Serum vitamin d status and its relationship to metabolic parameters in patients with type 2 diabetes mellitus

Abstract

The potential relationship between vitamin D (VitD) status and metabolic control in patients with type 2 diabetes mellitus (T2DM) warrants further study. We aimed to evaluate the relationship between the serum 25-hydroxyvitamin D [25(OH)D] level and various parameters in patients with T2DM. We analyzed retrospectively data from 276 Korean patients with T2DM whose serum 25(OH)D level was measured in our hospital. Nondiabetic healthy subjects who visited the hospital for health screening were selected as the control group (Non-DM, n=160). Compared with control subjects, patients with T2DM had a lower serum 25(OH)D level (15.4±0.5 vs. 12.9±0.4 ng/ml, p<0.01). Eleven percent of T2DM patients were VitD "insufficient" (20-29 ng/ml) and 87% of the patients were VitD "deficient" (<20 ng/ml). The serum 25(OH)D level was significantly related to serum fibrinogen, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ferritin, the urine albumin creatinine ratio, and hemoglobin A(1C) (HbA1C). In a multivariate logistic regression analysis, high levels of HbA1C, TG, and LDL-C were independently associated with VitD deficiency in T2DM patients. The results of the present study show that the majority of Koreans with T2DM are VitD deficient, and the serum 25(OH)D level in patients with T2DM is related to lipid and glucose parameters. Further studies are required of the relationship of VitD with fibrinogen and other related parameters.

Keywords: 25-Hydroxyvitamin D; Diabetes mellitus, Type2; Fibrinogen; Vitamin D.

FIG. 1

The distribution of vitamin D status in nondiabetic control subjects (Non-DM) and patients with type 2 diabetes mellitus (T2DM).

FIG. 2

Comparison of 25-hydroxyvitamin D [25(OH)D] according to various parameters in patients with type 2 diabetes mellitus (T2DM). (A) ^*p<0.01 vs. the subgroup with <7.3% hemoglobin A_1C (HbA1C) by one-way ANOVA test. (B) ^†p<0.05 vs. the subgroup with stage 1 chronic kidney disease (CKD) by one-way ANOVA test. (C) ^‡p<0.05 vs. the subgroup with <30 mg/g creatinine or 30-300 mg/g creatinine by one-way ANOVA test. (D) ^§p<0.01 vs. the subgroup with <100 mg/dl low-density lipoprotein (LDL) by independent-sample t-test. (E) ^∥p<0.05 vs. the subgroup with <150 mg/dl fibrinogen by independent-sample t-test. (F) ^¶p<0.05 vs. the subgroup with <0.5 mg/dl high-sensitivity C-reactive protein (hsCRP) by independent-sample t-test. Note that patients with estimated glomerular filtration rate <30 ml/min/1.73 m² were excluded from the analysis.