title: Association between vitamin D and diabetic neuropathy in a nationally representative sample: results from 2001-2004 NHANES.
abstract: OBJECTIVE
  To evaluate the association between vitamin D insufficiency and peripheral neuropathy in a nationally representative sample of adults with diagnosed diabetes.
  
  
  METHODS
  Vitamin D concentrations, medical examination variables and questionnaire results from the 2001-2004 National Health and Nutrition Examination Survey were analysed for adults ≥ 40 years old with diagnosed diabetes (unweighted n = 591, weighted n = 8.82 million). Neuropathy was defined as self report of peripheral neuropathy symptoms of painful sensation, tingling, numbness or loss of feeling in hands or feet. Additionally, Semmes-Weinstein monofilament test results were used as an indicator of neuropathy. Insufficient vitamin D was characterized as < 30 ng/ml.
  
  
  RESULTS
  In the weighted population, 81% of adults with diabetes had vitamin D insufficiency. Vitamin D insufficiency was more common among Hispanics (92%) and non-Hispanic black people (98%) than among non-Hispanic white people (76%). Within the 3 months preceding the questionnaire, 50% reported experiencing pain or numbness (paresthesia) in their hands or feet; 37% reported pain or tingling in hands or feet; and 38% reported numbness or loss of feeling in hands or feet. Eight per cent had 4-6 insensate areas on their feet as determined by the Semmes-Weinstein monofilament test. Logistic regressions demonstrate vitamin D insufficiency is associated with the adjusted composite paresthesia measure (odds ratio 2.12; 95% CI 1.17-3.85) and the adjusted numbness measure (odds ratio 2.04; 95% CI 1.18-3.52).
  
  
  CONCLUSIONS
  Vitamin D insufficiency is associated with self-reported peripheral neuropathy symptoms even after adjusting for demographic factors, obesity, co-morbidities, use of medications for neuropathy and diabetes duration and control.
authors: Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA.
authors: L H
authors: LH
authors: Soderstrom
authors: S P
authors: SP
authors: Johnson
authors: V A
authors: VA
authors: Diaz
authors: A G
authors: AG
authors: Mainous
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D015995:Prevalence; D057566:Self Report; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000208:ethnology*
chemical_list: D014807:Vitamin D