Frontiers in Endocrinology (Oct 2021)

Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON)

  • João Soares Felício,
  • Hana Andrade de Rider Britto,
  • Pedro Celeira Cortez,
  • Fabrício de Souza Resende,
  • Manuela Nascimento de Lemos,
  • Lorena Vilhena de Moraes,
  • Vitória Teixeira de Aquino,
  • Fernanda de Souza Parente,
  • Natércia Neves Marques de Queiroz,
  • João Felício Abrahão Neto,
  • Angélica Leite de Alcântara,
  • Wanderson Maia da Silva,
  • Norberto Jorge Kzan de Souza Neto,
  • Pedro Paulo Freire Piani,
  • Ícaro José Araújo de Souza,
  • Lilian de Souza D’Albuquerque Silva,
  • Maria Clara Neres Iunes de Oliveira,
  • Nivin Mazen Said,
  • Gabriela Nascimento de Lemos,
  • Franciane Trindade Cunha de Melo,
  • Daniela Lopes Gomes,
  • Ana Carolina Contente Braga de Souza,
  • Melissa de Sá Oliveira dos Reis,
  • Valéria Suênya Galvão Leal,
  • Isabel Jane Campos Lobato,
  • Karem Miléo Felício

DOI
https://doi.org/10.3389/fendo.2021.723502
Journal volume & issue
Vol. 12

Abstract

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BackgroundThe effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified.ObjectiveEvaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM).Patients and MethodsCross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function.ResultsPatients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 – 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently.ConclusionOur study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.

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