Low Serum Levels of ۲۵-Hydroxyvitamin D in Association with Type ۲ Diabetes in Indian Patients

Objective: Vitamin D deficiency is a common disorder worldwide and is indicated by low serum ۲۵-hydroxyvitamin D levels. Recent studies have suggested an association of ۲۵-hydroxyvitamin D deficiency with diabetes mellitus. The objective of this study is to investigate the relationship between ۲۵-hydroxyvitamin D concentration and type ۲ diabetes in South Indian patients. Materials and Methods: In a cross sectional study, we recruited ۱۵۰ patients with type ۲ diabetes and ۱۵۰ age and sex matched controls, Yashoda hospital, Hyderabad, India, from December ۲۰۱۱ to November ۲۰۱۳. All cases and controls were evaluated for fasting serum glucose, fasting insulin, serum cholesterol, calcium, phosphorus, alkaline phosphatase, C-reactive protein (CRP), glycosylated hemoglobin (HbA۱c) and ۲۵-hydroxyvitamin D levels. Results: In both ۱۵۰ cases and ۱۵۰ controls, mean age was ۵۱.۵ years and ۷۰% participants were men. Deficiency of ۲۵-hydroxyvitamin D (۴۲.۶%) (P<۰.۰۰۰۱) and CRP positivity (۴۸%) (P<۰.۰۰۰۱) were significantly more common and mean alkaline phosphatase (۱۴۳±۳.۴) (P<۰.۰۰۰۱), mean HbA۱c (۸.۳±۱.۸) (P<۰.۰۰۰۱) and mean HOMA IR (۳.۸۰ +۱.۴۵) (P<۰.۰۰۰۱) were higher in cases compared to controls. In type ۲ diabetes, ۲۵-hydroxyvitamin D deficiency was significantly associated with elevated longer mean duration of diabetes ۱۵.۱±۴.۳ years (P<۰.۰۰۰۱), positive CRP (۰.۰۲), increased HOMA –IR (<۰.۰۰۰۱), neuropathy ۱۹ (۲۹.۶%) (P=۰.۰۳), and retinopathy ۱۱(۱۵.۶%) (P=۰.۰۴).After adjustment using multiple logistic regression analysis, deficiency of ۲۵-hydroxyvitamin D was independently associated with type ۲ diabetes (odds: ۲.۸ ۹۵% CI: ۱.۸۰ - ۸.۰۹). Conclusion: Our study showed a ۴۲.۶% prevalence of ۲۵-hydroxyvitamin D deficiency in type ۲ diabetes and was independently associated with type ۲ diabetes in Indian adults.

Keywords:

Diabetes mellitus , ۲۵-hydroxyvitamin D , South Indian adults.