Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle‐aged patients

Niu, Yang; Li, Ji; Peng, Rongxia; Zhao, Xiaoming; Wu, Jiang; Tang, Qingya

doi:10.1002/dmrr.3162

Cited by 20 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We noticed that the level of vitamin D was lower in the mixed DPN group than in the non-DPN group, which was in line with several previous studies [14][15][16]. Possible mechanisms include vitamin D protecting Schwann cells against advanced glycation end product (AGE)-induced apoptosis [17] and promoting proangiogenic molecules [18].…”

Section: Clinical Factors Related To Pure Sfn and Mixed Dpnsupporting

confidence: 90%

Better Islet Function and Cardiovascular Autonomic Function in Type 2 Diabetic Patients With Pure Small Fibre Neuropathy Than With Mixed Neuropathy

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundThe clinical characteristics and outcomes of small fibre neuropathy (SFN) in Chinese patients with type 2 diabetes have not been thoroughly described, and we investigated metabolic and neurological indexes and the prognosis of type 2 diabetic patients based on skin biopsy. MethodsThirty-four healthy Chinese volunteers were recruited for skin biopsy to establish the reference range of intraepidermal nerve fibre density (IENFD). Eighty-nine patients with type 2 diabetes from the Department of Endocrinology at Nanjing Drum Tower Hospital between December 2015 and April 2020 were included in the final study. Metabolic and neurological indexes were evaluated at baseline. Diabetic cardiovascular autonomic function was tested through cardiovascular autonomic reflex tests (CARTs). Seventeen pure SFN subjects and 9 mixed diabetic polyneuropathy (DPN) subjects were reassessed after the follow-up. ResultsLevels of HbA1c and postprandial blood glucose were lower (P=0.005 and P=0.041, respectively), while postprandial C-peptide and insulin were higher (P=0.001 and P=0.019, respectively) in the pure SFN group than in the mixed DPN group. Regarding the CARTs, the mixed DPN group obtained the highest score, indicating the worst cardiovascular autonomic neuropathy (CAN). Among the four CART items, postural BP change was lower while deep breathing max-min was higher in the pure SFN group than in the mixed DPN group (P=0.023 and P=0.040, respectively). A partial correlation showed that there was a negative correlation between IENFD of the distal leg and CART scores (r=-0.513, P=0.001) after adjusting for age and duration of diabetes. Only vitamin B12 (p=0.028) and motor nerve conduction velocity (MCV) of the common peroneal nerve (p=0.045) were increased in the 17 patients with pure SFN after the follow-up. However, MCVs of the common peroneal nerve (p=0.025) and tibial nerve (p=0.047) were decreased at the final visit in the mixed DPN group. ConclusionsBetter islet function and cardiovascular autonomic function were observed in patients with pure SFN compared with mixed DPN. CART scores were negatively correlated with IENFD in the distal leg even after adjusting for age and duration of diabetes. The metabolic and neurological indexes remained relatively stable in the follow-up of pure SFN subjects.

show abstract

Section: Clinical Factors Related To Pure Sfn and Mixed Dpnsupporting

confidence: 90%

Better Islet Function and Cardiovascular Autonomic Function in Type 2 Diabetic Patients With Pure Small Fibre Neuropathy Than With Mixed Neuropathy

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The cohort of subjects evaluated in this study was exclusively white European thus minimising ethnicity as a confounding factor. However, a large population‐based study (n = 1461) from China indicated a low vitamin D concentration to be a risk factor for diabetic neuropathy in older adults (≥65 years) ( P < .05) 43 . There was no such relationship in the youth or middle‐aged groups suggesting an age‐related differential effect 43 …”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency is associated with painful diabetic neuropathy

