Ahi Salma, Reiskarimian Amirreza, Bagherzadeh Mohammad Aref, Rahmanian Zhila, Pilban Parisa, Sobhanian Saeed
Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
PLoS One. 2025 May 28;20(5):e0324729. doi: 10.1371/journal.pone.0324729. eCollection 2025.
Vitamin D has been increasingly recognized for its potential role in modulating various health conditions, including diabetes and its complications. Despite growing evidence suggesting that adequate vitamin D levels may reduce the risk of developing type 2 diabetes and its associated microvascular complications, the precise nature of this relationship remains unclear. This study aims to elucidate the connection among vitamin D status, glycemic control, and microvascular complications in patients with type 2 diabetes, thereby highlighting the importance of vitamin D in diabetes management.This analytical cross-sectional study included 199 type 2 diabetic mellitus (T2DM) patients from the Jahrom city endocrinology clinic. Serum 25(OH)D levels were measured, and their microvascular complications (microalbuminuria, retinopathy, neuropathy, macroalbuminuria) and glycemic control (HbA1C) were measured and confirmed according to ADA guidelines and endocrinologist supervision. All analysis were done with SPSS software. The study enrolled 199 type 2 diabetic patients with a mean age of 56.79 ± 10.8 years, of which 63.3% were female and 57.3% had hypertension. The mean BMI was 28.91 kg/m², and 29.1% of participants had vitamin D deficiency. The prevalence of microvascular complications was 25.6% for retinopathy, 14.1% for neuropathy, and 40% for nephropathy. Vitamin D deficiency was notably higher among patients with retinopathy (37.25%), neuropathy (50%), and macroalbuminuria (56.25%). Patients with neuropathy and retinopathy had significantly lesser serum 25(OH)D concentrations compared to patients without these complications. There was a slight inverse correlation between vitamin D levels and both the urine albumin creatinine ratio (r = -0.175, p = 0.018) and HbA1C (r = -0.19, p = 0.007). Although the link between vitamin D levels and retinopathy was not statistically significant (η = 0.903, p = 0.68), the alteration in vitamin D levels was suggestively linked with neuropathy (η = 0.975, p < 0.001).Vitamin D deficiency is prevalent among type 2 diabetic patients and is related to a higher occurrence of microvascular complications and poorer glycemic control. These findings underscore the potential importance of managing vitamin D levels in reducing complications and improving diabetes outcomes. Future studies should investigate whether oral vitamin D supplements consumption can improve glycemic control and reduce microvascular complications in these patients.
维生素D在调节包括糖尿病及其并发症在内的各种健康状况中的潜在作用已得到越来越多的认可。尽管越来越多的证据表明,充足的维生素D水平可能会降低患2型糖尿病及其相关微血管并发症的风险,但这种关系的确切性质仍不清楚。本研究旨在阐明2型糖尿病患者的维生素D状态、血糖控制和微血管并发症之间的联系,从而突出维生素D在糖尿病管理中的重要性。
这项分析性横断面研究纳入了来自贾赫罗姆市内分泌诊所的199名2型糖尿病(T2DM)患者。测量了血清25(OH)D水平,并根据美国糖尿病协会(ADA)指南和内分泌科医生的监督,测量并确认了他们的微血管并发症(微量白蛋白尿、视网膜病变、神经病变、大量白蛋白尿)和血糖控制情况(糖化血红蛋白HbA1C)。所有分析均使用SPSS软件进行。
该研究招募了199名2型糖尿病患者,平均年龄为56.79±10.8岁,其中63.3%为女性,57.3%患有高血压。平均体重指数(BMI)为28.91kg/m²,29.1%的参与者存在维生素D缺乏。视网膜病变的微血管并发症患病率为25.6%,神经病变为14.1%,肾病为40%。在患有视网膜病变(37.25%)、神经病变(50%)和大量白蛋白尿(56.25%)的患者中,维生素D缺乏明显更高。与没有这些并发症的患者相比,患有神经病变和视网膜病变的患者血清25(OH)D浓度明显更低。维生素D水平与尿白蛋白肌酐比值(r = -0.175,p = 0.018)和HbA1C(r = -0.19,p = 0.007)之间存在轻微的负相关。尽管维生素D水平与视网膜病变之间的联系在统计学上不显著(η = 0.903,p = 0.68),但维生素D水平的变化与神经病变有提示性关联(η = 0.975,p < 0.001)。
维生素D缺乏在2型糖尿病患者中普遍存在,并且与微血管并发症的发生率较高和血糖控制较差有关。这些发现强调了在降低并发症和改善糖尿病预后方面管理维生素D水平的潜在重要性。未来的研究应调查口服维生素D补充剂是否可以改善这些患者的血糖控制并减少微血管并发症。