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Hypovitaminosis D is highly prevalent in type 2 diabetes. The aim of this study is to determine the serum levels of 25-hydroxyvitamin D [25(OH)D] in type 2 diabetic patients with and without mild cognitive impairment (MCI), and examine the relationship of 25(OH)D and MCI with other clinical factors. One hundred and sixty-five diabetic patients were enrolled in this study. Among whom, 95 patients were considered as MCI [Montreal Cognitive Assessment score (MoCA) < 26] and the other 70 as no MCI (MoCA ≥ 26). Subjects were assessed clinically. Diabetic patients with MCI had a longer duration of DM, fewer years of education, elevated fasting blood glucose (FBG), resistant index (RI) of carotid, and lower levels of 25(OH)D {[17.35 (13.02-25.92) vs 28.00 (19.67-34.30)] ng/ml, P < 0.001}. The MoCA score was positively correlated with log10[25(OH)D], education year, and inversely correlated with duration of DM, history of hypertension, intima-media thickness (IMT), FBG, max-RI, and min-RI. Log10[25(OH)D] was positively correlated with MoCA score, and inversely correlated with IMT, in multivariate regression analysis adjusted for age, sex, and education year, 25(OH)D (β = 0.210, P = 0.003), history of hypertension (β = -0.191, P = 0.007), IMT (β = -0.194, P = 0.007), and FBG (β = -0.157, P = 0.026) independently predicted MoCA score. In conclusion, our results suggest that levels of serum 25(OH)D are inversely associated with the cognitive impairment in diabetic patients. Vitamin D may be a potential protective factor for cognitive impairment in patients with type 2 diabetes.

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Background: Implantable cardioverter-defibrillator (ICD) is the most effective strategy for prevention of ventricular tachyarrhythmia in patients with arrhythmogenic cardiomyopathy (ACM). However, some patients receive ventricular electrical storm (VES), characterized by multiple episodes of sustained ventricular tachyarrhythmia. The purpose of this study was to determine the incidence, predictors and prognostic implications of VES in ACM patients with an ICD. Methods: A total of 88 patients with definite ACM who received an ICD and followed up continuously were included in this study. VES was defined as the occurrence of ≥3 separate episodes of sustained ventricular arrhythmias within a 24-hour period. Results: During a median follow-up time of 4.0 years (range 1.6-6.9), VES occurred in 19/ 88 patients (21.6%). The interval between the ICD implantation and the first VES ranged from 1 month to 128 months. The median number of ventricular tachyarrhythmia events per VES was 7.5 (range 3-32). Multivariate analysis showed that VES was associated with a high body mass index (BMI) [adjusted hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.00-1.45, P=0.048)] and extensive T-wave inversion (TWI) (HR 23.39, P=0.017). Kaplan-Meier method showed that patients with VES did not have a worse cardiac mortality compared to those without such an event. Conclusion: There is a relatively high incidence of VES in ACM patients. The presence of high BMI and extensive TWI were strong predictors of VES occurrence in ACM patients with ICD. VES does not independently confer increased cardiac mortality.