title: Body weight and waist circumference as predictors of vitamin D deficiency in patients with type 2 diabetes and cardiovascular disease.
abstract: OBJECTIVE
  Vitamin D deficiency is a well-established risk factor for bone disease, but emerging data suggest that altered vitamin D homeostasis may play a role in the development of type 2 diabetes mellitus (T2DM), dyslipidemia hypertension, and other cardiovascular diseases (CVD). The aim of this study was to investigate the prevalence of vitamin D deficiency in patients with T2DM with/without CVD, to correlate it with anthropometric and metabolic parameters and to determine the predictors of vitamin D deficiency.
  
  
  METHODS
  A total of 88 patients with T2DM (49 male/39 female, aged 61.0 +/- 0.9 yrs, body mass index (BMI) 29.9 +/- 0.4 kg/m2) and 67 patients (44 male/23 female, aged 63.6 +/- 1.0 yrs, BMI 29.2 +/- 0.5 kg/m2) with T2DM and CVD (myocardial infarction in 57 patients and angina pectoris in 10 patients) were included in this study. These patients were compared with 87 healthy subjects (35 male/52 female, aged 52.8 +/- 1.4 yrs, BMI 27.2 +/- 0.5 kg/m2). Weight, height, waist circumference and BMI were recorded in all patients. Also, total cholesterol, triglycerides, hemoglobin A1c (HbA1c) and 25-hydroxy-vitamin D [25(OH)D] levels were measured in all. According to 25(OH)D level, all subjects were divided into three categories: severe vitamin D deficiency (< or = 15 ng/mL), vitamin D insufficiency (15-20 ng/mL) and vitamin D sufficiency (?20 ng/mL). We correlated vitamin D levels with anthropometric and metabolic status and determined the predictors of vitamin D deficiency.
  
  
  RESULTS
  Severe vitamin D deficiency was registered in 16.1% healthy subjects, in 21.6% patients with T2DM and in 26.9% patients with T2DM and CVD. Patients with T2DM who were vitamin D deficient had increased weight, waist circumference, cholesterol and triglyceride levels when compared with patients with T2DM who had sufficient vitamin D level. 25(OH)D levels correlated with BMI and waist circumference in all subjects, but did not correlate with metabolic parameters (lipids, HbA1c). The best predictors of vitamin D level in all subjects were weight, waist circumference and BMI.
  
  
  CONCLUSIONS
  The high prevalence of vitamin D deficiency in patients with T2DM and particularly in patients with T2DM and CVD suggests that supplementation with vitamin D may be beneficial although there is still not sufficient evidence for recommending prescribing vitamin D.
authors.affiliation: Clinic of Internal Medicine, Clinical Center Montenegro, Podgorica, Montenegro. skavaric@t-com.me
authors.forename: Sreten
authors.initials: S
authors.lastname: Kavarić
authors.forename: Milica
authors.initials: M
authors.lastname: Vuksanović
authors.forename: Dragica
authors.initials: D
authors.lastname: Bozović
authors.forename: Marko
authors.initials: M
authors.lastname: Jovanović
authors.forename: Veljko
authors.initials: V
authors.lastname: Jeremić
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojicić
authors.forename: Sandra
authors.initials: S
authors.lastname: Pekić
authors.forename: Vera
authors.initials: V
authors.lastname: Popović
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008050:Lipid A / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis; D055105:Waist Circumference
chemical_list: D006442:Glycated Hemoglobin; D008050:Lipid A