Hassan Alan Bapeer, Al-Dosky Ali Hussein Ahmad
Basic Medical Sciences Unit, College of Nursing, University of Duhok, Duhok, Iraqi Kurdistan.
Department of Medical Chemistry, College of Medicine, University of Duhok, Duhok, Iraqi Kurdistan.
Steroids. 2023 Nov;199:109289. doi: 10.1016/j.steroids.2023.109289. Epub 2023 Aug 10.
Several clinical studies have shown an association between vitamin D deficiency and painful diabetic peripheral neuropathy (DPN). However, it is still unclear whether vitamin D status and inflammatory markers correlate in patients with painful DPN. In this context, we aimed to investigate the associations between serum vitamin D levels and inflammatory status in Kurdish type 2 diabetes patients (T2DM) with painful DPN and without painful DPN. A clinical case-control study was conducted on 86 Kurdish patients with T2DM. The patients were divided into two groups: the case group consisted of 45 patients with painful DPN and the control group consisted of 41 age- and sex-matched diabetics without DPN. In T2DM patients with and without painful DPN, the prevalence of severe vitamin D deficiency was observed in 46.67% and 21.95% of the patients, respectively (p = 0.0283). The mean serum 25(OH)-vitamin D level in patients with painful DPN (mean = 12.00, SD = 5.78) was significantly lower than in patients without DPN (mean = 16.36, SD = 7.86; p = 0.0041). Regression analysis revealed that vitamin D deficiency (p = 0.0120) and higher glycated hemoglobin (HbA1c) (p = 0.00003) were identified as predictive risk factors for painful DPN. However, there was no significant association between inflammatory status and vitamin D levels. The duration of sun exposure was the only controlling factor for vitamin D in painful DPN patients. In the Kurdish population, lower vitamin D and high HbA1c levels were predictive factors for painful DPN.
多项临床研究表明维生素D缺乏与疼痛性糖尿病周围神经病变(DPN)之间存在关联。然而,疼痛性DPN患者的维生素D状态与炎症标志物之间是否相关仍不清楚。在此背景下,我们旨在研究库尔德2型糖尿病(T2DM)伴疼痛性DPN和不伴疼痛性DPN患者血清维生素D水平与炎症状态之间的关联。对86名库尔德T2DM患者进行了一项临床病例对照研究。患者分为两组:病例组由45名疼痛性DPN患者组成,对照组由41名年龄和性别匹配的无DPN糖尿病患者组成。在有和没有疼痛性DPN的T2DM患者中,分别有46.67%和21.95%的患者存在严重维生素D缺乏(p = 0.0283)。疼痛性DPN患者的血清25(OH)-维生素D平均水平(平均值 = 12.00,标准差 = 5.78)显著低于无DPN患者(平均值 = 16.36,标准差 = 7.86;p = 0.0041)。回归分析显示,维生素D缺乏(p = 0.0120)和较高的糖化血红蛋白(HbA1c)(p = 0.00003)被确定为疼痛性DPN的预测风险因素。然而,炎症状态与维生素D水平之间无显著关联。日晒时长是疼痛性DPN患者维生素D的唯一控制因素。在库尔德人群中,较低的维生素D水平和较高的HbA1c水平是疼痛性DPN的预测因素。