Monday, May 09, 2011

Severe Vitamin D Deficiency Tied to Mortality in Diabetes

Vitamin D is not associated with microvascular complications in patients with type 1 diabetes

09 may 2011-- Severe vitamin D deficiency may be predictive of increased all-cause mortality in patients with type 1 diabetes, but it is not associated with microvascular complications in the kidney or eye, according to a study published online April 27 in Diabetes Care.

Christel Joergensen, M.D., from the Steno Diabetes Center in Gentofte, Denmark, and colleagues assessed the role of vitamin D as a predictor for all-cause mortality, and the development of microvascular complications in the kidney and eye in 220 patients with newly diagnosed type 1 diabetes. Plasma vitamin D levels were determined using high-performance liquid chromatography/tandem mass spectrometry before patients developed microalbuminuria. Severe vitamin D deficiency was considered equal to or below the 10th percentile (15.5 mmol/L).

The investigators found that 44 patients died during a 26-year median follow-up period. After adjusting for confounders, the hazard ratio for all-cause mortality in individuals with severe vitamin D deficiency was 2.7. Eighty-one patients (37 percent) developed microalbuminuria, and 27 (12 percent) of these progressed to macroalbuminuria. Background retinopathy developed in 192 patients (87 percent), and progression to proliferative retinopathy was seen in 34 individuals (15 percent). The presence of severe vitamin D deficiency at baseline did not predict the development of retinopathy or the progression from normoalbuminuria to micro- or macroalbuminuria.

"In patients with type 1 diabetes, severe vitamin D deficiency independently predicts all-cause mortality but not the development of microvascular complications in the eye and kidney," the authors write.

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