Hypovitaminosis D: a novel risk factor for coronary heart disease in type 2 diabetes?
Vitamin D (25(OH)D) levels have been associated with cardiovascular disease. Thus, the aim of our study was to investigate the association of 25(OH)D levels with coronary heart disease (CHD) in 698 consecutive type 2 diabetic outpatients. 698 consecutive type 2 diabetic outpatients (25.2 % men, age 66 ± 9 years) and 100 (90 % men, age 65 ± 13 years) age-matched non-diabetic volunteers were enrolled. 25(OH)D assay and the main cardiovascular risk factors were explored. 25(OH)D concentration was 22 ± 10 ng/ml in control subjects and 18.23 ± 10 ng/ml in diabetic patients (p < 0.01). The prevalence of hypovitaminosis D was higher in diabetic patients than in control subjects (90 vs. 83 %, p < 0.01). Diabetic subjects with hypovitaminosis D had higher prevalence of high values of A1C (p < 0.01), BMI (p < 0.01), LDL cholesterol (p < 0.01), triglycerides (p < 0.01), and glycemia (p < 0.01) than their vitamin D-sufficient counterparts. 25(OH)D and HDL cholesterol were lower (p < 0.01), while BMI (p < 0.01), age (p < 0.01), systolic (p < 0.01) and diastolic blood pressure (p < 0.01), diabetes duration (p < 0.01), A1C (p < 0.01), glycemia (p < 0.01), fibrinogen (p < 0.01), triglycerides (p < 0.01), and total (p < 0.01) and LDL cholesterol (p < 0.01) were higher in diabetic subjects with CHD than diabetic subjects without CHD. At the logistic regression analysis, the association of vitamin D with CHD was lost, while sex (p = 0.026), diabetes duration (p = 0.023), and age (p = 0.024) were the most powerful predictors of CHD. The current study demonstrates that 25(OH)D does not have a direct effect on CHD but may have an indirect effect mediated by cardiovascular risk factors such as diabetes duration, age, and sex.
Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy. giovanna.muscogiuri@gmail.com.
Giovanna
G
Muscogiuri
Internal Medicine Unit, San Gennaro Hospital, Naples, Italy.
Vincenzo
V
Nuzzo
Diabetology Unit, San Gennaro Hospital, Naples, Italy.
Adriano
A
Gatti
Internal Medicine Unit, San Gennaro Hospital, Naples, Italy.
Alfonso
A
Zuccoli
Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy.
Silvia
S
Savastano
IRCCS SDN, Naples, Italy.
Carolina
C
Di Somma
Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy.
Rosario
R
Pivonello
Department of Endocrinology, University "Parthenope" Naples, Naples, Italy.|Endocrinology of Fertile Age, "S. Giovanni di Dio e Ruggi d'Aragona" University Hospital Salerno, Salerno, Italy.
Francesco
F
Orio
Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy.
Annamaria
A
Colao
D000368:Aged; D001786:Blood Glucose; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
D001786:Blood Glucose; D008078:Cholesterol, LDL; D014280:Triglycerides; D014807:Vitamin D; C104450:25-hydroxyvitamin D
Cardiovascular disease; Coronary heart disease; Hypovitaminosis D; Obesity; Type 2 diabetes; Vitamin D