The role of vitamin D in type 1 diabetes complications: a cross sectional analysis of the Pittsburgh EDC study

Sung, Heng-Ming (2016) The role of vitamin D in type 1 diabetes complications: a cross sectional analysis of the Pittsburgh EDC study. Master Essay, University of Pittsburgh.

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Abstract

Background: It has been postulated that vitamin D deficiency may be associated with diabetic complications. A comprehensive analysis of microvascular and macrovascular complications, however, has not been conducted in patients with type 1 diabetes. Hence, we investigated the associations between vitamin D levels and the prevalence of microalbuminuria, overt nephropathy, impaired endothelial function, end stage renal failure, confirmed distal symmetric polyneuropathy, coronary artery disease and lower extremity arterial disease in individuals with type 1 diabetes. Methods: We measured circulating 25(OH)D and 25(OH)D3 in 214 individuals with type 1 diabetes who participated in the 25 year clinical visit of the Pittsburgh Epidemiology of Diabetes Complications study of childhood onset type 1 diabetes (n=214, mean age = 51 years and median diabetes duration = 42 years). Cross-sectional associations of 25(OH)D and 25(OH)D3 with diabetic complications were assessed with multivariable logistic regression adjusted for diabetes duration, sex, BMI, season of visit, HbA1c, insulin dose per body weight, hypertension, HDL and non-HDL cholesterol, WBC count, estimated glomerular filtration rate and albumin to creatinine ratio, as appropriate. Results: Fully adjusted models revealed that each 1 ng/ml increase in 25(OH)D was associated with 3% to 6% lower odds of microalbuminuria (OR=0.97, 95% CI=0.94, 0.99), impaired eGFR (OR=0.96, 95% CI=0.93, 0.99) and confirmed distal symmetric polyneuropathy (OR=0.94, 95% CI=0.90, 0.98). Similar results were found for 25(OH)D3. These vitamin D metabolites were not independently associated with overt nephropathy, end stage renal failure, coronary heart disease or lower extremity arterial disease. Conclusions: In this cohort of middle-aged adults with type 1 diabetes, both higher 25(OH)D and 25(OH)D3 were related with a lower prevalence of early diabetic kidney disease and diabetic neuropathy, but not with advanced renal disease and macrovascular disease. For the interest of public health, it would be imperative to determine whether vitamin D levels can further predict the risk of developing these diabetic complications.

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Details

Item Type:	Other Thesis, Dissertation, or Long Paper (Master Essay)
Status:	Unpublished
Creators/Authors:	Creators Email Pitt Username ORCID Sung, Heng-Ming
Contributors:	Contribution Contributors Name Email Pitt Username ORCID Committee Chair Costacou, Tina CostacouT@edc.pitt.edu UNSPECIFIED UNSPECIFIED Committee Member Vincent, Arena arena@pitt.edu UNSPECIFIED UNSPECIFIED Committee Member Fried, Linda Linda.Fried@va.gov UNSPECIFIED UNSPECIFIED Committee Member Orchard, Trevor OrchardT@edc.pitt.edu UNSPECIFIED UNSPECIFIED
Date:	2016
Date Type:	Publication
Access Restriction:	No restriction; Release the ETD for access worldwide immediately.
Publisher:	University of Pittsburgh
Institution:	University of Pittsburgh
Schools and Programs:	School of Public Health > Epidemiology
Degree:	MPH - Master of Public Health
Thesis Type:	Master Essay
Refereed:	Yes
Date Deposited:	07 Sep 2016 20:38
Last Modified:	01 May 2021 05:15
URI:	http://d-scholarship.pitt.edu/id/eprint/27399

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