Association between serum 25‐hydroxyvitamin D and glycated hemoglobin levels in type 2 diabetes patients with chronic kidney disease

摘要

Aims/Introduction Vitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25‐hydroxyvitamin D (25[OH]D) and glycemic control in non‐chronic kidney disease (CKD) patients with type 2 diabetes was reported. We aimed to examine this association among type 2 diabetes patients with CKD. Materials and Methods A total of 100 type 2 diabetes participants with stage 3–4 CKD were recruited. Blood for glycated hemoglobin (HbA_1c), serum 25(OH)D, renal and lipid profiles were drawn at enrollment. Correlation and regression analyses were carried out to assess the relationship of serum 25(OH)D, HbA_1c and other metabolic traits. Results A total of 30, 42, and 28% of participants were in CKD stage 3a, 3b and 4, respectively. The proportions of participants based on ethnicity were 51% Malay, 24% Chinese and 25% Indian. The mean (±SD) age and body mass index were 60.5 ± 9.0 years and 28.3 ± 5.9 kg/m2, whereas mean HbA_1c and serum 25(OH)D were 7.9 ± 1.6% and 37.1 ± 22.2 nmol/L. HbA_1c was negatively correlated with serum 25(OH)D ( r _s = ?0.314, P = 0.002), but positively correlated with body mass index ( r _s = 0.272, P = 0.006) and serum low‐density lipoprotein cholesterol ( P = 0.006). There was a significant negative correlation between serum 25(OH)D and total daily dose of insulin prescribed ( r _s = ?0.257, P = 0.042). Regression analyses showed that every 10‐nmol/L decline in serum 25(OH)D was associated with a 0.2% increase in HbA_1c. Conclusions Lower serum 25(OH)D was associated with poorer glycemic control and higher insulin use among multi‐ethnic Asians with type 2 diabetes and stage 3–4 CKD.