title: Vitamin D, carotid intima-media thickness and bone structure in patients with type 2 diabetes.
abstract: Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima-media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required.
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Karoline.winckler.01@regionh.dk.
authors.forename: Karoline
authors.initials: K
authors.lastname: Winckler
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Lundby-Christensen
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Almdal
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Wiinberg
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Eiken
authors.affiliation: Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Trine W
authors.initials: TW
authors.lastname: Boesgaard
keywords: 25-hydroxyvitamin D; bone structure; cardiovascular disease and type 2 diabetes; carotid intima–media thickness