%0 Journal Article
%T Hypovitaminosis D in Patients with Type 2 Diabetes Mellitus: A Relation to Disease Control and Complications
%A Hala Ahmadieh
%A Sami T. Azar
%A Najla Lakkis
%A Asma Arabi
%J ISRN Endocrinology
%D 2013
%R 10.1155/2013/641098
%X Aims. This study aims at assessing the relationship between 25 (OH) vitamin D (25-OHD) levels and microvascular complications in patients with type 2 diabetes mellitus (DM2). Methods. 136 patients (59£¿¡À£¿11 years) with DM2 (disease duration 8.6£¿¡À£¿7 years) participated in this cross-sectional study. Anthropometric data, HbA1c, 25-OHD levels, serum creatinine, and urine microalbumin/creatinine ratio were collected. Dilated retinal exam was performed, and diabetic neuropathy was assessed using the United Kingdom Screening Score. Results. Serum 25-OHD correlated negatively with HbA1c ( £¿£¿ ). Mean 25-OHD levels were lower in subjects with diabetic retinopathy compared to those without retinopathy (12.3£¿¡À£¿5.5 versus 21.8£¿¡À£¿13.7, ) and lower in subjects with diabetic neuropathy compared to those without neuropathy (16.4£¿¡À£¿10.4 versus 23.5£¿¡À£¿14.5, ). After adjustment for BMI, diabetes duration, and smoking, 25-OHD was an independent predictor of HbA1c (¦Â£¿£¿£¿0.14; ). After adjustment for HbA1c, age, smoking, BMI and disease duration, 25-OHD were independent predictors for diabetic retinopathy: OR 2.8 [95% CI 2.1¨C8.0] and neuropathy: OR 4.5 [95% CI 1.6¨C12] for vitamin D£¿<£¿20 versus vitamin D£¿¡Ý£¿20£¿ng/mL. Conclusion. Low serum 25-OHD level was an independent predictor of HbA1c, diabetic neuropathy, and diabetic retinopathy in patients with DM2. 1. Introduction Diabetes affects more than 300 million individuals in the world with significant morbidity and mortality worldwide [1]. In the United States, it has been estimated that the incidence is about 1 million new cases per year [2]. People with diabetes are at high risk of microvascular complications including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy, which have bad impact on quality of life and are associated with increased mortality [3¨C5]. Risk factors for the development of diabetic microvascular complications include glycaemic control, age, diabetes duration, and smoking. Additional risk factors are age at onset of diabetes and genetic factors [4, 6]. In parallel to the increase in the prevalence of diabetes mellitus, there has been a resurgence of vitamin D deficiency worldwide [7, 8]. Immigrants to Europe from the Middle East and Asia carry a high risk for vitamin D deficiency [7]. Vitamin D has traditionally been associated with calcemic activities, namely, calcium and phosphorus homeostasis and bone. However, recent evidence from various lines of research suggested nontraditional roles of vitamin D in human health including cancer, autoimmune, infectious, respiratory, and
%U http://www.hindawi.com/journals/isrn.endocrinology/2013/641098/