Vitamin D and Diabetic Retinopathy in Indian adults with Type 2 Diabetes Mellitus

  • Dr. Dinesh R B. Assistant Professor, Department of Vitreo Retina and Diabetology, Karnataka Institute of Endocrinology and Research (Autonomous Institute of Dept of Medical Education, Govt of Karnataka), SJICR Campus, Jayanagar 9th block, Bangalore, India
  • Dr. Anil Kumar. R Assistant Professor, Department of Vitreo Retina and Diabetology, Karnataka Institute of Endocrinology and Research (Autonomous Institute of Dept of Medical Education, Govt of Karnataka), SJICR Campus, Jayanagar 9th block, Bangalore, India
Keywords: Vitamin D levels, HbA1C, Diabetic retinopathy, Duration of DM

Abstract

Objective: To find an association with Vitamin D levels and Diabetic retinopathy (DR).

Methods: In a prospective clinical study, 412 Type 2 DM patients were evaluated for their ophthalmic findings. All patients underwent complete ophthalmic examination including detailed history, best corrected visual acuity, slit lamp examination, indirect ophthalmoloscopy and +90D lens biomicroscopy. All relevant blood investigation for evaluation of glycemic status including Vitamin D was done on first presentation.

Results: Among the 412 patients that were examined, thepercentage of patients with HbA1C <6.4 was 15%, 6.5- 8.0 was 31% and >8.0 was 54%. Among 222 patients with >5 years duration of DM, 95(43%) had HbA1C >8.0. Among 96 patients with 5-10 years duration of DM, 67 (70%) had HbA1C .8.0. Among 94 patients with>10 years duration of DM, 59(63%) had HbA1C >8.0, with a significant P value of <0.001. Among 412 patients, 7% had vitamin D levels >30, 13% had levels between 20-30 and 80% had <20. A significant P value of <0.001 was seen with respect to association of DR with HbA1C levels.

Conclusions: Type 2 DM patients with retinopathy were found to have significant vitamin D deficiency as compared to those without retinopathy.

Downloads

Download data is not yet available.

References

Nuria Alcubierre, Joan Valls, Esther Rubinat, Gonzalo Cao, Aureli Esquerda, Alicia Traveset, Minerva Granado- Casas, Carmen Jurjo, and Didac Mauricio1.Vitamin D Deficiency Is Associated with the Presence and Severity of Diabetic Retinopathy in Type 2 Diabetes Mellitus Journal of Diabetes Research Volume 2015, Article ID 374178, 7 pages. doi: http://dx.doi.org/10.1155/2015/374178.

Fang Liang1, Kuixiang Wang, Hongxia Zhang, Jian Zhang, XinshengNie, Zhanxiu Zhang, Zhenfeng Shi. Serum 25-hydroxyvitamin D levels and diabetic retinopathy: a systematic meta-analysisInt J ClinExpPathol 2016; 9 (12):12843-12848. http://www.ijcep.com/ISSN:1936-2625/IJCEP0036602.

Robinson JG, Manson JE, Larson J, Liu S, Song Y, Howard BV, Phillips L, Shikany JM, Allison M, Curb JD, Johnson KC, Watts N. Lack of association between 25(OH) D levels and incident type 2 diabetes in older women. Diabetes Care 2011 Mar;34(3):628-34. doi: https://doi.org/10.2337/dc10-1632. Epub 2011 Feb 2.

Suzuki A, Kotake M, Ono Y, Kato T, Oda N, Hayakawa N, Hashimoto S, Itoh M. Hypovitaminosis D in type 2 diabetes mellitus: Association with microvascular complications and type of treatment. Endocr J2006 Aug; 53 (4):503-10. Epub 2006 Jul 10.

Zhong X, Du Y, Lei Y, Liu N, Guo Y, Pan T. Effects of vitamin D receptor gene polymorphism and clinical characteristics on risk of diabetic retinopathy in Han Chinese type 2 diabetes patients. Gene 2015 Jul 25; 566(2): 212-6. doi: https://doi.org/10.1016/j.gene.2015.04.045. Epub 2015 Apr 18.

