Vitamin D Deficiency and Microalbuminuria in Patients with Diabetes Mellitus

Abstract

Aim: As diabetes mellitus and its complications become more prevalent in the world, it is becoming an important public health problem. Previous studies have investigated vitamin D in the context of diabetes mellitus and its complications.. Microalbuminuria is important as the initial level of diabetic nephropathy. In this context, we aimed to investigate the level and deficiency of vitamin D in diabetic patients with microalbuminuria. Material and Methods: 52 type 1 (20.1%) and 206 (79.9%) type 2 diabetes patients who applied to the outpatient Endocrinology and Metabolic Diseases clinic between April 2019 and December 2020 were included in the study. Patients were classified according to microalbuminuria. Fasting glucose, HbA1c, duration of diabetes, and 25 (OH) Vitamin D levels and mean waist circumference were compared between the groups. Finally, the groups were compared according to diabetes type and microalbuminuria. Results: Urinary albumin/creatinine rates (UAC) in 159 (42.7%) diabetic patients were in normal range, and 65 (17.5%) diabetics had UAC between 30-300 mcg. 12 (3.2%) had UAC >300 mcg. 22 (5.9%) had chronic renal failure. Vitamin D deficiency was 61.6% and vitamin D insufficiency was 28.6% in all study groups. Median GFR was 98 (38-136) ml/dk and median 25 (OH) D level was 17.1 (5.0- 44.2)mg/dl. 25 (OH) Vitamin D levels and GFR were found to be significantly lower in the microalbuminuria group (p<0.01). 25 (OH) D levels were found to be low in both type 1 and type 2 diabetes patients with the complication of microalbuminuria, however only in type 1 diabetes patients low vitamin D this was found significant (p=0.01) Conclusion: 25 (OH) vitamin D deficiency and insufficiency were found to be more common in patients with diabetes. with microalbuminuria, which was more significant in type 1 diabetes patients The underlying mechanisms and potential therapeutic effect of vitamin D should be further investigated.

Keywords

• Diabetes
• Microalbuminuria
• Vitamin D

Diabetes Mellituslu Hastalarda Mikroalbuminüri ve D Vitamini

Abstract

Amaç: Dünyada giderek artan sıklığı ile diyabet, komplikasyonları yolu ile önemli bir halk sağlığı sorunu olarak karşımıza çıkmaktadır. Önceki çalışmalar vitamin D için hem diyabet hem de komplikasyonları ile ilişkili olarak değerlendirmiştir. Mikroalbuminüri diyabetik nefropatinin başlangıç düzeyi olarak önem arz etmektedir. Bu bağlamda mikroalbuminürisi olan diyabetik hastalarda D vitamini düzeyini ve eksikliğini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya Nisan 2019 ve Aralık 2020 tarihleri arasında Endokrinoloji ve Metabolizma Hastalıkları polikliniğine başvuran 52 tip 1 (%20,1) ve 206 (%79,9) tip 2 diyabet hastası dahil edildi. Hastalar mikroalbüminüriye göre sınıflandırıldı. Açlık glikozu, HbA1c, diyabet süresi, 25 (OH) Vitamin D düzeyleri ve ortalama bel çevresi gruplar arasında karşılaştırıldı. Son olarak gruplar diyabet tipi ve mikroalbüminüriye göre karşılaştırıldı. Bulgular: 159 (%42,7) hastada normal idrar albümin / kreatinin oranı (UAC) vardı. 65 (%17,5) hastada 30-300 mcg arasında UAC vardı. 12 (%3,2) UAC> 300 mcg'ye sahipti. 22'sinde (%5,9) kronik böbrek yetmezliği vardı. Tüm çalışma gruplarında D vitamini eksikliği %61,6, D vitamini yetmezliği %28.6 olarak bulundu. Mikroalbüminüri grubunda ortanca GFR 98 (38-136) ml/dk)idi ve ortanca 25 (OH) D düzeyi 17.1 (5,0-44,2)mg/dl idi. GFR ve 25 (OH) D düzeyleri anlamlı olarak düşük bulundu (p<0,01). 25 (OH) D seviyeleri hem tip 1 hem de tip 2 diyabet hastalarında düşük saptandı. Ancak bu düşüklük sadece tip 1 diyabet hastaları için anlamlı bulundu. (p=0,01) Sonuç: 25 (OH) D vitamini eksikliği ve yetersizliği, özellikle tip 1 diyabette daha belirgin olmak üzere diyabet ve mikroalbüminürili hastalarda daha yaygın olarak saptandı. Komplikasyonların gelişmesinde D vitamininin diyabet tiplerine göre etki mekanizması ve potansiyel terapötik etkisi daha kapsamlı bir şekilde araştırılmalıdır

Keywords

• diyabet
• mikroalbuminüri
• d vitamini

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