Abstract | OBJECTIVE: METHODS: Cross-sectional analysis of the 2001 to 2006 National Health and Nutrition Examination Survey. A nationally representative sample of 1216 adults (> or =20 years old) with diagnosed diabetes provides population estimates for >12.6 million individuals. Nephropathy was defined as urinary albumin-to- creatinine ratio > or =30 mg/g in a random spot urine sample. Serum 25-hydroxycalciferol vitamin D levels were characterized as <20 ng/mL vitamin D deficiency, 20 to 29 ng/mL vitamin D insufficiency, and > or =30 ng/mL normal vitamin D. RESULTS: Overall, 30.7% of adults with diabetes have nephropathy, 48.9% have vitamin D deficiency and 36.6% have vitamin D insufficiency. Minorities are more likely to have nephropathy (non-Hispanic whites, 27.8%; non-Hispanic blacks, 36.2%; Hispanics 38.5%; P = .02) and vitamin D deficiency (non-Hispanic whites, 39.5%; non-Hispanic blacks, 80.4%; Hispanic, 59.0%; P < .01). Higher proportions of individuals with nephropathy have vitamin D deficiency than individuals without nephropathy (53.2% vs 47.0%; P = .03). Logistic regressions demonstrate vitamin D deficiency and insufficiency are associated with the presence of nephropathy after adjustment for race/ethnicity, age, sex, hypertension, high cholesterol, smoking status, and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (odds ratio, 1.85; 95% CI, 1.06-3.23 for vitamin D deficiency; and odds ratio, 1.79; 95% CI, 1.12-2.85 for vitamin D insufficiency). CONCLUSIONS: There is a high prevalence of vitamin D deficiency and insufficiency in individuals with diabetes; minorities have the highest prevalences. Thus, evaluating vitamin D levels in people with diabetes may be warranted. There is an independent association between vitamin D deficiency and vitamin D insufficiency with the presence of nephropathy, even after adjustment for race/ethnicity and other variables. Further studies of this relationship may lead to new interventions that decrease health disparities in the progression of diabetic nephropathy.
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Authors | Vanessa A Diaz, Arch G Mainous 3rd, Peter J Carek, Andrea M Wessell, Charles J Everett |
Journal | Journal of the American Board of Family Medicine : JABFM
(J Am Board Fam Med)
2009 Sep-Oct
Vol. 22
Issue 5
Pg. 521-7
ISSN: 1558-7118 [Electronic] United States |
PMID | 19734398
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Cross-Sectional Studies
- Diabetic Nephropathies
(ethnology, physiopathology)
- Female
- Health Status Disparities
- Health Surveys
- Humans
- Logistic Models
- Male
- Middle Aged
- Vitamin D Deficiency
(complications, ethnology)
- Young Adult
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