Serum 25-hydroxyvitamin D: a predictor of macrovascular and microvascular complications in patients with type 2 diabetes
Herrmann M, Sullivan DR, Veillard AS, McCorquodale T, Straub IR, Scott R, Laakso M, Topliss D, Jenkins AJ, Blankenberg S, Burton A, Keech AC, FIELD Study Investigators
Diabetes care · 115 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2014-12-18 · Diabetes Care · vol. 38 · número 3 · págs. 521–528
- Editorial
- American Diabetes Association
- Citado
- 173 citas · más que el 99% de estudios similares · 10.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 47 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Diabetes, Cardiovascular Risks, and Lipoproteins · Folate and B Vitamins Research
- Palabras clave
- 25-hydroxyvitamin D, vitamin D deficiency, type 2 diabetes, macrovascular complications, microvascular complications, cardiovascular risk, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, amputation, myocardial infarction, stroke, fenofibrate, cardiovascular risk prediction
- MeSH
- humans, myocardial infarction, diabetic angiopathies, diabetes mellitus, type 2, vitamin d deficiency, vitamin d, prognosis, incidence, logistic models, risk, aged, middle aged, female, male, stroke
12 autores
- Markus Herrmann🇦🇺Royal Prince Alfred Hospital
- DAVID R. SULLIVAN🇦🇺Royal Prince Alfred Hospital
- Anne-Sophie Veillard🇦🇺The University of Sydney; National Health and Medical Research Council
- Thomas McCorquodale🇦🇺Royal Prince Alfred Hospital
- Isabella R. Straub🇦🇺Royal Prince Alfred Hospital
- Russell S. Scott🇳🇿Christchurch Hospital
- Markku Laakso🇫🇮University of Eastern Finland; Kuopio University Hospital
- Duncan J. Topliss🇦🇺Monash University
- Alicia Josephine Jenkins🇦🇺The University of Sydney; National Health and Medical Research Council
- Stefan Blankenberg
- Anthony Burton🇦🇺Flinders Medical Centre
- ANTHONY C. KEECH🇦🇺 · autor de correspondenciaThe University of Sydney; National Health and Medical Research Council
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
People with diabetes frequently develop vascular disease. We investigated the relationship between blood 25-hydroxyvitamin D (25OH-D) concentration and vascular disease risk in type 2 diabetes.
Research design and methods
The relationships between blood 25OH-D concentration at baseline and the incidence of macrovascular (including myocardial infarction and stroke) and microvascular (retinopathy, nephropathy, neuropathy, and amputation) disease were analyzed with Cox proportional hazards models and logistic regression in an observational study of patients in the 5-year Fenofibrate Intervention and Event Lowering in Diabetes trial.
Results
A total of 50% of the patients had low vitamin D concentrations, as indicated by median blood 25OH-D concentration of 49 nmol/L. These patients with a blood 25OH-D concentration <50 nmol/L had a higher cumulative incidence of macrovascular and microvascular events than those with levels ≥50 nmol/L. Multivariate analysis, stratified by treatment and adjusted for relevant confounders, identified blood 25OH-D concentration as an independent predictor of macrovascular events. A 50 nmol/L difference in blood 25OH-D concentration was associated with a 23% (P = 0.007) change in risk of macrovascular complications during the study, and further adjustments for seasonality, hs-CRP, and physical activity level had little impact. The unadjusted risk of microvascular complications was 18% (P = 0.006) higher during the study, though the excess risk declined to 11-14% and lost significance with adjustment for HbA1c, seasonality, or physical activity.
Conclusions
Low blood 25OH-D concentrations are associated with an increased risk of macrovascular and microvascular disease events in type 2 diabetes. However, a causal link remains to be demonstrated.
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