Evaluation of plasma vitamin D levels in patients with chronic giardiasis referring to the laboratory of educational hospitals of Ahvaz Jundishapur University of Medical Sciences and the probable risk of type 2 diabetes in these cases

Document Type : Original Article


1 Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Parasitology,School of medicine,Jundishapur University of Medical Sciences

3 Department of Physiology, Faculty of Medicine, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Department of Physiology, Faculty of Medicine, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Department of Physiology, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran.

5 Department of Endocrinology & Metabolism, Department of Internal Medicine, School of Medicine,Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Introduction: Giardiasis is a parasitic disease induced by Giardia lamblia that leads to malabsorption of vitamin D and deficiency of this vitamin increase the probability of type 2 diabetes. Therefore, the present study aimed to investigate the effect of chronic Giardiasis on the status of vitamin D and the risk of type2 diabetes in patients.
Material and Methods: In this case-control study, 60patients were referred to the laboratories of educational hospitals of Ahvaz Jundishapur University of Medical Sciences. After confirmation of giardia parasite infection by direct and blood sampling from patients. Then Plasma sample was isolated and the amount of vitamin D, glucose, insulin, lipid factors, liver enzymes, Insulin resistance index (HOMA-IR), beta-cell function index (HOMA-β), insulin sensitivity index (QUICKI) were assessed.
‌‌‌‌Results: Plasma levels of vitamin D in patients with giardiasis were significantly lower than healthy subjects (P <0.05). Although insulin did not increase in these patients, glucose (P <0.001) and HOMA-IR (P <0.05) increased in these patients. Also, HOMA-β, QUICKI, and DI in patients with giardiasis decreased versus to control group (P <0.05). The values of AST (P <0.001), ALT (P <0.01) and ALP (P <0.05) enzymes were significantly higher in patients with giardiasis.
Conclusion: In general, the results of this study indicate that chronic giardiasis leads to a decrease in vitamin D levels and an increase in variables related to type2 diabetes. It was also found that there is a direct relationship between chronic giardiasis, decreased vitamin D, and increased liver enzymes.


1-Pasupuleti V, Escobedo AA, Deshpande A, Thota P, Roman Y, Hernandez AV. Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. PLoS neglected tropical diseases. 2014;8(3):e2733.
2-Zarebavani M, Dargahi D, Einollahi N, Dashti N, Mohebali M, Rezaeian M. Serum levels of zinc, copper, vitamin B12, folate and immunoglobulins in individuals with giardiasis. Iranian journal of public health. 2012;41(12):47.
3-Ortega YR, Adam RD. Giardia: overview and update. Clinical infectious diseases. 1997;25(3):545-9.
4-Sotto A, Gra B. Hepatic manifestations in giardiasis. Acta gastroenterologica Latinoamericana. 1985;15(2):89-94.
5-Girard C, Dereure O, Blatière V, Guillot B, Bessis D. Vitamin A deficiency phrynoderma associated with chronic giardiasis. Pediatric dermatology. 2006;23(4):346-9.
6-Abed NT, Mohamed N, Abdel-Gawad ER, Ibrahim SG. Vitamin D status in children with recurrent acute diarrhea. Int J Curr Microbiol App Sci. 2014;3:858-68.
7-Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes research and clinical practice. 2000;47(2):123-8.
8-Dobretsov M, Hastings SL, Romanovsky D, Stimers JR, Zhang J-M. Mechanical hyperalgesia in rat models of systemic and local hyperglycemia. Brain research. 2003;960(1-2):174-83.
9-Dalgård C, Petersen MS, Weihe P, Grandjean P. Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians. Diabetes care. 2011:DC_102084.
10-Akram Ahangarpour HTZ, Jabari A, Nia HM, Heidari H. Antidiabetic and hypolipidemic effects of Dorema aucheri hydroalcoholic leave extract in streptozotocin-nicotinamide induced type 2 diabetes in male rats. Iranian journal of basic medical sciences. 2014;17(10):808.
11-Astiazaran-Garcia H, Lopez-Teros V, Valencia ME, Vazquez-Ortiz F, Sotelo-Cruz N, Quihui-Cota L. Giardia lamblia infection and its implications for vitamin A liver stores in school children. Annals of nutrition & metabolism. 2010;57(3-4):228-33.
12-Voloc A. Study on Vitamin D and nutritional status in children and adolescents with helminthiases in central Moldova. Curierul medical. 2015;58(6):22-9.
13-Talaei A, Mohammadi K, Adgi Z. The evaluation of the effect of vitamin D on insulin resistance in type II diabetic patients. Arak Medical University Journal. 2011;14(5 (58)):79-84.
14-Takahashi M, Katayama Y, Takada H, Hirakawa J, Kuwayama H, Yamaji H, et al. Silent infection of Giardia lamblia causing bleeding through vitamin K malabsorption. Journal of gastroenterology and hepatology. 2001;16(10):1171-2.
15-Ma'ani N, Jabir DM. Study of lipid profile alteration in the patients infected with Giardia lamblia and compare the results with healthy individuals. AL-QADISIYAH MEDICAL JOURNAL. 2013;9(15):119-29.
16-Voloc A. Study on Vitamin D and nutritional status in children and adolescents with helminthiases in central Moldova. Curierul medical. 2015;58(6):22-8.
17-Saedisomeolia A, Taheri E, Djalali M, Moghadam AM, Qorbani M. Association between serum level of vitamin D and lipid profiles in type 2 diabetic patients in Iran. Journal of Diabetes & Metabolic Disorders. 2014;13(1):7.
18-Swaroop T, Gowda S. Hepatotoxicity mechanisms and its biomarkers. Int J Pharm Chem Sci. 2012;1:675-82.
19-Skaaby T, Husemoen LLN, Borglykke A, Jørgensen T, Thuesen BH, Pisinger C, et al. Vitamin D status, liver enzymes, and incident liver disease and mortality: a general population study. Endocrine. 2014;47(1):213-20.
20-Zhang Q, Teh JGX, Chan WPW. A patient with typhoid fever, Giardia lamblia gastroenteritis and hepatitis E. Proceedings of Singapore Healthcare. 2016;25(1):61-3.