title: Low 25-Hydroxyvitamin D Level Is Associated with Peripheral Arterial Disease in Type 2 Diabetes Patients.
abstract: OBJECTIVE
  Patients with type 2 diabetes have an increased risk of atherosclerosis and vascular disease. Vitamin D deficiency is associated with vascular disease and is prevalent in diabetes patients. We undertook this study to determine the association between 25-hydroxyvitamin D (25[OH]D) levels and prevalence of peripheral arterial disease (PAD) in type 2 diabetes patients.
  
  
  METHODS
  A total of 1028 type 2 diabetes patients were recruited at Nanjing Medical University Affiliated Nanjing Hospital from November 2011 to October 2013. PAD was defined as an ankle-brachial index (ABI) < 0.9. Cardiovascular risk factors (blood pressure, HbA1c, lipid profile), comorbidities, carotid intima-media thickness (IMT) and 25(OH)D were assessed.
  
  
  RESULTS
  Overall prevalence of PAD and of decreased 25(OH)D (<30 ng/mL) were 20.1% (207/1028) and 54.6% (561/1028), respectively. PAD prevalence was higher in participants with decreased (23.9%) than in those with normal (15.6%) 25(OH)D (≥30 ng/mL, p <0.01). Decreased 25(OH)D was associated with increased risk of PAD (odds ratio [OR], 1.69, 95% CI: 1.17-2.44, p <0.001) and PAD was significantly more likely to occur in participants ≥65 years of age (OR, 2.56, 95% CI: 1.51 -4.48, vs. 1.21, 95% CI: 0.80-1.83, p-interaction = 0.027). After adjusting for known cardiovascular risk factors and potential confounding variables, the association of decreased 25(OH)D and PAD remained significant in patients <65 years of age (OR, 1.55; 95% CI: 1.14-2.12, p = 0.006).
  
  
  CONCLUSIONS
  Low serum 25(OH)D levels were significantly associated with a higher prevalence of PAD in type 2 diabetes patients <65 years of age. It may increase the risk of PAD independent of other known cardiovascular risk factors.
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China. Electronic address: lidongmeiamy@126.com.
authors: Dong-mei
authors: DM
authors: Li
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
authors: Ying
authors: Y
authors: Zhang
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
authors: Qian
authors: Q
authors: Li
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
authors: Xiao-hua
authors: XH
authors: Xu
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
authors: Bo
authors: B
authors: Ding
authors: Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China. Electronic address: majianhua@china.com.
authors: Jian-hua
authors: JH
authors: Ma
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000453:epidemiology; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D006442:Glycated Hemoglobin; D014807:Vitamin D; C517652:hemoglobin A1c protein, human; C104450:25-hydroxyvitamin D
keywords: 25-Hydroxyvitamin D; Atherosclerosis; Peripheral arterial disease; Type 2 diabetes