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Association between 25-hydroxyvitamin D and hemoglobin A1c levels in patients with type 2 diabetic kidney disease

Abstract

Introduction

Vitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25-hydroxyvitamin D (25(OH)D) and glycemic control in non-chronic kidney disease (CKD) patients with type 2 diabetes was reported. We aimed to examine this association among type 2 diabetes patients with CKD.

Objectives

To examine the relation between plasma 25-hydroxyvitamin D3 (25(OH)D3) levels and glycemic state in diabetic patients at various stages of CKD.

Patients and methods

A total of 70 participants (40 men and 30 women) with a mean age of 65.3±11.5 years suffering from type 2 diabetes mellitus with various stages of CKD were recruited. Blood for glycated hemoglobin (HbA1c), serum 25(OH)D3, renal profile, and estimated glomerular filtration rate was drawn at enrollment. Correlation and regression analyses were carried out to assess the relationship of serum 25(OH)D, HbA1c, and other metabolic traits.

Results

Our study shows the following results:

Most of the participants are urban with age range from 50 to 70 years.

Forty percent of the participants are with good glycemic control, 30% with moderate control, and 30% with bad control.

Fifty percent of the patients were at CKD stage 3. Stage 5 patients differed significantly from stages 1 to 4 patients where they were younger, with lowest mean HbA1C value and a much higher mean 25(OH)D level (around twice of stage 1 patients).

Half of the cases are vitamin D deficient, nearly a third of them are insufficient, and about 20% are sufficient.

The level of 25(OH)D3 correlates inversely with the level of HbA1C irrespective of estimated glomerular filtration rate or the age of the patients.

Conclusion

The present study reported a significant inverse relationship between serum 25 (OH)D3 and HbA1c levels in type 2 diabetics with suboptimal glycemic control and concomitant different stages of CKD.

References

  1. Khardori R, Griffing GT, Bessen HA, Brenner BE, Isley WL, Ligaray KPL, et al. (Floride causes diabetes 2018 update), Emedicine.medscape.com/article/117853-overview. 12 October, 2018, DOI: 10.13140/ RG.2.2.16846.10569.

  2. International Diabetes Federation. One adult in ten will have diabetes by 2030. 2011. Available at: https://diabetesatlas.org/component/attachments/?task=download&id=70

  3. Batuman V, Schmidt RJ, Soman AS, Soman SS, Talavera F, Khardori R, et al. Diabetic nephropathy, June 19, 2019, available at: https://emedicine.medscape.com/article/238946-overview.

  4. Nguyen HCT, Balderia PG, Chernoff A, Staros EB. (Vitamin D3 25-Hydroxyvitamin D). Feb. 07, 2014; available at: https://emedicine.medscape.com/article/2088694-overview.

  5. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia 2006; 48:1247–1257. , PMID: 15971062 DOI: 10.1007/ s00125-005-1802-7.

    Article  Google Scholar 

  6. Seshadria KG, Tamilselvana B, Rajendrana A. Role of vitamin D in diabetes. J Endocrinol Metab 2011; 1: 47–56.

    Google Scholar 

  7. Pittas AG, Dawson-Hughes B, Sheehan PR, Rosen CJ, Ware JH, Knowler WC, et al. Rationale and design of the vitamin D and type 2 diabetes (D2d) study: a diabetes prevention trial. Diabetes Care 2014; 37:3227–3234.

    Article  Google Scholar 

  8. Kajbaf F, Mentaverri R, Diouf M, Fournier A, Kamel S, Lalau J-D. The association between 25-hydroxyvitamin D and hemoglobin A1c levels in patients with type 2 diabetes and stage 1–5 chronic kidney disease. Int J Endocrinol 2014; 2014:142468.

    Article  Google Scholar 

  9. Kajbaf F, Mentaverri R, Diouf M, Fournier A, Kamel S, Lalau J. The association between 25 hydroxy-vitamin D and hemoglobin A1c levels in patients with type 2 diabetes and stage 1–5 chronic kidney disease. Int J Endocrinol 2014; 21:1038–1044.

    Google Scholar 

  10. Lim LL, Ng YM, Kang PS, Lim SK. Association between serum 25-hydroxyvitamin D and glycated hemoglobin levels in type 2 diabetes patients with chronic kidney disease. J Diabetes Investig 2018; 9: 375–382.

    Article  CAS  Google Scholar 

  11. Hoffmann MR, Senior PA, Jackson ST, Jindal K, Mager DR. Vitamin D status, body composition and glycemic control in an ambulatory population with diabetes and chronic kidney disease. Eur J Clin Nutr 2016; 70: 743–749.

    Article  CAS  Google Scholar 

  12. Husemoen LL, Skaaby T, Thuesen BH, et al. Serum 25(OH)D and incident type 2 diabetes: a cohort study. Eur J Clin Nutr 2012; 66: 1309–1314.

    Article  CAS  Google Scholar 

  13. Forouhi NG, Ye Z, Rickard AP, et al. Circulating 25 hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies. Diabetologia 2012; 55: 2173–2182.

    Article  CAS  Google Scholar 

  14. Schafer AL, Napoli N, Lui L, et al. Serum 25 hydroxyvitamin D concentration does not independently predict incident diabetes in older women. Diabetic Med 2014; 31: 564–569.

    Article  CAS  Google Scholar 

  15. Pittas AG, Dawson-Hughes B, Li T, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006; 29:650–656.

    Article  CAS  Google Scholar 

  16. Kirii K, Mizoue T, Iso H, Takahashi Y, Kato M, Inoue M, et al. Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort. Diabetologia 2009; 52:2542–2550.

    Article  CAS  Google Scholar 

  17. De Boer IH, Tinker LF, Connelly S, Curb JD, Howard BV, Kestenbaum B, et al. Calcium plus vitamin D supplementation and the risk of incident diabetes in the Women’s Health Initiative. Diabetes Care 2008; 31: 701–707.

    Article  Google Scholar 

  18. Krul-Poel YH, Ter Wee MM, Lips P, Simsek S. Management of endocrine disease: the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and metaanalysis. Eur J Endocrinol 2017; 176:R1–R14.

    Article  CAS  Google Scholar 

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Correspondence to Haitham A. Azeem.

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Azeem, H.A., Mohammed, A.I. & Hashim, A.M. Association between 25-hydroxyvitamin D and hemoglobin A1c levels in patients with type 2 diabetic kidney disease. Egypt J Intern Med 31, 573–579 (2019). https://doi.org/10.4103/ejim.ejim_65_18

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