Endocrinology, Diabetes & Metabolism (Nov 2023)

Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients

  • Yomna E. Dean,
  • Sameh Samir Elawady,
  • Wangpan Shi,
  • Ahmed A. Salem,
  • Arinnan Chotwatanapong,
  • Haya Ashraf,
  • Tharun Reddi,
  • Prashant Obed Reddy Dundi,
  • Waleed Yasser Habash,
  • Mohamed Yasser Habash,
  • Safaa Ahmed,
  • Hana M. Samir,
  • Ahmed Elsayed,
  • Aryan Arora,
  • Abhinav Arora,
  • Abdelrahman Elsayed,
  • Tamer Mady,
  • Yousef Tanas,
  • Yusef Hazimeh,
  • Mohamed Alazmy,
  • Hani Aiash

DOI
https://doi.org/10.1002/edm2.453
Journal volume & issue
Vol. 6, no. 6
pp. n/a – n/a

Abstract

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Abstract Background and Aim Low serum Vitamin D levels have been associated with diabetic nephropathy (DN). Our study aimed to analyse the serum levels of vitamin D in patients suffering from DN and the subsequent changes in serum vitamin D levels as the disease progresses. Methods PubMed, Embase, SCOPUS and Web of Science were searched using keywords such as ‘25 hydroxyvitamin D’ and ‘diabetic nephropathy’. We included observational studies that reported the association between the serum 25 hydroxy vitamin D levels and diabetic nephropathy without restriction to age, gender, and location. R Version 4.1.2 was used to perform the meta‐analysis. The continuous outcomes were represented as mean difference (MD) and standard deviation (SD) and dichotomous outcomes as risk ratios (RR) with their 95% confidence interval (CI). Results Twenty‐three studies were included in our analysis with 7722 patients. Our analysis revealed that vitamin D was significantly lower in diabetic patients with nephropathy than those without nephropathy (MD: −4.32, 95% CI: 7.91–0.74, p‐value = .0228). On comparing diabetic patients suffering from normoalbuminuria, microalbuminuria, or macroalbuminuria, we found a significant difference in serum vitamin D levels across different groups. Normoalbuminuria versus microalbuminuria showed a MD of −1.69 (95% CI: −2.28 to −1.10, p‐value = .0002), while microalbuminuria versus macroalbuminuria showed a MD of (3.75, 95% CI: 1.43–6.06, p‐value = .0058), proving that serum vitamin D levels keep declining as the disease progresses. Notwithstanding, we detected an insignificant association between Grade 4 and Grade 5 DN (MD: 2.29, 95% CI: −2.69–7.28, p‐value = .1862). Conclusion Serum Vitamin D levels are lower among DN patients and keep declining as the disease progresses, suggesting its potential benefit as a prognostic marker. However, on reaching the macroalbuminuria stage (Grades 4 and 5), vitamin D is no longer a discriminating factor.

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