Serum 25-Hydroxyvitamin D Levels in Type 2 Diabetes Patients in North China: Seasonality and the Association between Vitamin D Status and Glycosylated Hemoglobin Levels

Abstract

Background and Aims. Previous studies have reported a correlation between vitamin D levels and seasonality in healthy populations. However, there are few studies on the seasonal variation in vitamin D levels and its relationship with glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to investigate seasonal changes in serum 25-hydroxyvitamin D [25(OH)D] levels and the associations between these vitamin D concentrations and HbA1c levels in T2DM patients in Hebei, China. Methods. A cross-sectional study of 1,074 individuals with T2DM was conducted from May 2018 to September 2021. Levels of 25(OH)D in these patients were assessed based on both sex and season, and relevant clinical or laboratory variables that could impact vitamin D status were also considered. Results. In the T2DM patient cohort, the mean blood 25(OH)D levels were 17.05 ng/mL. A total of 698 patients (65.0%) had insufficient serum 25(OH)D levels. The vitamin D deficiency rates were significantly higher in the winter and spring compared to the autumn ( P < 0.05 ), indicating that seasonal fluctuations can have a significant impact on 25(OH)D levels. The levels of vitamin D inadequacy were highest in the winter (74%), and females were more likely than males to be deficient (73.4% vs. 59.5%, P < 0.001 ). In comparison to the winter and spring, both males and females showed higher 25(OH)D levels in the summer ( P < 0.001 ). HbA1c levels were 8.9% higher in those with vitamin D deficiencies than in nondeficient patients ( P < 0.001 ). HbA1c and vitamin D levels were negatively correlated (r = −0.119, P < 0.001 ). Conclusion. Vitamin D deficiencies are particularly prevalent among T2DM patients in Hebei, China, with exceptionally high rates in the winter and spring. Female T2DM patients were at an elevated risk of vitamin D deficiency, and vitamin D levels were negatively correlated with HbA1c.

Determinants of Vitamin D deficiency among type 2 diabetes mellitus patients: A retrospective study

“…[ 17 ] Recent Indian and Chinese studies have reported 75% and 64% of VDD among T2DM individuals, respectively. [ 18 , 19 ]…”

“…[ 23 ] Wang et al, 2023 reported that women with T2DM exhibited increased susceptibility to VDD, and there was an inverse correlation between vitamin D levels and HbA1c. [ 19 ] In a Brazilian study, the prevalence of hypovitaminosis D in T2DM was correlated with a high BMI, obesity, and HbA1c. [ 24 ] Similarly, a German study reported that VDD was linked with the prevalence of T2DM and severe VDD was significantly associated with increasing FPG levels and HbA1c.…”

The impact of vitamin D on the etiopathogenesis and the progression of type 1 and type 2 diabetes in children and adults

“…Achieving blood glucose control is one of the goals of diabetes treatment. Serum 25(OH)D 3 levels can be an independent risk factor for increased levels of glycated hemoglobin in T2DM, with women being at a higher risk of vitamin D deficiency ( 7 ). In addition to finding that vitamin D can be a risk factor for glycemic control, it is interesting to note that in patients with T2DM, the combined administration of metformin and vitamin D resulted in better glycemic and glycosylated hemoglobin control compared to metformin alone ( 8 ).…”