title: The Association of Vitamin D Status and Vitamin D Replacement Therapy with Glycemic Control, Serum Uric Acid Levels, and Microalbuminuria in Patients with Type 2 Diabetes and Chronic Kidney Disease.
abstract: OBJECTIVE
  To evaluate the relationship of vitamin D status and vitamin D replacement therapy with glycemic control, serum uric acid (SUA) levels, and microalbuminuria (MAU) in patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD). Subjectsand Methods: A total of 1,463 patients with T2DM and CKD (aged 14-88 years), 927 females and 536 males, were included in this study. The serum data of 25-hydroxyvitamin D, i.e., 25(OH)D, level, SUA, hemoglobin (Hb)A1c, creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio (UACR) were obtained from the medical records. The Mann-Whitney U test, the χ2 test, the Mantel-Haenszel test, and linear regression models were used for data analysis.
  
  
  RESULTS
  Vitamin D deficiency and insufficiency were evident in 770 (52.0%) and 357 (24.0%) patients, respectively. Median HbA1c levels (7.3 [IQR 3.9] vs. 6.5 [IQR 2.3]%; p < 0.01) were significantly higher in patients deficient in vitamin D than in those with a normal vitamin D status. A significantly low level of vitamin D was noted with a high UACR (β -0.01; 95% CI -0.01 to -0.001; p = 0.017) and HbA1c (β -1.1; 95% CI -1.6 to -0.6; p < 0.001), but with low levels of SUA (β 1.3; 95% CI 0.5-2.2; p = 0.002). Vitamin D replacement was associated with a significantly low level of HbA1c (7.4 [2.7] vs. 6.7 [1.9]%; p < 0.001].
  
  
  CONCLUSIONS
  In this study, there was a high prevalence of hypovitaminosis D among T2DM patients with CKD, with a higher UACR, higher HbA1c, and lower SUA being noted as playing a role in predicting a decrease in vitamin D levels and potential benefits of vitamin D replacement therapy on glycemic control in T2DM management.
authors.affiliation: Division of Nephrology, Department of Internal Medicine Faculty of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Sipahi
authors.forename: Seyyid Bilal
authors.initials: SB
authors.lastname: Acikgoz
authors.forename: Ahmed Bilal
authors.initials: AB
authors.lastname: Genc
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yildirim
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Solak
authors.forename: Ali
authors.initials: A
authors.lastname: Tamer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine*; D001786:Blood Glucose / Q000502:physiology*; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D019587:Dietary Supplements; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology*; D014527:Uric Acid / Q000097:blood*; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin; D014527:Uric Acid; D014807:Vitamin D