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Serum 25(OH) vitamin D level and its relation to diabetic peripheral neuropathy in Egyptian patients with type 2 diabetes mellitus.

ABSTRACT: Background:Some clinical studies demonstrated a significant association between vitamin D deficiency and diabetic peripheral neuropathy (DPN). Objective:This study aims to evaluate the correlation between serum levels of 25(OH) vitamin D and DPN in Egyptian patients with type 2 diabetes mellitus (T2DM). Patients and method:Sixty patients were known to have T2DM, which classified into the following: group I included 40 patients with DPN and group II included 20 diabetic patients, without DPN, compared with 30 apparently healthy subjects of matched age and sex as control group. Laboratory investigations including fasting and 2-h postprandial blood glucose levels, serum calcium, phosphorus, glycosylated hemoglobin (HbA1c), lipid profile, serum 25(OH) vitamin D, and nerve conduction studies were carried out for every participant to detect the existence and severity of DPN. Results:Vitamin D deficiency was found in 73.3% of T2DM groups and in 35% of control subjects with statistical significant differences (p?

SUBMITTER: Abdelsadek SE

PROVIDER: S-EPMC6245139 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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Serum 25(OH) vitamin D level and its relation to diabetic peripheral neuropathy in Egyptian patients with type 2 diabetes mellitus.

Abdelsadek Seham E SE El Saghier Entesar O EO Abdel Raheem Sabah I SI

The Egyptian journal of neurology, psychiatry and neurosurgery 20181120 1

<h4>Background</h4>Some clinical studies demonstrated a significant association between vitamin D deficiency and diabetic peripheral neuropathy (DPN).<h4>Objective</h4>This study aims to evaluate the correlation between serum levels of 25(OH) vitamin D and DPN in Egyptian patients with type 2 diabetes mellitus (T2DM).<h4>Patients and method</h4>Sixty patients were known to have T2DM, which classified into the following: group I included 40 patients with DPN and group II included 20 diabetic pati ...[more]

PMID: 30532515

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Project description:Aims/introductionNon-alcoholic fatty liver disease and type 2 diabetes mellitus are closely related, and often occur simultaneously in patients. Type 2 diabetes increases the risk of diabetic peripheral neuropathy, resulting in intolerable pain and extremity amputation that reduces the quality of life. However, the role of non-alcoholic fatty liver disease in the pathogenesis of diabetic peripheral neuropathy remains unclear. Thus, we evaluated the correlation of liver fibrosis and steatosis, which are representative histological morphologies of non-alcoholic fatty liver disease, with diabetic peripheral neuropathy in type 2 diabetes patients.Materials and methodsFive hundred twenty individuals with type 2 diabetes were recruited. All the patients were detected nerve conduction study for diabetic peripheral neuropathy and fibro touch for liver steatosis and fibrosis. Correlation of DPN with liver steatosis and fibrosis were analysed with binary logistic analysis.ResultsAmong the 520 patients, the prevalence of liver steatosis, fibrosis and diabetic peripheral neuropathy was 63.0% (n = 328), 18.1% (n = 94) and 52.1% (n = 271), respectively. The prevalence of diabetic peripheral neuropathy was significantly elevated in patients with liver steatosis (55.7 vs 44.9%, P = 0.03) and fibrosis (61.5 vs 50%, P = 0.04), and it increased as liver stiffness measurement increased. Additionally, both hepatic steatosis (odds ratio 1.48, 95% confidence interval 1.04-2.11, P = 0.03) and fibrosis (odds ratio 1.60, 95% confidence interval 1.02-2.51, P = 0.04) were correlated with diabetic peripheral neuropathy. After adjusting for age, sex, weight, height, body mass index, waist hip ratio, duration of type 2 diabetes, blood glucose, homeostatic model assessment of insulin resistance, blood pressure, serum lipid, liver enzyme, urea, uric acid, creatinine and inflammatory factors, liver fibrosis remained associated with diabetic peripheral neuropathy (odds ratio 2.24, 95% confidence interval 1.11-4.53, P = 0.02).ConclusionsThe prevalence of diabetic peripheral neuropathy was elevated in patients with liver steatosis and fibrosis. Liver fibrosis was also independently associated with an increased risk of diabetic peripheral neuropathy.

Project description:BACKGROUND:Vitamin-D2 (D2) treatment has been associated with a decrease in 25-hydroxy (25(OH)) vitamin-D3 (D3) level, suggesting that D3 treatment would be preferred to raise total 25(OH) vitamin-D (D) level. We postulated that D2 treatment-associated decrease in 25(OH)D3 level is related to the increase in 25(OH)D level rather than being D2-specific, and thus there would be a similar D3 treatment-associated decrease in 25(OH)D2 level. METHODS:Fifty volunteers were block-randomized to 50,000?IU D2 or placebo orally once (study-1) and fifty volunteers received 50,000?IU D2 orally once and 4?days later block-randomized to 50,000?IU D3 or placebo orally once (study-2). Interventions were concealed from volunteers and research coordinators and blindly-administered. Serum 25(OH)D2 and 25(OH)D3 levels were blindly-determined at baseline and days 14, 28, 42, and 56, post-randomization by high performance liquid chromatography assay. Results of 97 participants were analyzed. Primary outcome measure was day-28 D2-associated change in 25(OH)D3 level in study-1 and D3-associated change in 25(OH)D2 level in study-2, adjusted for baseline levels. RESULTS:Mean (95% confidence interval) difference between the active and placebo arms in the decrease in day-28 25(OH)D3 (study-1) and 25(OH)D2 (study-2) levels was 13.2 (9.7 to 16.6) and 9.8 (5.2 to 14.4) nmol/L, respectively. Corresponding differences at day-56 were 10.8 (6.8 to 14.8) and 1.7 (-?7.6 to 11.1) nmol/L, respectively. The difference between the placebo and active arms in area-under-the-curve at day-28 (AUC28) and day-56 (AUC56) were 262.3 (197.8 to 326.7) and 605.1 (446.3 to 784.0) for 25(OH)D3 (study-1) and 282.2 (111.2 to 453.3) and 431.2 (179.3 to 683.2) nmol.d/L for 25(OH)D2 (study-2), respectively. There were significant correlations between day-28 changes in 25(OH)D2 and 25(OH)D3 levels in study-1 (rho?=?-?0.79, p?<?0.001) and study-2 (rho?=?-?0.36, p?=?0.01), and between day-28 changes in 25(OH)D2 level and baseline 25(OH)D level in study-2 (rho?=?-?0.42, p?=?0.003). CONCLUSIONS:Compared to placebo, D3 treatment is associated with a decrease in 25(OH)D2 level similar in magnitude to D2-treatment associated decrease in 25(OH)D3 level; however, the D3-placebo difference in 25(OH)D2 level is shorter-lasting. Changes in 25(OH)D2 and 25(OH)D3 levels are correlated with each other and with baseline 25 (OH) D levels, suggesting a common regulatory mechanism. TRIAL REGISTRATION:ClinicalTrial.gov identifier: NCT03035084 (registered January 27, 2017).

Dataset Information

Serum 25(OH) vitamin D level and its relation to diabetic peripheral neuropathy in Egyptian patients with type 2 diabetes mellitus.

Publications

Serum 25(OH) vitamin D level and its relation to diabetic peripheral neuropathy in Egyptian patients with type 2 diabetes mellitus.

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