International Journal of Retina and Vitreous (Nov 2019)

Serum vitamin D is a biomolecular biomarker for proliferative diabetic retinopathy

  • Gauhar Nadri,
  • Sandeep Saxena,
  • Abbas Ali Mahdi,
  • Apjit Kaur,
  • Md. Kaleem Ahmad,
  • Pragati Garg,
  • Carsten H. Meyer

DOI
https://doi.org/10.1186/s40942-019-0181-z
Journal volume & issue
Vol. 5, no. 1
pp. 1 – 5

Abstract

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Abstract Background Vitamin D is a multi-functional fat-soluble metabolite essential for a vast number of physiological processes. Non-classical functions are gaining attention because of the close association of vitamin D deficiency with diabetes, and its complications. The present study was undertaken to evaluate the role of vitamin D as a biomarker for proliferative diabetic retinopathy. Methods A tertiary care center based cross-sectional study was undertaken. Seventy-two consecutive cases of type 2 diabetes mellitus were included. Diagnosis of diabetes mellitus was made using American Diabetes Association guidelines. Study subjects included: diabetes mellitus with no retinopathy (No DR) (n = 24); non-proliferative diabetic retinopathy (n = 24); and proliferative diabetic retinopathy (n = 24) and healthy controls (n = 24). All of the study subjects underwent complete ophthalmological evaluation. Best Corrected Visual Acuity (BCVA) was measured on the logarithm of the minimum angle of resolution (logMAR) scale. Serum 25-OH Vitamin D assay was done using chemiluminescent microparticle immunoassay technology. Diagnostic accuracy of vitamin D was assessed using receiver operating characteristics curve analysis and area under curve (AUC) was determined for the first time. Results ANOVA revealed a significant decrease in serum vitamin D levels with severity of diabetic retinopathy (F = 8.95, p < 0.001). LogMAR BCVA was found to increase significantly with the severity of DR (F = 112.64, p < 0.001). On AUC analysis, a cut off value of 18.6 ng/mL for Vitamin D was found to be significantly associated with proliferative diabetic retinopathy [sensitivity = 86.36% (95% CI 65.1–96.9); specificity = 81.82% (95% CI 59.7–94.7); AUC = 0.91 (excellent); and Z value = 8.17]. Conclusions Serum vitamin D levels of ≤ 18.6 ng/mL serve as sensitive and specific indicator for proliferative disease, among patients of DR.

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