Cited by 84Vitamin D Research StudiesFolate and B Vitamins ResearchChronic Kidney Disease and Diabetes

Vitamin D Status, Vitamin D Receptor Polymorphisms, and Risk of Microvascular Complications Among Individuals With Type 2 Diabetes: A Prospective Study

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Chen, Xue, Wan, Zhenzhen, Geng, Tingting, Zhu, Kai, Li, Rui, Lu, Qi, Lin, Xiaoyu, Liu, Sen +7 more·2023·Diabetes Care

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Abstract

OBJECTIVE: Evidence is limited regarding the associations between vitamin D status and microvascular complications in individuals with type 2 diabetes (T2D), among whom vitamin D deficiency or insufficiency is particularly common. In this study we aimed to prospectively investigate the associations of serum 25-hydroxyvitamin D [25(OH)D] and vitamin D receptor (VDR) polymorphisms with risk of diabetic microvascular complications. RESEARCH DESIGN AND METHODS: This analysis included 14,709 participants with T2D who were free of microvascular complications from the UK Biobank. Incidence of diabetic microvascular complications was ascertained via electronic health records. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: Median serum 25(OH)D concentration was 40.7 nmol/L (interquartile range 27.5, 56.4). During a median of 11.2 years of follow-up, 1,370 people developed diabetic microvascular complications. Compared with participants with 25(OH)D <25 nmol/L, individuals with 25(OH)D ≥75 nmol/L had a multivariable-adjusted HR of 0.65 (95% CI 0.51, 0.84) for composite diabetic microvascular complications, 0.62 (0.40, 0.95) for diabetic retinopathy, 0.56 (0.40, 0.79) for diabetic nephropathy, and 0.48 (0.26, 0.89) for diabetic neuropathy. In addition, in comparisons with participants with 25(OH)D <25 nmol/L and minor allele homozygotes (TT of rs1544410 and GG of rs731236), the multivariable-adjusted HRs of composite diabetic microvascular complications were 0.54 (0.38, 0.78) and 0.55 (0.38, 0.80) for participants with serum 25(OH)D ≥50 nmol/L and major allele homozygotes (CC and AA), respectively, although no significant interaction was observed. CONCLUSIONS: Higher serum 25(OH)D concentrations were significantly associated with lower risk of diabetic microvascular complications, including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. Our findings suggest a potential beneficial role of maintaining adequate vitamin D status in the prevention of diabetic microvascular complications.

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Authors
Chen, X., Wan, Z., Geng, T., Zhu, K., Li, R., Lu, Q., Lin, X., Liu, S., Chen, L., Guo, Y., Shan, Z., Liu, L., Pan, A., Manson, J. E., & Liu, G.
Affiliations
  • Huazhong University of Science and Technology (CN)
  • Brigham and Women's Hospital (US)
Corresponding author
Liu, Gang
Venue
Diabetes Care
Published
2022-09-28
Volume
46
Issue
2
Pages
270-277
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W4297460859
Cited by
84
References
38
Citations by year
2026: 23 · 2025: 32 · 2024: 21 · 2023: 8
FWCI
10.37
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Research Funds for the Central Universities (2021GCRC075, 2021GCRC076)
  • National Nature Science Foundation of China (2021CFA048, 81930124, 82021005, 82073554)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
  • Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
vitamin D status, 25-hydroxyvitamin D, VDR polymorphisms, type 2 diabetes, diabetic microvascular complications, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, rs1544410, rs731236, vitamin D deficiency, genetic susceptibility, vitamin D supplementation, UK Biobank, electronic health records
MeSH terms
Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Neuropathies, Diabetic Retinopathy, Humans, Prospective Studies, Risk Factors, Vitamin D, Vitamin D Deficiency, Vitamins, Receptors, Calcitriol

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