelin, M. and Virtanen, S. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet , 2001, 358: 1500–1503.
22. Maxwell, C. and Wood, R. Update on vitamin D and type 2 diabetes. Nutr Rev , 2011, 69 : 291–295.
23. Lim, S., Kim, M., Choi, S., Shin, C., Park, K., Jang, H. et al. Association of VDD with incidence of type 2 diabetes in high-risk Asian subjects. Am J Clin Nutr. 2013, 97 : 524–530.
24. Hurskainen, A., Virtanen, J., Tuomainen, T., Nurmi, T. and Voutilainen, S. Association of serum 25-hydroxyvitamin D with type 2 diabetes and markers of insulin resistance in a general older population in Finland. Diabetes Metab Res Rev 2012, 28: 418–423.
25. Heaney, R., French, C., Nguyen, S., Ferreira, M., Baggerly, L., Brunel, L. et al. A novel approach localizes the association of vitamin d status with insulin resistance to one region of the 25-hydroxyvitamin D continuum. Adv Nutr , 2013, 4 : 303–310.
26. Pittas, A., Sun, Q., Manson, J., Dawson-Hughes, B. and Hu, F. Plasma 25-hydroxyvitamin D concentration and risk of incident type 2 diabetes in women. Diabetes Care , 2010, 33: 2021–2023.
27. Pittas, A., Nelson, J., Mitri, J., Hillmann, W., Garganta, C., Nathan, D. et al. Plasma 25-hydroxyvitamin D and progression to diabetes in patients at risk for diabetes: an ancillary analysis in the Diabetes Prevention Program. Diabetes Care, 2012, 35: 565–573.
28. Schöttker, B., Herder, C., Rothenbacher, D., Perna, L., Müller, H. and Brenner, H. Serum 25-hydroxyvitamin D levels and incident diabetes mellitus type 2: a competing risk analysis in a large population-based cohort of older adults. Eur J Epidemiol , 2013, 28: 267–275.
29. Liu, S., Song, Y., Ford, E., Manson, J., Buring, J. and Ridker, P. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care, 2005, 28: 2926–2932.
30. Pittas, A., Dawson-Hughes, B., Li, T., Van Dam, R., Willett, W., Manson, J. et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care, 2006, 29: 650–656.
31. Chiu, K., Chu, A., Go, V. and Saad, M. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr , 2004, 79: 820–825.
32. Need, A., O’Loughlin, P., Horowitz, M. and Nordin, B. Relationship between fasting serum glucose, age, body mass index and serum 25 hydroxyvitamin D in postmenopausal women. Clin Endocrinol (Oxford), 2005, 62: 738–741.
33. Lau, S., Gunton, J., Athayde, N., Byth, K. and Cheung, N. Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Med J Aust , 2011,194: 334–337.
34. Alzaim, M. and Wood, R. Vitamin D and gestational diabetes mellitus. Nutr Rev, 2013, 71:158–167.
35. Bland, R., Markovic, D., Hills, C., Hughes, S., Chan, S., Squires, P. et al. (2004) Expression of 25-hydroxyvitamin D3–1alpha-hydroxylase in pancreatic islets. J Steroid Biochem Mol Biol 89–90: 121–125.
36. Zeitz, U., Weber, K., Soegiarto, D., Wolf, E., Balling, R. and Erben, R. (2003) Impaired insulin secretory capacity in mice lacking a functional vitamin D receptor. FASEB J 17: 509–511.
37. Maestro, B., Campión, J., Dávila, N. and Calle, C. (2000) Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 47: 383–391.
38. Talaei, A., Mohamadi, M. and Adgi, Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetol Metab Syndr, 2013, 5: 8.
39. Osei, K. 25-OH vitamin D: is it the universal panacea for metabolic syndrome and type 2 diabetes? J Clin Endocrinol Metab, 2010, 95: 4220-22.
40. Al-Daghri, N.M., Alkharfy, K.M., Al-Othman, A., El-Kholie, E., Moharram, O., Alokail, M.S. et al. Vitamin D supplementation as an adjuvant therapy for patients with T2DM: an 18-month prospective interventional study. Cardiovasc Diabetol , 2012, 11: 85.
41. Heshmat, R., Tabatabaei-Malazy, O., Abbaszadeh- Ahranjani, S., Shahbazi, S., Khooshehchin, G., Bandarian, F. et al. Effect of vitamin D on insulin resistance and anthropometric parameters in Type 2 diabetes: a randomized double-blind clinical trial. Daru , 2012, 20: 10.
42. Mitri, J., Dawson-Hughes, B., Hu, F. and Pittas, A. Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial. Am J Clin Nutr , 2011, 94: 486–494.
43. Huang, Y., Yu, H., Lu, J., Guo, K., Zhang, L., Bao, Y. et al. Oral supplementation with cholecalciferol 800 IU ameliorates albuminuria in Chinese type 2 diabetic patients with nephropathy. PLoS One, 2012, 7: e50510.
44. Salum, E., Kals, J., Kampus, P., Salum, T., Zilmer, K., Aunapuu, M. et al. Vitamin D reduces deposition of advanced glycation end- products in the aortic wall and systemic oxidative stress in diabetic rats. Diabetes Res Clin Pract , 2013, 100: 243–249.
45. Chagas, C., Borges, M., Martini, L. and Rogero, M. (2012) Focus on vitamin D, inflammation and type 2 diabetes. Nutrients 4: 52–67.
46. Holick, M. Evidence-based D-bate on health benefits of vitamin D revisited. Dermatoendocrinology, 2012, 4: 183–190.
47. Ochs-Balcom, H., Chennamaneni, R., Millen, A., Shields, P., Marian, C., Trevisan, M. et al. Vitamin D receptor gene polymorphisms are associated with adiposity phenotypes. Am J Clin Nutr , 2011, 93: 5–10.
48. Landrier, J., Marcotorchino, J. and Tourniaire, F. Lipophilic micronutrients and adipose tissue biology. Nutrients, 2012, 4: 1622–1649.




How to Cite

Hadi, S. M., Al-Tu’ma, F. J., & Al-Zubaidi, R. D. (2020). Association between Hypovitaminosis D3 and Type II Diabetes Mellitus of Iraqi Patients. Journal of Contemporary Medical Sciences, 6(3), 120–125.

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