Dong-mei Li1, Ying Zhang2, Qian Li2, Xiao-hua Xu2, Bo Ding2, Jian-hua Ma3. 1. Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China. Electronic address: lidongmeiamy@126.com. 2. Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China. 3. Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China. Electronic address: majianhua@china.com.
Abstract
BACKGROUND AND AIMS: 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.
BACKGROUND AND AIMS: 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 diabetespatients. 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 diabetespatients. METHODS: A total of 1028 type 2 diabetespatients 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 diabetespatients <65 years of age. It may increase the risk of PAD independent of other known cardiovascular risk factors.
Authors: Hugh Tunstall-Pedoe; Sanne A E Peters; Mark Woodward; Allan D Struthers; Jill J F Belch Journal: J Am Heart Assoc Date: 2017-09-18 Impact factor: 5.501
Authors: Mengxue Yang; Jun Liu; Xue Zhou; Heyuan Ding; Jie Xu; Bo Yang; Bowen Sun; Dandan Xiao; Jie Yu; Qihai Gong Journal: J Diabetes Res Date: 2019-11-28 Impact factor: 4.011