Vitamin D, carotid intima–media thickness and bone structure in patients with type 2 diabetes

Abstract

Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima–media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required.

Serum Vitamin D Level and Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis of Observational Studies and Randomized Control Trials

“…Similarly, van de Luijtgaarden et al [41] showed that low vitamin D status was associated with higher CIMT. Our findings are in contrast with recent studies [42][43][44][45][46] that demonstrated there was no association between vitamin D level and CIMT. There are several possible explanations for discrepancy in findings of the studies including differences in vitamin D dosage of supplementation and serum level of vitamin D, differences in study design, different methods of CIMT measurement and the various populations (healthy vs. unhealthy subjects and adult vs. children).…”

Association of Serum Vitamin D Level and Carotid Atherosclerosis: A Systematic Review and Meta‐analysis

“…As mentioned above, emerging clinical and epidemiologic evidence supported an association between a low serum vitamin D level and an increased risk of carotid atherosclerosis, which was independent of conventional risk factors. However, several studies demonstrated no evidence of a relationship between vitamin D and carotid atherosclerosis after adjustment for potential confounders . Blondon et al found no independent associations between 25(OH)D and carotid intima‐media thickness at baseline (increment of 1.9 μm [95% CI, –5.1 to 8.9 μm] per 10 ng/mL lower 25(OH)D after adjustment for body mass index).…”

Vitamin D and progression of carotid intima‐media thickness in HIV‐positive Canadians

“…Single measured CIMT, as CIMT extent, has been the primary outcome in most investigations that have examined vitamin D effects on subclinical vascular disease and findings have been mixed. Null CIMT extent findings have been found in Old Order Amish Americans [33], individuals living at extremes of the socioeconomic spectrum in Scotland [34], people with diabetes [35,36], individuals with SLE [32,37,38], and a Danish cohort of people with HIV infection [39]. Positive vitamin DÀCIMT associations have been reported in the contexts of diabetes [40][41][42], psoriasis [43], postmenopausal woman [41], secondary CVD prevention [44], and HIV infection [15].…”