Vitamin D deficiency increases the risk of retinopathy in Chinese patients with Type 2 diabetes

He, Rui; Shen, Jing; Liu, F.; Zeng, Hui; Li, L.; Yu, Hongwei; Lu, Huijuan; Lu, Fengdi; Wu, Qiang; Jia, Weitao

doi:10.1111/dme.12581

Cited by 59 publications

(61 citation statements)

References 24 publications

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“…Similar to the findings of our study, the authors did not find any significant difference of parathormone level. He et al (2014) and thus, conflicted with our study result. According to the study by Zoppini et al (2015), the multiple logistic regression analysis showed that there were significant association of high vitamin D with reduced risk of diabetic retinopathy and that of longer duration of diabetes with increased risk of diabetic retinopathy.…”

Section: Discussioncontrasting

confidence: 97%

Association of serum vitamin D and parathormone levels in patients of type 2 diabetes mellitus with diabetic retinopathy

Zaman

Rahman

Biswas

et al. 2017

Bangabandhu Sheikh Mujib Medical Univ J

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<p>The present study was aimed to evaluate the association of serum 25-hydroxy vitamin D and parathormone in 46 patients of type 2 diabetes mellitus with diabetic retinopathy [non-proliferative, (n=27); proliferative (n=19)]. Twenty one diabetic patients without retinopathy were taken as control. Serum 25-hydroxy vitamin D and intact parathyroid hormone were measured by chemiluminescence microparticle immunoassay. Concentration of 25-hydroxy vitamin D differed significantly among groups (p=0.018) and it was significantly lower in proliferative diabetic retinopathy than no diabetic retinopathy (p=0.003). Logistic regression analysis revealed that vitamin D deficiency [25-hydroxy vitamin D <20 ng/mL] was indepen-dently associated with development of diabetic retinopathy (p=0.007, OR 20.90, 95%CI 2.33-187.23). In conclusion, vitamin D deficiency is associated with diabetic retinopathy complicating type 2 diabetes mellitus.</p>

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Section: Discussioncontrasting

confidence: 97%

Association of serum vitamin D and parathormone levels in patients of type 2 diabetes mellitus with diabetic retinopathy

Zaman

Rahman

Biswas

et al. 2017

Bangabandhu Sheikh Mujib Medical Univ J

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“…A number of studies have compared 25(OH)D concentrations between groups of individuals with and without diabetic retinopathy in case–control designs [3, 11, 13, 17, 22] with a protective association of 25(OH)D on prevalent retinopathy found in three studies [3, 11, 13]. The majority of other studies consist of cross-sectional designs recruiting participants from clinical settings [5, 6, 9, 10, 12, 14, 15, 19, 21, 23] with half of these studies supporting a protective association of vitamin D with retinopathy [5, 6, 9, 10, 12]. All noted studies recruited participants with diabetes from clinic settings, perhaps limiting the generalizability of study findings.…”

Section: Discussionmentioning

confidence: 99%

“…Results from nationally representative surveys [4, 6] comprised primarily of individuals with type 2 diabetes have supported a protective association between retinopathy status and 25(OH)D concentrations; however a population-based cohort [20] of individuals with type 1 diabetes has not. Strengths of these studies include the use of graded, retinal photographs, adjustment for other confounding factors, and large sample sizes (~500 + participants).…”

Section: Discussionmentioning

confidence: 99%

Adequate vitamin D status is associated with the reduced odds of prevalent diabetic retinopathy in African Americans and Caucasians

Millen

Sahli

Nie

et al. 2016

Cardiovasc Diabetol

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BackgroundVitamin D status has been hypothesized to protect against development of diabetic retinopathy via its anti-inflammatory and anti-angiogenic properties. Additionally, in vitro and in vivo studies suggest vitamin D favorably influences blood pressure and blood glucose control, strong risk factors for diabetic retinopathy. We examined the association between vitamin D status and prevalent diabetic retinopathy in participants with diabetes from a population-based cohort.MethodsAmong participants in the Atherosclerosis Risk in Communities (ARIC) study with diabetes at visit 3 (1993–1995), 1339 (906 Caucasians, 433 African Americans) had serum 25-hydroxyvitamin (25[OH]D) concentrations assessed at visit 2 (1989–1992) and nonmydriatic retinal photographs taken at visit 3. Dietary intake of vitamin D was assessed at visit 1 (1987–1989). Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetic retinopathy by categories of season-adjusted 25(OH)D (<30 [referent], 30–<50, 50–<75 and ≥75 nmol/L), by quartile of vitamin D intake (IU/day), and use of vitamin D or fish oil supplements (yes/no). P for trend was estimated using continuous 25(OH)D or vitamin D intake. ORs were adjusted for race, and duration of diabetes. We further adjusted for HBA1c and hypertension to examine if 25(OH)D influenced diabetic retinopathy via its effects on either glycemic control or blood pressure.ResultsORs (95 % CIs) for retinopathy, adjusted for race and duration, were 0.77 (0.45–1.32), 0.64 (0.37–1.10), and 0.39 (0.20–0.75), p for trend = 0.001, for participants with 25(OH)D of 30–<50, 50–<75, and ≥75 nmol/L, respectively. Further adjustment for hypertension minimally influenced results (data not show), but adjustment for HBA1c attenuated the OR among those with 25(OH)D ≥75 (0.47 [0.23–0.96], p for trend = 0.030). No statistically significant association was observed between vitamin D intake from foods or supplements and retinopathy.Conclusions25(OH)D concentrations ≥75 nmol/L were associated with lower odds of any retinopathy assessed 3 years later. We speculate this may be due in part to vitamin D’s influence on blood glucose control.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0434-1) contains supplementary material, which is available to authorized users.

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“…Most of them [255][256][257][258][259][260][261][262][263][264][265], including the larger ones, but not all [258,264], found associations between low vitamin D levels and the presence and severity of diabetic retinopathy. In a cross-sectional study of the Children's Hospital at Westmead type 1 diabetes cohort, vitamin D levels were inversely associated with the presence diabetic retinopathy, which was assessed based on vascular lesions [261].…”

Section: Nutrition-related Biomarkersmentioning

confidence: 99%

Biomarkers in Diabetic Retinopathy

et al. 2015

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■ AbstractThere is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat diabetic retinopathy, there is need to reliably identify and triage people with diabetes. Biomarkers may facilitate a better understanding of diabetic retinopathy, and contribute to the development of novel treatments and new clinical strategies to prevent vision loss in people with diabetes. This article reviews key aspects related to biomarker research, and focuses on some specific biomarkers relevant to diabetic retinopathy.

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Vitamin D deficiency increases the risk of retinopathy in Chinese patients with Type 2 diabetes

Abstract: Vitamin D deficiency is an independent risk factor for diabetic retinopathy and sight-threatening diabetic retinopathy. The prevalence of sight-threatening diabetic retinopathy doubles when the serum 25-hydroxyvitamin D level is < 15.57 ng/ml.

Cited by 59 publications

References 24 publications

Association of serum vitamin D and parathormone levels in patients of type 2 diabetes mellitus with diabetic retinopathy

Association of serum vitamin D and parathormone levels in patients of type 2 diabetes mellitus with diabetic retinopathy

Adequate vitamin D status is associated with the reduced odds of prevalent diabetic retinopathy in African Americans and Caucasians

Biomarkers in Diabetic Retinopathy

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