Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China.
Front Endocrinol (Lausanne). 2020 Sep 16;11:564738. doi: 10.3389/fendo.2020.564738. eCollection 2020.
Vitamin D status has been linked to diabetes-related complications due to multiple extraskeletal effects. We aimed to investigate the association between vitamin D deficiency (VDD) and diabetic vascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic foot ulcers (DFU). A total of 4,284 Chinese patients with type 2 diabetic mellitus (T2DM) were enrolled into the cross-sectional study. VDD was defined as serum 25-hydroxyvitamin D <50 nmol/L. Demographic data, physical measurements, laboratory measurements, comorbidities, and related medications were collected and analyzed by VDD status. Poisson regression with robust variance estimation and binary logistic regression were performed to explore the relationship between VDD and diabetic complications. The prevalence of VDD, DR, DKD, DFU accounted to 71.7% (95% confidence intervals [CI]: 70.3-73.0%), 28.5% (95% CI: 27.2-29.9%), 28.2% (95% CI: 26.8-29.5%), and 5.7% (95% CI: 5.1-6.5%), respectively. The prevalence ratios (95% CI) for DR and DKD by VDD status, adjusted for demographics, physical measurements, laboratory measurements, related complications, and comorbidities, and medications, were 1.093 (0.983-1.215) and 1.041 (0.937-1.156), respectively. The odds ratio (95% CI) for DFU by VDD status was 1.656 (1.159-2.367) in the final adjusted model. Meanwhile, the prevalence of VDD was significantly higher in patients with DFU compared with patients without DFU. The present study firstly indicated that VDD was significantly associated with a higher prevalence of DFU among Chinese T2DM patients. The association between VDD status and DR or DKD was not significant when adjusting for all potential covariates. Vitamin D screening or supplementation may be beneficial to prevent DFU and improve the prognosis of T2DM patients.
维生素 D 状态与多种骨骼外效应相关的糖尿病并发症有关。我们旨在研究维生素 D 缺乏(VDD)与糖尿病血管并发症之间的关系,包括糖尿病视网膜病变(DR)、糖尿病肾病(DKD)和糖尿病足溃疡(DFU)。一项纳入了 4284 例中国 2 型糖尿病(T2DM)患者的横断面研究。VDD 定义为血清 25-羟维生素 D <50 nmol/L。收集并按 VDD 状态分析人口统计学数据、体格测量、实验室测量、合并症和相关药物。采用泊松回归和二元逻辑回归分析 VDD 与糖尿病并发症之间的关系。VDD、DR、DKD、DFU 的患病率分别为 71.7%(95%置信区间[CI]:70.3-73.0%)、28.5%(95% CI:27.2-29.9%)、28.2%(95% CI:26.8-29.5%)和 5.7%(95% CI:5.1-6.5%)。VDD 状态下 DR 和 DKD 的患病率比(95% CI),经人口统计学、体格测量、实验室测量、相关并发症和合并症以及药物校正后,分别为 1.093(0.983-1.215)和 1.041(0.937-1.156)。VDD 状态下 DFU 的优势比(95% CI)在最终校正模型中为 1.656(1.159-2.367)。同时,与无 DFU 患者相比,DFU 患者的 VDD 患病率显著更高。本研究首次表明,VDD 与中国 T2DM 患者中 DFU 的患病率显著升高有关。在调整所有潜在混杂因素后,VDD 状态与 DR 或 DKD 之间的相关性不显著。维生素 D 筛查或补充可能有益于预防 DFU 并改善 T2DM 患者的预后。
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