Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial

Chiara M A Cefalo, Caterina Conte, Gian Pio Sorice, Simona Moffa, Vinsin A Sun, Francesca Cinti, Enrica Salomone, Giovanna Muscogiuri, Alex A G Brocchi, Alfredo Pontecorvi, Teresa Mezza, Andrea Giaccari, Chiara M A Cefalo, Caterina Conte, Gian Pio Sorice, Simona Moffa, Vinsin A Sun, Francesca Cinti, Enrica Salomone, Giovanna Muscogiuri, Alex A G Brocchi, Alfredo Pontecorvi, Teresa Mezza, Andrea Giaccari

Abstract

Objective: The aim was to investigate whether vitamin D supplementation, combined with a hypocaloric diet, could have an independent effect on insulin sensitivity in subjects with both overweight and hypovitaminosis D. Changes from baseline in anthropometric parameters, body composition, glucose tolerance, and insulin secretion were considered as secondary outcomes.

Methods: Eighteen volunteers who were nondiabetic and vitamin D deficient and had BMI > 25 kg/m2 were randomized (1:1) in a double-blind manner to a hypocaloric diet + either oral cholecalciferol at 25,000 IU/wk or placebo for 3 months. Hyperinsulinemic-euglycemic clamp to measure insulin sensitivity was performed at baseline and after intervention.

Results: Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Serum 25-hydroxyvitamin D levels in the vitamin D group increased considerably (from 36.7 ± 13.2 nmol/L to 74.8 ± 18.7 nmol/L; P < 0.001). Insulin sensitivity in the vitamin D group improved (from 4.6 ± 2.0 to 6.9 ± 3.3 mg·kg-1 ·min-1 ; P < 0.001), whereas no changes were observed in the placebo group (from 4.9 ± 1.1 to 5.1 ± 0.3 mg·kg-1 ·min-1 ; P = 0.84).

Conclusions: Cholecalciferol supplementation, combined with a weight loss program, significantly improves insulin sensitivity in healthy subjects with obesity and might represent a personalized approach for insulin-resistant subjects with obesity.

Trial registration: ClinicalTrials.gov NCT02020694.

© 2018 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Figures

Figure 1
Figure 1
(A) Body weight and (B) 25‐hydroxyvitamin D (25[OH]D) levels at baseline (black bars) and after 3 months of treatment (white bars); *P < 0.001.
Figure 2
Figure 2
Insulin sensitivity (glucose uptake) at baseline (black bars) and after 3 months of treatment (white bars) in the placebo (PLA) and vitamin D (VITD) groups; *P = 0.02.
Figure 3
Figure 3
Areas under the curve (AUC) for (A) glycemia and, (B) insulin and (C) glucose and (D) insulin curves during oral glucose tolerance tests at baseline and after 3 months of treatment in both groups.

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