Impact of the Glycemic Control and Duration of Type 2 Diabetes on Vitamin D Level and Cardiovascular Disease Risk

Abstract

Background and Aims. To investigate the impact of glycemic control and T2D duration on vitamin D status and cardiovascular disease (CVD) risk among Saudi patients. Methods. This case-control study was conducted in King Faisal Specialist Hospital, Saudi Arabia. A total of 25 nondiabetic controls and 92 patients with confirmed T2D, aged 20–60 years, were included. Patients with T2D were divided into the following groups based on disease duration (newly diagnosed: ≈6 months and long duration: ≥5 years) and glycemic control based on their glycated hemoglobin (HbA1C) level with a threshold of ≤0.053 mol/mol: newly diagnosed controlled (NC, n=25), newly diagnosed uncontrolled (NU, n=17), long duration controlled (LC, n=25), and long duration uncontrolled (LU, n=25). Blood levels of fasting blood glucose, HbA1C, lipid profile, and serum 25-hydroxyvitamin D (25(OH)D) were assessed and used to define the CVD risk score. Results. Our study showed that T2D duration was an independent predictor of vitamin D deficiency. The longer disease duration, the lower odds of being vitamin D deficient (odds ratio (OR) = 0.05, 95% CI: 0.01–0.29, p<0.05). No significant association was observed between vitamin D and HbA1C levels. In the NU group, CVD risk scores were directly correlated with serum 25(OH)D (r=0.53, p<0.05). On the contrary, 25(OH)D was moderately inversely correlated with CVD risk score in the LU group (r=−0.45, p<0.05). Conclusion. Duration of diabetes rather than glycemic control is associated with vitamin D deficiency. Glycemic uncontrol may augment vitamin D deficiency-associated CVD risk in both newly diagnosed and old patients with type 2 diabetes.

The Association between Vitamin D Hypovitaminosis and Cardiovascular Disease Risk in Saudi Diabetic Patients Type II

“…10 years of ASCVD risk by Kruskall Whalis Mann-Whiteny test: P ″ : sufficiency vs. deficiency * statistically significant at P < 0.05. In line with our finding, Alaidarous and his colleagues found that hypovitaminosis of vitamin D is significantly associated with CVD risk in T2DM patients especially in uncontrolled cases regardless of the duration of the disease; however, they used different assessment units of vitamin D deficiency as a cut off (<50 nmol/l) which is equivalent to the cut off we used in our study (<20 ng/ml) [37].…”

Vitamin D Prevents High Glucose-Induced Lipid Droplets Accumulation in Cultured Endothelial Cells: The Role of Thioredoxin Interacting Protein

“…Observational data have consistently established low serum concentrations of VitD in patients with Type 2 Diabetes Mellitus (T2D). Of note, it seems that the duration of diabetes rather than glycemic control is associated with VitD deficiency [ 26 ]. Remarkably, observational studies as well as preclinical data support that low VitD correlates with increased risk of hypertension, atherosclerosis, metabolic disorders, and low-grade inflammation, all of which are conditions that share endothelial dysfunction as a common element [ 27 , 28 , 29 ].…”

Is There is a Correlation between Vitamin D Status and Glycemic Control (HBa1c) in Patients with Type 2 Diabetes Mellitus: Review Article with Meta-Analysis

“…In the study of Serdar Olt et al (32) , it was found that 98% of the T2DM patients had insufficient vitamin D levels and found in contrary to Dhia J. al-Timimi et al (23) that the impact of vitamin D on Hba1c was insignificant depending on the fact that there is presently inadequate evidence for recommending vitamin D supplementation as a means for correction of glycemic indices and improving insulin sensitivity (44) . In the study of Mohmmed A. AlHewishel et al which assess many glycemic indices in T2DM patients found that the patients with higher level of fasting blood glucose and Hba1c had lower status of vitamin D. It also support that the deficiency of vitamin D enhance the early occurrence of diabetes and encourage the administration of supplement of vitamin D for correction of glycaemia .Thuraya A. Alaidarous et al (38) explain that the correlation between deficient vitamin D status and indicator of hyperglycemia was in significant and this supported by Sheth et al, (45) study and another case-control study (46) .But such study have some limits such as the size sample was small, significant difference in age between patients group and control group and the insignificant correlation between status of vitamin D level and Hba1c may be related to effect of statin drugs which was taken by the patients.…”