Ali Muhammad, Ejaz Ayesha, Solangi Shafique A, Junejo Abdul Manan, Yaseen Mahjabeen, Iram Hina, Solangi Sagheer Ahmed
Nephrology, Fazaia Ruth Pfau Medical College, Karachi, PAK.
Nephrology, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus. 2020 Nov 23;12(11):e11668. doi: 10.7759/cureus.11668.
To assess the association of hypovitaminosis D with diabetes mellitus (DM) in patients with end stage renal disease (ESRD) undergoing hemodialysis.
This cross-sectional study was conducted at the Jinnah Postgraduate Medical Centre between July 2019 and February 2020. Patients with diagnosed ESRD who were on hemodialysis, with or without concomitant DM were registered. Vitamin D levels were categorized according to the severity of the deficiency or excess as 0-10 ng/mL, severely deficient; 11-20 ng/mL, deficient; 21-32 ng/mL; insufficient, 33-49 ng/mL, adequate; 50-65 ng/mL, optimum; and above that as high. Patients were stratified according to the status of DM. Results: In a total of 80, the mean age was 45.21±12.67 years with 51 (63.75%) males and 29 (36.25%) females. A total of 36 (45%) CKD patients had concomitant diabetes. The median vitamin D levels were 20.25ng/mL. It was found that chronic kidney disease (CKD) patients with concomitant DM had significantly lower levels of vitamin D [15.19±6.83 vs. 30.28±14.22 (p<0.001)]. Out of the 12 patients with a severe deficiency, three-fourths of the population had DM as comorbidity, while in those with 'deficiency', 19 (67.9%) had DM. The majority of the patients without DM had adequate or optimum levels of serum 25-hydroxyvitamin D levels.
Current study indicated that deficiency of serum vitamin D is associated with concomitant DM in patients with CKD as the majority had a severe deficiency of serum 25(OH)D. Supplemental vitamin D may help correct the deficiency and prevent the associated complications in patients.
评估接受血液透析的终末期肾病（ESRD）患者维生素D缺乏与糖尿病（DM）之间的关联。
本横断面研究于2019年7月至2020年2月在真纳研究生医学中心进行。登记诊断为ESRD且正在接受血液透析的患者，无论是否合并DM。根据维生素D缺乏或过量的严重程度将维生素D水平分类为：0 - 10 ng/mL，严重缺乏；11 - 20 ng/mL，缺乏；21 - 32 ng/mL，不足；33 - 49 ng/mL，充足；50 - 65 ng/mL，最佳；高于此值为高水平。根据DM状态对患者进行分层。结果：总共80例患者，平均年龄为45.21±12.67岁，其中男性51例（63.75%），女性29例（36.25%）。共有36例（45%）CKD患者合并糖尿病。维生素D水平中位数为20.25 ng/mL。发现合并DM的慢性肾脏病（CKD）患者维生素D水平显著更低[15.19±6.83 vs. 30.28±14.22（p<0.001）]。在12例严重缺乏的患者中，四分之三的人群合并DM，而在“缺乏”的患者中，19例（67.9%）合并DM。大多数无DM的患者血清25 - 羟维生素D水平充足或最佳。
当前研究表明，CKD患者血清维生素D缺乏与合并DM有关，因为大多数患者血清25(OH)D严重缺乏。补充维生素D可能有助于纠正缺乏并预防患者的相关并发症。
