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Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

2020; Frontiers Media; Volume: 11; Linguagem: Inglês

10.3389/fendo.2020.605681

1664-2392

Lilian de Souza D’Albuquerque Silva, Natércia Neves Marques de Queiroz, Franciane Trindade Cunha de Melo, João Felício Abrahão Neto, Luísa Corrêa Janaú, Norberto Jorge Kzan de Souza Neto, Manuela Nascimento de Lemos, Maria Clara Neres Iunes de Oliveira, Angélica Leite de Alcântara, Lorena Vilhena de Moraes, Wanderson Maia da Silva, Ícaro José Araújo de Souza, Nivin Mazen Said, Gabriela Nascimento de Lemos, Karem Miléo Felício, Márcia Costa dos Santos, Ana Regina Bastos Motta, Melissa de Sá Oliveira dos Reis, Isabel Jane Campos Lobato, Priscila Boaventura Barbosa de Figueiredo, Ana Carolina Contente Braga de Souza, Pedro Paulo Freire Piani, João Soares Felício,

Blood Pressure and Hypertension Studies

Background Cardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus , increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients. Methods We performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30–60 ng/ml were given 4,000 IU/day for 12 weeks. Results There was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively). Conclusion Our pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose. Clinical Trial Registration http://www.isrctn.com/ISRCTN32601947 , identifier ISRCTN32601947.