Importance of vitamin D supplementation for the prevention of diabetes mellitus type I in children

Deficiency in calcium and vitamin D has always been associated with poor bone health which may lead to osteoporosis in elderly. Now, there is evidence from both observational studies and clinical trials that malnutrition of these micronutrients are predisposing conditions for various common chronic diseases, including the endocrine function of pancreas.  This article reviews the molecular and cellular processes by which deficits in calcium and vitamin D cause specific changes in cell and organ functions and thereby increase the risk for chronic diseases of different etiology.  1,25-dihydroxyvitamin D3 and extracellular Ca2+ are both key regulators of proliferation, differentiation and function at the cellular level.  The efficiency of vitamin D receptor-mediated intracellular signaling is limited by the negative effects of hypovitaminosis D on extrarenal 25-hydroxyvitamin D-1á-hydroxylase activity and thus on the production of 1,25-dihydroxyvitamin D3.  Hypponen et al. reported the results of a large birth-cohort study highlighting the importance of vitamin D supplementation for the prevention of diabetes mellitus type I in children. Their data clearly showed that regular vitamin D intake compared with no supplementation during the first year of life was associated with an 88% risk reduction of type 1 diabetes mellitus in later life. Even children who received vitamin D irregularly had an 84% lower risk than those with no supplementation.

Calcium malnutrition eventually causes a decrease in calcium concentration in extracellular fluid compartments, resulting in organ-specific modulation of calcium-sensing receptor activity.  Attenuation of signal transduction from the ligand-activated vitamin D receptor and calcium-sensing receptor (CaR) seems to be the prime mechanism by which calcium and vitamin D insufficiencies cause perturbation of cellular functions in bone, kidney, intestine, mammary and prostate glands, endocrine pancreas, vascular endothelium, and, importantly, in the immune system.

References

1.      Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM. 2001.  Intake of vitamin D and risk of type 1 diabetes: a birth- cohort study. Lancet.  358:1500–3.

2.      Peterlik, M., and H. S. Cross. 2005.  Vitamin D and Calcium Deficits Predispose for Multiple Chronic Diseases.  European Journal of Clinical Investigation.  35: 290-304.

3.      Peterlik, M., S. Boonen, H. Cross, and C. Lamberg-Allardt.  2009.  Vitamin D and Calcium Insufficiency-Related Chronic Diseases: an Emerging World Wide Public Health Problem.  International Journal of Environmental Research and Public Health.  6: 2585-2607