Frontiers in Endocrinology (Mar 2024)

Association of vitamin D deficiency and subclinical diabetic peripheral neuropathy in type 2 diabetes patients

  • Xiaoyang Sun,
  • Xiaoyang Sun,
  • Xinyu Yang,
  • Xinyu Yang,
  • Xiaopeng Zhu,
  • Xiaopeng Zhu,
  • Yu Ma,
  • Xu Li,
  • Yuying Zhang,
  • Yuying Zhang,
  • Qiling Liu,
  • Qiling Liu,
  • Chenmin Fan,
  • Chenmin Fan,
  • Miao Zhang,
  • Miao Zhang,
  • Binger Xu,
  • Binger Xu,
  • Yanlan Xu,
  • Yanlan Xu,
  • Yanlan Xu,
  • Xin Gao,
  • Xin Gao,
  • Jihong Dong,
  • Mingfeng Xia,
  • Mingfeng Xia,
  • Hua Bian,
  • Hua Bian

DOI
https://doi.org/10.3389/fendo.2024.1354511
Journal volume & issue
Vol. 15

Abstract

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BackgroundDiabetic peripheral neuropathy (DPN) contributes to disability and imposes heavy burdens, while subclinical DPN is lack of attention so far. We aimed to investigate the relationship between vitamin D and distinct subtypes of subclinical DPN in type 2 diabetes (T2DM) patients.MethodsThis cross-sectional study included 3629 T2DM inpatients who undertook nerve conduction study to detect subclinical DPN in Zhongshan Hospital between March 2012 and December 2019. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25(OH)D) level < 50 nmol/L.Results1620 (44.6%) patients had subclinical DPN and they were further divided into subgroups: distal symmetric polyneuropathy (DSPN) (n=685), mononeuropathy (n=679) and radiculopathy (n=256). Compared with non-DPN, DPN group had significantly lower level of 25(OH)D (P < 0.05). In DPN subtypes, only DSPN patients had significantly lower levels of 25(OH)D (36.18 ± 19.47 vs. 41.03 ± 18.47 nmol/L, P < 0.001) and higher proportion of vitamin D deficiency (78.54% vs. 72.18%, P < 0.001) than non-DPN. Vitamin D deficiency was associated with the increased prevalence of subclinical DPN [odds ratio (OR) 1.276, 95% confidence interval (CI) 1.086-1.501, P = 0.003] and DSPN [OR 1. 646, 95% CI 1.31-2.078, P < 0.001], independent of sex, age, weight, blood pressure, glycosylated hemoglobin, T2DM duration, calcium, phosphorus, parathyroid hormone, lipids and renal function. The association between vitamin D deficiency and mononeuropathy or radiculopathy was not statistically significant. A negative linear association was observed between 25(OH)D and subclinical DSPN. Vitamin D deficiency maintained its significant association with subclinical DSPN in all age groups.ConclusionsVitamin D deficiency was independently associated with subclinical DSPN, rather than other DPN subtypes.

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