Diabetology Xagena

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Type 2 diabetes: lower levels of 25-hydroxyvitamin D3 are associated with a higher prevalence of microvascular complications

Low levels of serum 25-hydroxyvitamin D [ 25(OH)D ] are commonly found in type 2 diabetes.
Researchers have examined whether there is an association between circulating 25(OH)D concentrations and the presence of microvascular complications in people with type 2 diabetes.

A total of 715 outpatients with type 2 diabetes who regularly attended Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Verona ( Italy ) were studied.

Participants were evaluated for the presence of microvascular complications ( namely retinopathy and/or nephropathy ) by clinical evaluation, fundus examination, urine examination and biochemical tests.

Serum 25(OH)D levels were also measured for each participant.

Hypovitaminosis D ( ie, a serum 25(OH)D level less than 30 ng/mL ) was found in 75.4%, while deficiency ( ie, a 25(OH)D level less than 20 ng/mL ) was found in 36.6% of these patients.

Serum 25(OH)D levels decreased significantly in relation to the severity of either retinopathy or nephropathy or both.

In multivariate logistic regression analysis, lower 25(OH)D levels were independently associated with the presence of microvascular complications ( considered as a composite end point; odds ratio, OR=0.758; 95% CI 0.607 to 0.947, p=0.015 ).

Notably, this association remained significant even after excluding those with an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2).

In conclusion, researchers found an inverse and independent relationship between circulating 25(OH)D levels and the prevalence of microvascular complications in patients with type 2 diabetes.
However, vitamin D may be simply a marker and causality cannot be implied from this cross-sectional study.
Whether vitamin D supplementation in patients with type 2 diabetes may have beneficial effects on the risk of microvascular complications remains to be investigated. ( Xagena )

Zoppini G et al, BMJ Open Diabetes Res Care 2015;3(1):e000058. doi: 10.1136/bmjdrc-2014-000058. eCollection 2015