Liu Z, Liu L, Chen X, He W, Yu X. Associations study of vitamin D receptor gene polymorphisms with diabetic microvascular complications: a meta-analysis. Gene 2014 Aug 1;546(1):6-10. doi: https://doi.org/10.1016/j.gene.2014.05.052. Epub 2014 May 24.

Ouchi M, West K, Crabb JW, Kinoshita S, Kamei M. Proteomic analysis of vitreous from diabetic macular edema. Exp Eye Res 2005 Aug;81(2):176-82.

Patrick PA, Visintainer PF, Shi Q, et al. Vitamin D and retinopathy inadults with diabetes mellitus. Arch Ophthalmol 2012 Jun;130(6):756-60. doi: https://doi.org/10.1001/archophthalmol.2011.2749.

Aksoy H, Akçay F, Kurtul N, et al. Serum 1,25 dihydroxy-vitamin D(1,25(OH)2D3), 25 hydroxy-vitamin D (25(OH)D) and parathormonelevelsin diabetic retinopathy. ClinBiochem2000 Feb;33(1):47-51.

Diaz VA, Mainous AG, Carek PJ, et al. The association of vitamin Ddeficiency and insufficiency with diabetic nephropathy: implicationsfor health disparities. J Am Board Fam 2009 Sep-Oct;22(5):521-7. doi: https://doi.org/10.3122/jabfm.2009.05.080231.

Chandoshi Mukherjee. et al. Does Vitamin D Deficiency Affect Diabetic Retinopathy?: A Primary Care Survey and Literature Review. EC Ophthalmology 4.1 (2016): 451-458.

Mathieu,C.Gysemans,C, Giulietti,A, Bouillon,R.VitaminDanddiabetes. Diabetologia 2006 Jan;49(1):217-8. Epub 2005 Dec 13. DOI: https://doi.org/10.1007/s00125-005-0047-9.

The Association between Vitamin D Deficiency and Diabetic Retinopathy in Type 2 Diabetes: A Meta-Analysis of Observational StudiesBang-An Luo , Fan Gao and Lu-Lu Qin .Nutrients 2017 Mar; 9(3): 307. doi: https://doi.org/10.3390/nu9030307.

A. Suzuki., et al. Hypovitaminosis D in type 2 diabetes mellitus: association with microvascular complications and type of treatment.Endocrine Journal2006 Aug;53(4):503-10. Epub 2006 Jul 10.

H. Ahmadieh., et al. Hypovitaminosis D in patients with type 2 diabetes mellitus: a relation to disease control and complications. International scholarly research Notices-Endocrinology ISRN Endocrinology Volume 2013. doi: http://dx.doi.org/10.1155/2013/641098.

Robinson JG, Manson JE, Larson J, Liu S, Song Y, Howard BV, Phillips L, Shikany JM, Allison M, Curb JD, Johnson KC, Watts N. Lack of association between 25(OH) D levels and incident type 2 diabetes in older women. Diabetes Care 2011 Mar;34(3):628-34. doi: 10.2337/dc10-1632. Epub 2011 Feb 2.

R. He., et al. Vitamin D deficiency increases the risk of retinopathy in Chinese patients with Type 2 diabetes. Diabetic Medicine2014 Dec;31(12):1657-64. doi: https://doi.org/10.1111/dme.12581. Epub 2014 Oct 10.

A. Gungor. et al. Retinal Nerve Fiber Layer Thickness in Early-Stage Diabetic Retinopathy with Vitamin D Deficiency”. InvestigativeOphthalmology & Visual Science56(11):6433-6437. doi: https://doi.org/10.1167/iovs.15-16872.

Vitamin D and Diabetic Retinopathy in Indian adults with Type 2 Diabetes Mellitus
CITATION
DOI: 10.17511/ijmrr.2018.i04.04
Published: 2018-04-30
How to Cite
1.
R B. D, Kumar. R A. Vitamin D and Diabetic Retinopathy in Indian adults with Type 2 Diabetes Mellitus. Int J Med Res Rev [Internet]. 2018Apr.30 [cited 2024Dec.23];6(4):221-7. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/981
Section
Original Article