Vitamin D Deficiency Is Associated with the Presence and Severity of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Alcubierre, Núria; Valls, Joan; Rubinat, Esther; Cao, Gonzalo; Esquerda, Aureli; Traveset, Alícia; Granado-Casas, Minerva; Jurjo, Carmen; Mauricio, Dı́dac

doi:10.1155/2015/374178

Cited by 72 publications

(76 citation statements)

References 23 publications

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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].…”

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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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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“…Furthermore, any BMI category may be associated with systemic inflammation in older people . Vitamin D deficiency has been shown in several studies to be associated with greater prevalence of retinopathy, but it was not found to be correlated with BMI in subjects with DM . Frailty in subjects with DM may play a role in the greater risk of VI, but the present study lacked sufficient power to evidence such an effect because one‐third of the population was not assessed for it.…”

Section: Discussionmentioning

confidence: 66%

Near Visual Impairment Incidence in Relation to Diabetes in Older People: The Three‐Cities Study

Danet-Lamasou

Pérès

Matharan

et al. 2018

J American Geriatrics Society

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“…Lu et al [42] also demonstrated that vitamin D could decrease diabetes-induced reactive oxygen species and exert protective effects against retinal vascular damage and cell apoptosis. Many clinical studies have recognized VDD as a risk factor for DR [16,[43][44][45], whereas other epidemiological researches showed an opposite result [19,23,46,47]. In this study, we took full advantage of the data already gathered and we reported that VDD status was associated with a higher prevalence of DR when adjusting demographics, physical measurements and biochemical indices (PR: 1.132; 95% CI: 1.014-1.264).…”

Section: Discussionmentioning

confidence: 84%

Associations between vitamin D status and diabetic complications in Chinese population with type 2 diabetes mellitus: a cross-sectional study

Xiao

Wei

Xiong

et al. 2020

Preprint

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Background Vitamin D status has been linked to diabetes-related complications due to multiple extraskeletal effects. We aimed to investigate the association between vitamin D deficiency (VDD) and diabetic vascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic foot ulcers (DFU).Methods A total of 4284 Chinese patients with type 2 diabetic mellitus (T2DM) were enrolled into the cross-sectional study. VDD was defined as serum 25-hydroxyvitamin D < 50 nmol/L. Demographic data, physical measurements, laboratory measurements, comorbidities, and related medications were collected and analyzed by VDD status. Poisson regression with robust variance estimation and binary logistic regression were performed to explore the relationship between VDD and diabetic complications.Results The prevalence of VDD, DR, DKD, DFU accounted to 71.7% (95% confidence intervals [CI]: 70.3%-73.0%), 28.5% (95% CI: 27.2%-29.9%), 28.2% (95% CI: 26.8%-29.5%) and 5.7% (95% CI: 5.1%-6.5%), respectively. The prevalence ratios (95% CI) for DR and DKD by VDD status, adjusted for demographics, physical measurements, laboratory measurements, related complications and comorbidities, and medications, were 1.093 (0.983–1.215) and 1.041 (0.937–1.156), respectively. The odds ratio (95% CI) for DFU by VDD status was 1.656 (1.159–2.367) in the final adjusted model. Meanwhile, the prevalence of VDD was significantly higher in patients with DFU compared with patients without DFU.Conclusions The present study firstly indicated that VDD was significantly associated with a higher prevalence of DFU among Chinese T2DM patients. The association between VDD status and DR or DKD was not significant when adjusting for all potential covariates. Vitamin D screening or supplementation may be beneficial to prevent diabetic complications and improve the prognosis of T2DM patients.

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Vitamin D Deficiency Is Associated with the Presence and Severity of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Cited by 72 publications

References 23 publications

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

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

Near Visual Impairment Incidence in Relation to Diabetes in Older People: The Three‐Cities Study

Associations between vitamin D status and diabetic complications in Chinese population with type 2 diabetes mellitus: a cross-sectional study

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