Is There a Relation Between Serum Vitamin D Level and Microvascular Comlications in Type 2 Diabetes?

Abstract

V itamin D is absorbed into the body through exposure to sunlight, a diet of vitamin-fortified foods, and dietary supplements. The major source of vitamin D absorption is through skin synthesis. Vitamin D receptors have been found in various tissues, including the brain, prostate, breast, colon, pancreas, and immune cells.[1] The estimated worldwide prevalence of vitamin D (25-hydroxyvitamin D [25(OH) D]) deficiency is 30% to 87%.[2] A study in Turkey in 2000 demonstrated that the deficiency prevalence ranged between 44% and 100% in women.[3] Furthermore, studies have revealed a high prevalence of vitamin D deficiency in type 2 diabetes mellitus (T2DM) patients in the Turkish population. [4,5] Recently, vitamin D was found to have various effects on glucose metabolism, obesity, metabolic syndrome, cardiovascular diseases, and cancer, as well as bone metabolism. It has been suggested that vitamin D is involved in insulin sensitivity by controlling calcium flux through the membrane in both beta-cells and peripheral Objectives:The aim of this study was to further investigate the prevalence of Vitamin D deficiency in diabetes mellitus (DM) patients, as well as the association between hypovitaminosis D and the microvascular complications of type 2 (T2) DM. Methods: This was a cross-sectional, case-control study of 206 T2DM patients and 34 healthy control subjects. Participants were evaluated for the presence of diabetic retinopathy, nephropathy, and neuropathy. Results: The level of serum 25-hydroxyvitamin D (25(OH) D) was significantly lower in the T2DM patients (11.16±3.99 ng/mL vs. 15.58±3.16 ng/mL; p<0.05). Furthermore, 2.7% of the patients were found to have retinopathy (n=53), 3.6% had neuropathy (n=65), and 29.1% of the patients had microalbuminuria (n=60). Although serum 25(OH) D levels were significantly lower in the presence of retinopathy and neuropathy (p<0.05 for both), no significant association between Vitamin D level and microalbuminuria was found. Conclusion: An inverse relationship between the circulating 25(OH) D level and the prevalence of retinopathy and neuropathy in T2DM patients was determined. However, there was no significant association between microalbuminuria and the 25(OH) D level.

The relationship between atrial natriuretic peptide and microvascular complications of diabetes

“…They have shown in that study that plasma ANP level was increased in patients with unstable angina, acute myocardial infarction, congestive heart failure, diabetic microangiopathy and isolated diastolic dysfunction [6]. Also, a previous study has shown a relation between microvascular complications of diabetes and serum vitamin D levels [7].…”