Vitamin D on Early Stages of Diabetic Kidney Disease: A Cross-sectional Study in Patients with Type 1 Diabetes Mellitus

Felício, João Soares; Luz, Rafael Mendonça; Melo, Franciane Trindade Cunha de; Resende, Fabrício de Souza; Oliveira, Alana Ferreira de; Peixoto, Amanda Soares; Neto, João Felício Abrahão; Carvalho, Carolina Tavares; Silva, Denisson Dias da; Santos, Márcia Costa Dos; Queiroz, Natércia Neves Marques de; Lemos, Manuela Nascimento de; Yamada, Elizabeth Sumi; Felício, Karem Miléo

doi:10.3389/fendo.2016.00149

Cited by 15 publications

(26 citation statements)

References 20 publications

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“…In addition, recently, we have compared T1DM subjects with controls and observed a progressive decline in VD levels/status as DKD worsened. Through linear regression analysis, we have suggested that a possible association between higher VD levels and lower values of microalbuminuria was independent of HbA1c and BP levels, hypothesizing a kidney direct effect of VD ( 18 ). Nonetheless, it is necessary to clarify how VD supplementation could bring improvements on this scenario.…”

Section: Discussionmentioning

confidence: 99%

Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

et al. 2017

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BackgroundSome studies suggest an association between diabetic kidney disease (DKD) and vitamin D (VD), but there is no data about the effect of high dose of VD on DKD in type 1 diabetes mellitus (T1DM). Our pilot study aims to evaluate albuminuria reduction in patients with T1DM supplemented with high dose of VD.Methods22 patients received doses of 4,000 and 10,000 IU/day of cholecalciferol for 12 weeks according to patient’s previous VD levels. They were submitted to continuous glucose monitoring system, 24 hours ambulatory blood pressure monitoring and urine albumin-to-creatinine ratio before and after VD supplementation.ResultsThere was a reduction of DKD prevalence at the end of the study (68 vs 32%; p = 0.05), with no changes on insulin doses, glycated hemoglobin, glycemic variability and blood pressure values. A correlation between percentage variation of VD levels (ΔVD) and albuminuria at the end of the study was presented (r = −0.5; p < 0.05). Among T1DM patients with DKD at the beginning of the study, 8/13 (62%) had their DKD stage improved, while the other five ones (38%) showed no changes (p < 0.05).ConclusionOur pilot study suggests an association between VD high dose supplementation, lower prevalence and improvement in stages of DKD in T1DM.

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Section: Discussionmentioning

confidence: 99%

Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

et al. 2017

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“…We performed a prospective study to evaluate the effect of vitamin D supplementation on CAN in T1DM patients as part of a research protocol (ISRCTN32601947) that has already provided evidence on other aspects of VD supplementation outcomes (17)(18)(19)(20).…”

Section: Study Design and Patientsmentioning

confidence: 99%

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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BackgroundCardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients.MethodsWe performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30–60 ng/ml were given 4,000 IU/day for 12 weeks.ResultsThere was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively).ConclusionOur pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.

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“…who reported that VDD correlated with eGFR and worsening renal function from stage 3–5 ( 38 ). In addition, other researchers reported that VDD can be associated with diabetic nephropathy in both type 1 and type 2 diabetes ( 39 , 40 ). Moreover, diabetic patients on hemodialysis have significantly lower levels of vitamin D than patients without diabetes ( 41 ).…”

Section: Discussionmentioning

confidence: 96%

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

et al. 2021

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IntroductionPancreas transplantation is a high-risk procedure in terms of cardiovascular complications. Therefore, identification of all cardiovascular risk factors is crucial to prevent cardiovascular complications after pancreas transplantation. Vitamin D deficiency (VDD) appears to be a potential risk factor for coronary artery disease.ObjectiveTo determine the prevalence of VDD in pancreas transplant candidates, and further to examine the relationship between vitamin D and the prevalence of coronary artery disease and lipid profile parameters.Materials and MethodsThis is a prospective cross-sectional study. We enrolled consecutive patients with type 1 diabetes eligible for simultaneous pancreas-kidney transplantation or pancreas transplant alone. The laboratory tests included HbA1c, lipid profile, creatinine, and total 25-hydroxyvitamin D (25(OH)D). The diagnosis of coronary artery disease was based on coronary angiography.ResultsThe study population included 48 patients. VDD was revealed in 48% of patients and coronary artery disease in 35% of patients. The mean concentration of vitamin D in the entire cohort was 21.3 ± 9.48 ng/ml. The median value of 25(OH)D in patients with coronary artery disease was significantly lower than in patients without coronary artery disease (18.5 (11.6–21.5) vs. 24.8 (18.4–31.8) ng/ml, p = 0.018). There was a significant relationship between VDD and coronary artery disease (OR = 4.36; 95% confidence interval (CI): 1.22–15.64, p = 0.034). A patient’s odds of having coronary artery disease while having a sufficient level of vitamin D was 4.36 times lower than if the patient had VDD. There was a significant relationship between VDD and hypertension (OR = 5.91; 95% CI: 1.12–31.20, p = 0.039) and hemodialysis (OR = 4.25; 95% CI: 1.25–14.5, p = 0.023). There was no significant correlation between 25(OH)D and lipid profile.ConclusionsVDD is highly prevalent in pancreas transplant candidates with type 1 diabetes. There is a significant relationship between VDD and increased prevalence of coronary disease. The lack of any significant association between serum vitamin D and lipid profile suggests that the relationship between vitamin D and coronary artery disease results from other causes.

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Vitamin D on Early Stages of Diabetic Kidney Disease: A Cross-sectional Study in Patients with Type 1 Diabetes Mellitus

Cited by 15 publications

References 20 publications

Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

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