Lv W S, Zhao W J, Gong S L, Fang D D, Wang B, Fu Z J, Yan S L, Wang Y G
Department of Endocrinology, Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.
Essencemed Clinic, Weifang, 261000, China.
J Endocrinol Invest. 2015 May;38(5):513-8. doi: 10.1007/s40618-014-0210-6. Epub 2014 Dec 21.
Vitamin D is a multifunctional pro-hormone and has widespread actions in human body. Several studies showed a possible association between vitamin D deficiency and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes, but no definite conclusion was available.
A systematic review and meta-analysis was performed to comprehensively assess the association between serum 25-hydroxyvitamin D [25(OH)D] levels and DPN in patients with type 2 diabetes. Data from eligible studies were pooled using meta-analysis.
Six studies that involved a total of 1,484 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis showed that there were obviously decreased serum 25(OH)D levels in DPN patients [weighted mean difference (WMD) = -6.36 ng/ml, 95 % confidence interval (95 % CI) -8.57 to -4.14, P < 0.00001]. Vitamin D deficiency was also significantly associated with increased risk of DPN in patients with type 2 diabetes [odds ratio (OR) 2.88, 95 % CI 1.84-4.50, P < 0.00001]. Meta-analysis of three studies with adjusted estimates showed that vitamin D deficiency was independently associated with increased risk of DPN in patients with type 2 diabetes (OR 2.68, 95 % CI 1.67-4.30, P < 0.0001). Sensitivity analysis showed that there was no obvious change in the pooled estimates.
Vitamin D is involved in the development of DPN in type 2 diabetic patients, and vitamin D deficiency is very likely to be associated with DPN in type 2 diabetic patients. Further studies are needed to validate the association between vitamin D deficiency and DPN.
维生素D是一种多功能前体激素，在人体中具有广泛作用。多项研究表明，2型糖尿病患者维生素D缺乏与糖尿病周围神经病变（DPN）之间可能存在关联，但尚无定论。
进行一项系统评价和荟萃分析，以全面评估2型糖尿病患者血清25-羟维生素D[25(OH)D]水平与DPN之间的关联。采用荟萃分析对符合条件的研究数据进行汇总。
最终纳入荟萃分析的有6项研究，共涉及1484例2型糖尿病患者。荟萃分析显示，DPN患者血清25(OH)D水平明显降低[加权均数差（WMD）=-6.36 ng/ml，95%置信区间（95%CI）为-8.57至-4.14，P<0.00001]。维生素D缺乏也与2型糖尿病患者发生DPN的风险增加显著相关[比值比（OR）为2.88，95%CI为1.84-4.50，P<0.00001]。对3项进行了校正估计的研究进行荟萃分析显示，维生素D缺乏与2型糖尿病患者发生DPN的风险增加独立相关（OR为2.68，95%CI为1.67-4.30，P<0.0001）。敏感性分析显示，汇总估计值无明显变化。
维生素D参与2型糖尿病患者DPN的发生发展，维生素D缺乏很可能与2型糖尿病患者的DPN相关。需要进一步研究来验证维生素D缺乏与DPN之间的关联。
