The Association of Vitamin D Status and Vitamin D Replacement Therapy with Glycemic Control, Serum Uric Acid Levels, and Microalbuminuria in Patients with Type 2 Diabetes and Chronic Kidney Disease.

Abstract

OBJECTIVE:

To evaluate the relationship of vitamin D status and vitamin D replacement therapy with glycemic control, serum uric acid (SUA) levels, and microalbuminuria (MAU) in patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD). Subjectsand Methods: A total of 1,463 patients with T2DM and CKD (aged 14-88 years), 927 females and 536 males, were included in this study. The serum data of 25-hydroxyvitamin D, i.e., 25(OH)D, level, SUA, hemoglobin (Hb)A1c, creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio (UACR) were obtained from the medical records. The Mann-Whitney U test, the χ2 test, the Mantel-Haenszel test, and linear regression models were used for data analysis.

RESULTS:

Vitamin D deficiency and insufficiency were evident in 770 (52.0%) and 357 (24.0%) patients, respectively. Median HbA1c levels (7.3 [IQR 3.9] vs. 6.5 [IQR 2.3]%; p < 0.01) were significantly higher in patients deficient in vitamin D than in those with a normal vitamin D status. A significantly low level of vitamin D was noted with a high UACR (β -0.01; 95% CI -0.01 to -0.001; p = 0.017) and HbA1c (β -1.1; 95% CI -1.6 to -0.6; p < 0.001), but with low levels of SUA (β 1.3; 95% CI 0.5-2.2; p = 0.002). Vitamin D replacement was associated with a significantly low level of HbA1c (7.4 [2.7] vs. 6.7 [1.9]%; p < 0.001].

CONCLUSION:

In this study, there was a high prevalence of hypovitaminosis D among T2DM patients with CKD, with a higher UACR, higher HbA1c, and lower SUA being noted as playing a role in predicting a decrease in vitamin D levels and potential benefits of vitamin D replacement therapy on glycemic control in T2DM management.

• Authors: Savas Sipahi, Seyyid Bilal Acikgoz, Ahmed Bilal Genc, Mehmet Yildirim, Yalcin Solak, Ali Tamer
• Journal: Medical principles and practice : international journal of the Kuwait University, Health Science Centre (Med Princ Pract) Vol. 26 Issue 2 Pg. 146-151 ( 2017) ISSN: 1423-0151 [Electronic] Switzerland
• PMID: 27931015 (Publication Type: Journal Article)
• Copyright: © 2016 S. Karger AG, Basel.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Vitamin D
• Uric Acid
• Creatinine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Albuminuria (urine)
• Blood Glucose (physiology)
• Creatinine (blood)
• Diabetes Mellitus, Type 2 (blood, epidemiology)
• Dietary Supplements
• Female
• Glomerular Filtration Rate
• Glycated Hemoglobin
• Humans
• Male
• Middle Aged
• Renal Insufficiency, Chronic (blood, epidemiology)
• Uric Acid (blood)
• Vitamin D (therapeutic use)
• Vitamin D Deficiency (drug therapy, epidemiology)
• Young Adult