Hypovitaminosis D and microvascular complications in diabetic patients
Elena Garcia, Guillermo Martinez, Raquel Sanchez & Federico Hawkins
Background: High prevalence of hypovitaminosis D in diabetic patients has been reported and has been associated with microvascular complications and insulin treatment in type 2 diabetic patients.
Methods: Observational study in 92 inhospital patients with different types of diabetes. We analyzed the relationship between serum 25-hydroxyvitamin D (25-OHD) concentration and the clinical features associated with diabetes.
Results: Of 36.2% had type 1 diabetes, 57.4% had type 2 diabetes, 2.3% had pancreatoprive diabetes and 4.3% had LADA. Of 51.1% were treated with insulin while 14.1% were treated with antidiabetics drugs (with or without insulin). Of 18.5% had retinopathy, 21.7% nephropathy, and 22.8% neuropathy. Mean HbA1c was 11.5±2.7%. Mean serum concentration of 25-OHD was 19.6±11.9 ng/ml. The prevalence of hypovitaminosis D (<20 ng/ml) was 56.5%. Its concentration decreased according to the number of microvascular complications without significance. Only serum albumin (P=0.025) were significantly associated with the decreased in 25-OHD. There was no significant association between 25-OHD and age, gender, BMI, type of diabetes, duration of diabetes, type of treatment, microvascular complications iPTH or HbA1c.
Conclusions: The mean serum concentration of 25-OHD in our subjects is considered as a relative hypovitaminosis D. It is possible that a decrease of protein synthesis can affect the concentration of serum 25-OHD. Progression of diabetic microangiopathy is possibly associated with the decreased of the vitamin. Statistically significant differences in serum 25-OHD between patients treated with insulin and with antidiabetic drugs were not found.