Alam

Petropoulos

Ponirakis

et al. 2020

Diabetes Metabolism Res

View full text Add to dashboard Cite

BackgroundThe aetiology of painful diabetic neuropathy is unclear. We have evaluated vitamin D levels in diabetic patients with and without painful neuropathy.MethodsForty‐three patients with type 1 diabetes and painless (DPN) (n = 20) or painful (PDN) (n = 23) neuropathy and 14 non‐diabetic healthy control subjects (C) underwent assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal confocal microscopy (CCM) and measurement of serum 25(OH)D.ResultsThere were no significant differences for age, BMI, HbA1c, lipids, neurological deficits, QST, electrophysiology, intra‐epidermal nerve fibre density (IENFD) and corneal nerve morphology between patients with DPN and PDN. Both positive (hyperalgesia and allodynia) and negative symptoms (paraesthesia and numbness) of diabetic neuropathy were greater in PDN compared with DPN (P = .009 and P = .02, respectively). Serum 25(OH)D levels were significantly lower in PDN (24.0 ± 14.1 ng/mL) compared with DPN (34.6 ± 15.0 ng/mL, P = .01) and controls (34.1 ± 8.6 ng/mL, P = .03). The odds ratio in favour of painful diabetic neuropathy was 9.8 [P = .003 (95% CI, 2.2–76.4)] for vitamin D deficiency (<20 ng/mL) and 4.4 [P = .03 (95% CI, 1.1‐19.8)] for vitamin D insufficiency (<30 ng/mL).ConclusionsThis study suggests that vitamin D deficiency and insufficiency are associated with painful diabetic neuropathy.

show abstract

“…Diabetic peripheral neuropathy (DPN) can be a quite painful and disabling complication in elderly with T2DM. The two studies (one meta-analysis and one cross-sectional) [ 32 - 33 ] for DPN revealed that VDD is strongly correlated with DPN, while the VD status might be used as a predictor of DPN in elderly with T2DM. Cognition dysfunction is a relatively new complication of diabetes mellitus with partially undefined pathophysiology.…”

Section: Reviewmentioning

confidence: 99%

Vitamin D Deficiency in Elderly With Diabetes Mellitus Type 2: A Review

Papaioannou¹,

Πανταζίδου²,

Kokkalis³

et al. 2021

Cureus

View full text Add to dashboard Cite

Diabetes mellitus type 2 (T2DM) is an emerging public health issue with high prevalence among older adults (>60 years old). Taking into consideration the great increase in the elderly population (approximately 7.5 billion worldwide), we can easily understand the impact of this chronic disease and its complications. On the other hand, vitamin D deficiency (VDD) is also a serious public health problem with significant impacts and multiple health effects. The correlation between DM and VDD has been suggested and established from many observational studies, reviews, and meta-analyses. The literature in PubMed and Google Scholar was searched for relevant articles published up to October 2020. The keywords used were the following: vitamin D deficiency, elderly, and diabetes mellitus type 2. Among the 556 articles retrieved, 90 full texts were eligible and only 34 studies (12 retrospective studies, two prospective cohorts, three meta-analyses, seven cross-sectional studies, nine randomized control trials (RCTs), and one observational study) met the inclusion criteria for the review. The author's name, year of publication, country, type of study, and the number of patients were reported. According to this review there is adequate evidence to support the correlation between VDD and T2DM in the elderly. The results from the RCTs are more conflicting and more studies are needed to confirm the impact of vitamin D deficiency (VD) supplementation on metabolic and lipid profile, oxidative stress, and the complications of T2DM in older patients. VDD is clearly related with severe retinopathy, diabetic peripheral neuropathy, and poor cognition performance, while there is consensus about the beneficial effect of VD on peripheral artery disease, foot ulceration prevention, and wound healing. On the other hand, there is controversy about the effect of VD supplementation on cardiovascular adverse events, endothelial function, and estimated glomerular filtration rate (eGFR). Finally, the association of VDD with fragility fractures and depression in the elderly with T2DM is currently insufficiently studied and remains controversial.

show abstract

Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle‐aged patients

Cited by 20 publications

References 30 publications

Better Islet Function and Cardiovascular Autonomic Function in Type 2 Diabetic Patients With Pure Small Fibre Neuropathy Than With Mixed Neuropathy

Better Islet Function and Cardiovascular Autonomic Function in Type 2 Diabetic Patients With Pure Small Fibre Neuropathy Than With Mixed Neuropathy

Vitamin D deficiency is associated with painful diabetic neuropathy

Vitamin D Deficiency in Elderly With Diabetes Mellitus Type 2: A Review

Contact Info

Product

Resources

About