title: Hypovitaminosis D in type 2 diabetes mellitus: Association with microvascular complications and type of treatment.
abstract: The prevalence of hypovitaminosis D has been recently reevaluated, and diabetes is considered as a risk factor for osteoporosis. We studied the association of the prevalence of hypovitaminosis D with the clinical features of diabetes. We conducted the observational study in 581 Japanese patients with type 2 diabetes mellitus and 51 normal subjects, and analyzed the relationship between serum 25-hydroxyvitamin D (25-OHD) concentration and the clinical features associated with type 2 diabetes. Mean serum 25-OHD concentration in type 2 diabetes patients was 17.0 +/- 7.1 ng/ml (Mean +/- SD) in winter, and was not statistically different from normal population (17.5 +/- 3.6 ng/ml). The prevalence of hypovitaminosis D (<20 ng/ml) was 70.6%. Serum concentrations of 25-OHD were associated with HbA1c (P = 0.013), age (P = 0.070) and serum albumin (P < 0.001), but were not related to BMI or the duration of diabetes. The levels of 25-OHD were significantly lower in the population with apparent microvascular complications, although serum creatinine levels were below 2.0 mg/dl. Serum 25-OHD concentrations in the group treated with insulin (15.4 +/- 6.5 ng/ml) was lower than those in the patients treated with diet alone (20.8 +/- 7.6 ng/ml) and with oral hypoglycemic agents (17.3 +/- 7.0 ng/ml). Furthermore, the highest incidence of osteoporotic fracture and/or back deformity was observed in insulin-treated patients with hypovitaminosis D. In conclusion, these results suggest that microvascular complications and insulin treatment in type 2 diabetes patients are associated with the co-existence of hypovitaminosis D, and that hypovitaminosis D in insulin-treated patients is possibly related to the risk of osteoporotic fracture.
authors.affiliation: Department of Internal Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Motoko
authors.initials: M
authors.lastname: Kotake
authors.forename: Yasunaga
authors.initials: Y
authors.lastname: Ono
authors.forename: Taiya
authors.initials: T
authors.lastname: Kato
authors.forename: Naohisa
authors.initials: N
authors.lastname: Oda
authors.forename: Nobuki
authors.initials: N
authors.lastname: Hayakawa
authors.forename: Shuji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000628:therapy; D005260:Female; D050723:Fractures, Bone; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D003404:Creatinine