Association between serum 25-hydroxyvitamin D and diabetic kidney disease in Chinese patients with type 2 diabetes

Abstract

Objective The objective was to assess the association between 25-hydroxyvitamin D (25OHD) level and diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes. Methods Data pertaining to 351 in-patients with type 2 diabetes were collected. Subjects were classified into three groups based on the level of urinary albumin-to-creatinine ratio (UACR). UACR < 30 mg/g was defined as normoalbuminuria, while UACR levels of 30–300 mg/g and ≥ 300 mg/g were defined as microalbuminuria and macroalbuminuria, respectively. Serum 25OHD and other clinical characteristics among various UACR groups were compared. The relationship between albuminuiria and 25OHD was analyzed. Results The prevalence of 25OHD insufficiency in the microalbuminuria group was significantly higher than that in the normoalbuminuria group (25.1% vs . 19.6%; P < 0.05); patients with macroalbuminuria had the highest prevalence of 25OHD deficiency (37.8%; P < 0.01 versus normoalbuminuria). Logistic regression analyses demonstrated that low 25OHD levels were associated with DKD [odds ratio ( OR) = 1.51, 95% confidence interval ( CI ) 1.16–1.97). The association was more robust after adjusting for sex, hypertension, increased systolic blood pressure, glycemic status, and hyperuricemia ( OR = 1.62, 95% CI 1.19–2.20). Conclusions The prevalence of vitamin D insufficiency/deficiency in patients with albuminuria was overtly higher than that in patients without albuminuria among Chinese adults with type 2 diabetes. Vitamin D insufficiency/deficiency was independently associated with DKD in type 2 diabetes.

Associations between vitamin D status and diabetic complications in Chinese population with type 2 diabetes mellitus: a cross-sectional study

“…However, clinical studies pertaining to the association between vitamin D status and DKD have reported inconsistent results. A recent cross-sectional study of 351 Chinese inpatients with T2DM demonstrated that VDD was independently associated with DKD [21]. This was consistent with many previous studies which had linked albuminuria to low vitamin D levels [58][59][60][61][62].…”

“…A Chinese cross-sectional survey among diabetic inpatients reported that the proportions of persons with VDD were 83.5%, the recruitment center of which was located in north China (latitude 34°-37° N) [33]. Besides, approximately 62.7% of T2DM subjects were affected in two epidemiological studies conducted in Nanjing, which is located in eastern coastal China (latitude 31°-33° N) [21]. In present study, we found that the prevalence of VDD was about 71.7% among this study population with T2DM, who were recruited in Changsha, a city located in central China (latitude 27°-29° N).…”

“…In the past few years, the association between vitamin D deficiency (VDD) and other nonclassical outcomes besides skeletal disorders has drawn increasing attention, especially diabetes and diabetes-related complications [14][15][16][17]. Although the inverse association between vitamin D levels and risk of T2DM [18,19], DR [20], DKD [21], or DFU [22] among diverse populations has been reported, uncertainties still exist due to the discordant results [23,24]. More importantly, large-scale epidemiological studies on the association of VDD and diabetes-related complications among the Chinese population are scarce, especially studies evaluating the relationship between VDD and DFU.…”

Association Between Vitamin D Status and Diabetic Complications in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study in Hunan China

“…A Chinese cross-sectional survey among diabetic inpatients reported that the proportions of persons with VDD were 83.5%, the recruitment center of which was located in north China (latitude 34 • -37 • N) (36). Besides, ∼62.7% of T2DM subjects were affected in two epidemiological studies conducted in Nanjing, which is located in eastern coastal China (latitude 31 • -33 • N) (19). In present study, we found that the prevalence of VDD was about 71.7% among this study population with T2DM, who were recruited in Changsha, a city located in central China (latitude 27 • -29 • N).…”

“…In the past few years, the association between vitamin D deficiency (VDD) and other nonclassical outcomes besides skeletal disorders has drawn increasing attention, especially diabetes and diabetes-related complications (14)(15)(16)(17). The inverse association between vitamin D levels and risk of DR (18), DKD (19), or DFU (20) among diverse populations has been demonstrated, whereas other studies reported discordant results regarding the correlations between vitamin D status and these three complications of diabetes (21)(22)(23). More importantly, large-scale epidemiological studies on the association of VDD and diabetes-related complications among the Chinese population are scarce (24,25), which have revealed that lower vitamin D level was associated with increased albuminuria/creatine ratio and higher risk of DR. And no study has evaluated the relationship between VDD and DFU in Chinese diabetic population.…”