Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON)

The effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified. Evaluate the relationship betwe...

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Published in:	Frontiers in endocrinology (Lausanne) Vol. 12; p. 723502
Main Authors:	Felício, João Soares, de Rider Britto, Hana Andrade, Cortez, Pedro Celeira, de Souza Resende, Fabrício, de Lemos, Manuela Nascimento, de Moraes, Lorena Vilhena, de Aquino, Vitória Teixeira, de Souza Parente, Fernanda, de Queiroz, Natércia Neves Marques, Abrahão Neto, João Felício, de Alcântara, Angélica Leite, da Silva, Wanderson Maia, de Souza Neto, Norberto Jorge Kzan, Freire Piani, Pedro Paulo, de Souza, Ícaro José Araújo, Silva, Lilian de Souza D'Albuquerque, de Oliveira, Maria Clara Neres Iunes, Said, Nivin Mazen, Nascimento de Lemos, Gabriela, de Melo, Franciane Trindade Cunha, Gomes, Daniela Lopes, Contente Braga de Souza, Ana Carolina, de Sá Oliveira Dos Reis, Melissa, Leal, Valéria Suênya Galvão, Lobato, Isabel Jane Campos, Felício, Karem Miléo
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 07-10-2021
Subjects:	Aged albuminuria Albuminuria - blood Albuminuria - epidemiology Albuminuria - etiology Brazil - epidemiology Cross-Sectional Studies diabetes Diabetes Mellitus - blood Diabetes Mellitus - epidemiology Diabetic Nephropathies - blood Diabetic Nephropathies - diagnosis Diabetic Nephropathies - epidemiology Diabetic Nephropathies - etiology Endocrinology epidemiology Female Glycated Hemoglobin A - metabolism Glycemic Control - statistics & numerical data HbA1c Humans Male Middle Aged Risk Factors vitamin D Vitamin D - analogs & derivatives Vitamin D - blood Vitamin D Deficiency - blood Vitamin D Deficiency - complications Vitamin D Deficiency - epidemiology Brazil albuminuria epidemiology HbA1c diabetes vitamin D endocrinology
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Summary:	The effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified. Evaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM). Cross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function. Patients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 - 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently. Our study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 This article was submitted to Systems Endocrinology, a section of the journal Frontiers in Endocrinology Reviewed by: Daniela Patrizia Foti, University of Catanzaro, Italy; Eusebio Chiefari, University Magna Graecia of Catanzaro, Italy Edited by: Marcus M. Seldin, University of California, Irvine, United States
ISSN:	1664-2392 1664-2392
DOI:	10.3389/fendo.2021.723502