In this study, we aimed to reveal the pro-inflammatory effects of serum 25-hydroxyvitamin D3 (Vit D) deficiency and insufficiency in new-onset type 2 diabetes mellitus (T2DM) and prediabetes. We recruited 84 prediabetes patients, 94 new-onset T2DM patients and 113 healthy participants. We measured the levels of C-reactive protein (CRP), fibrinogen, ferritin, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), nuclear factor kappa-B (NF-κB) and mitogen-activated protein kinase (MAPK) in the serum of the participants. ANOVA Bonferroni and Kruskal–Wallis Dunn tests were used to compare the inflammation markers and vitamin D levels between the groups. Based on covariance analysis with age, gender and BMI, the Vit D levels of the T2DM group were significantly lower (p < 0.003). Pro-inflammatory markers and CRP were significantly higher in prediabetic and diabetic subjects. In the prediabetes group, IL-1β, IL-6, IL-8, TNF-α and MAPK were significantly higher in those with Vit D insufficiency and deficiency groups. In the T2DM group, IL-1β, IL-6, IL-8, TNF-α, NF-κB, MAPK and CRP were significantly higher in those with Vit D insufficiency and deficiency. Our study emphasizes the pro-inflammatory effects of Vit D deficiency and insufficiency in new-onset type 2 diabetes mellitus and prediabetes.

Background: A biopsychosocial approach is needed to assess the background of headache and pain disorders for their effective treatment. Method: Four dimensional symptom questionnaire (4DSQ) was used to determine the mental health status of 158 participants who were seperated into four groups as follows: 1: Control; 2: Headache, 3: Bodily pain without headache, 4: Headache with bodily pain. A demographic data form, a pain questionnaire querying the type, severity, duration of pain and other pain attitudes were both applied to the participants. The data were evaluated by SPSS 21, using Kruskal Wallis, Fischer’s exact, Chi square tests and logistic regressions. Results: Participants with headache (groups 2 and 4) had significantly higher scores on all four dimensions of 4DSQ than participants without headache (group1 and 3) (p<0.01). Headache group was significantly different from those without headache in terms of gender, age, income, occupation, psychiatric disease, exercise, alcohol use, and diabetes (p=0.001, p=0.001, p=0.001, p=0.001, p=0.031, p=0.023, p=0.005, p=0.018, respectively). Participants with headache and bodily pain (group4) had significantly higher scores on somatization and distress than other three groups (p<0. 001), and higher scores on depression than control group (p=0. 006) and higher scores on anxiety when compared to control and ‘bodily pain without headache’ groups (group 1 and 3) (p<0.001). The severity of pain was significantly correlated with anxiety (p=0.014), distress (p=0.003), and somatization (p=0.032). The severity of pain was significantly higher in the group with headache and bodily pain when compared to bodily pain group (p=0.003). In the logistic regression analysis performed to determine the factors that independently affected headache symptom: somatization (OR: 4.75;1.90-11.87) and lower or middle income levels (OR: 9.13;1.64-50.77, OR: 5.67; 2.18-14.74, respectively) were directly related while older age (OR:0.93; 0.89-0.97) and alcohol use (OR:0.20; 0.07-0.58) were inversely related with headache symptom. Discussion and conclusion: Patients with primary headache are likely to have a multifaceted etiology as well as comorbidities. Socioeconomic and several individual factors seem to influence the relationship between headache and mental symptoms . It is of paramount importance for primary health service providers not to overlook psychiatric symptoms and to interrogate pain in other regions to improve patient compliance and satisfaction.