Low Vitamin D Levels Correlate With the Proinflammatory State in Type 1 Diabetic Subjects With and Without Microvascular Complications

Epidemiologic studies link vitamin D deficiency to onset of type I diabetes mellitus (T1DM). T1DM exhibits increased inflammation, which is pronounced with microvascular complications (T1DM-MV). However, there are a paucity of data on vitamin D in T1DM-MV in relation to biomarkers of inflammation, and this formed the aim of the study. Healthy control subjects (n = 36), patients with T1DM (n = 24), and patients with T1DM-MV (n = 26) were recruited. Serum vitamin D levels, monocyte toll-like receptor (TLR) 2 and TLR4 expression and nuclear factor-kappa B (NF kappa B) activity were assessed. Patients with T1DM and T1DM-MV were significantly vitamin D deficient compared with control subjects (P < .01). There was a significant negative correlation between vitamin D levels and high-sensitivity C-reactive protein, NF kappa B activity, and TLR4 expression (P < .05). Preincubation with vitamin D significantly decreased lipopolysaccharide-activated TLR4 expression and cytokine levels in monocytes (P < .05). Low vitamin D levels may contribute to increased inflammation in T1DM. Future studies will elucidate the immunomodulatory effects of vitamin D in decreasing vascular risk in this population.