Clinical, metabolic, and immunological characterisation of adult Ugandan patients with new-onset diabetes and low vitamin D status

Abstract

Abstract Background Low vitamin D concentrations are associated with metabolic derangements, notably insulin resistance and pancreatic beta-cell dysfunction in Caucasian populations. Studies on its association with the clinical, metabolic, and immunologic characteristics in black African adult populations with new-onset diabetes are limited. This study aimed to describe the clinical, metabolic, and immunologic characteristics of a black Ugandan adult population with recently diagnosed diabetes and hypovitaminosis D. Methods Serum vitamin D concentrations were measured in 327 participants with recently diagnosed diabetes. Vitamin D deficiency, vitamin D insufficiency, and normal vitamin D status were defined as serum 25 hydroxyvitamin D levels of < 20 ng/ml, 21–29 ng/ml, and ≥ 30 ng/ml, respectively. Results The median (IQR) age, glycated haemoglobin, and serum vitamin D concentration of the participants were 48 years (39–58), 11% (8–13) or 96 mmol/mol (67–115), and 24 ng/ml (18–30), respectively. Vitamin D deficiency, vitamin D insufficiency, and normal vitamin D status were noted in 105 participants (32.1%), 140 participants (42.8%), and 82 participants (25.1%), respectively. Compared with those having normal serum vitamin D levels, participants with vitamin D deficiency and insufficiency had higher circulating concentrations of interleukin (IL) 6 (29 [16–45] pg/ml, 23 [14–40] pg/ml vs 18 [14–32] pg/ml, p = 0.01), and IL-8 (24 [86–655] pg/ml, 207 [81–853] pg/ml vs 98 [67–224], p = 0.03). No statistically significant differences were noted in the markers of body adiposity, insulin resistance, and pancreatic beta-cell function between both groups. Conclusion Vitamin D deficiency and insufficiency were highly prevalent in our study population and were associated with increased circulating concentrations of pro-inflammatory cytokines. The absence of an association between pancreatic beta-cell function, insulin resistance, and low vitamin D status may indicate that the latter does not play a significant role in the pathogenesis of type 2 diabetes in our adult Ugandan population.

Keywords

• Vitamin D deficiency
• Vitamin D insufficiency
• Newly diagnosed diabetes
• African population
• Uganda
• Sub-Saharan Africa