title: The effects of calcitriol on albuminuria in patients with type-2 diabetes mellitus.
abstract: The renin-angiotensin system has a major role in the development of diabetic nephropathy (DN). It is reported that vitamin D analogues are able to suppress renin excretion. Thus, this study was conducted to determine whether there is any correlation between albuminuria as a marker of DN with vitamin D levels in diabetic patients. Also, an assessment was made on the effects of vitamin D therapy on albuminuria in this group of patients. We conducted this cross-sectional study on 119 outpatients with type-2 diabetes. The serum levels of 25-hydroxy vitamin D [25 (OH) D] and the albumin to creatinine ratio were assessed in all the study patients. Patients with vitamin D deficiency/insufficiency received calcitriol therapy for eight weeks, following which the laboratory tests were repeated. The mean age of the study patients was 55.3 ± 11.2 years, 43 (36.13%) had vitamin D insufficiency [25 (OH) D <25 ng/mL] and 31 (26.1%) had vitamin D deficiency [25 (OH) D <15 ng/mL]. We found a significant correlation between 25 (OH) D levels and presence of microalbuminuria (P = 0.04) in patients with vitamin D deficiency. Therapy with calcitriol had a beneficial effect on the albumin excretion rate, although this change was not significant (P = 0.22). However, the effects of calcitriol on reduction of diastolic blood pressure (P = 0.004), glycosylated hemoglobin (P = 0.014) and levels of total cholesterol (P = 0.019), low-density lipoprotein (0.04) and high-density lipoprotein (P = 0.001) was significant. Our study suggests that vitamin D deficiency has a negative effect on albuminuria in diabetic patients, and its replacement may be associated with a beneficial effect on the risk factors of DN, such as hyperlipidemia and hypertension.
authors.affiliation: Endocrine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Bonakdaran
authors.forename: Maryam
authors.initials: M
authors.lastname: Hami
authors.forename: Asieh
authors.initials: A
authors.lastname: Hatefi
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002117:Calcitriol / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007492:Iran; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D002117:Calcitriol; D002784:Cholesterol; D006442:Glycated Hemoglobin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014807:Vitamin D; D014815:Vitamins; C517652:hemoglobin A1c protein, human; C104450:25-hydroxyvitamin D