Vitamin D Status and its Correlation with Section Carotid Intima-media Thickness amongst Type 2 Diabetes Mellitus Patients: A Hospital-based Cross-sectional Study

Abstract

Introduction: There is rising concern about vitamin D deficiency around the globe due to its increasing association with multiple medical disorders. Diabetes Mellitus (DM) is an established risk factor for atherosclerotic disorders, and Carotid Artery IntimaMedia Thickness (CIMT) is considered a radiological marker of subclinical atherosclerosis. Aim: To find a correlation between serum 25-hydroxy vitamin D (25-(OH)-D) levels and CIMT among patients with DM. Materials and Methods: A hospital-based cross-sectional study was conducted, including 100 adult patients with Type 2 DM who were admitted to the Department of Medicine at SCB Medical College and Hospital in Cuttack, Odisha, India from October 2020 to September 2021. Vitamin D deficiency was defined as serum 25-(OH)-D levels <20 ng/mL, and insufficiency as <30 ng/mL. The demographic profile of patients, family history of Type 2 DM, smoking history, blood pressure, haemogram, blood sugar, serum electrolytes, and lipid profile were studied. CIMT of the bilateral Common Carotid Artery (CCA) was measured by B-mode ultrasonography. CIMT values ≥ 0.8 mm were considered abnormal. Data were analysed using appropriate statistical tests in Statistical Packages for Social Sciences (SPSS) version 26.0. Results: The present study included 55% males (n=55) and 45% females (n=45). The average age of the patients was 60 ±10 years, ranging from 26-75 years. Vitamin D deficiency was highly prevalent among patients with Type 2 DM (73% deficient, 12.5 ng/mL; 21% insufficient, 24.7 ng/mL). Vitamin D deficiency/ insufficiency was higher among male participants (57.5%, 62%) compared to females (42.4%, 38%). Vitamin D levels were significantly associated with dyslipidemia. Mean CIMT among the vitamin D deficiency versus insufficiency versus normal group were 0.87 versus 0.87 versus 0.7 mm on the right Common Carotid Artery (CCA), and 0.95 versus 0.86 versus 0.75 mm on the left CCA, respectively. Significant negative correlations were observed for HbA1c (r=-0.025), Triglycerides (r=-0.274), right CIMT (r=-0.284), and left CIMT (r=-0.264) with serum 25-(OH)-D levels. Conclusion: The majority of patients with Type 2 DM have concurrent vitamin D deficiency. A significant inverse linear association between serum vitamin D levels and CIMT was observed, indicating the association of vitamin D deficiency with subclinical atherosclerosis. Although unproven in the present study, the role of vitamin D supplementation in the improvement of atherosclerosis remains unclear.

Keywords

• atherogenesis
• cholecalciferol
• dyslipidemia
• prevalence
• ultrasonography