Adequate vitamin D status is associated with the reduced odds of prevalent diabetic retinopathy in African Americans and Caucasians

摘要

Background Vitamin D status has been hypothesized to protect against development of diabetic retinopathy via its anti-inflammatory and anti-angiogenic properties. Additionally, in vitro and in vivo studies suggest vitamin D favorably influences blood pressure and blood glucose control, strong risk factors for diabetic retinopathy. We examined the association between vitamin D status and prevalent diabetic retinopathy in participants with diabetes from a population-based cohort. Methods Among participants in the Atherosclerosis Risk in Communities (ARIC) study with diabetes at visit 3 (1993–1995), 1339 (906 Caucasians, 433 African Americans) had serum 25-hydroxyvitamin (25[OH]D) concentrations assessed at visit 2 (1989–1992) and nonmydriatic retinal photographs taken at visit 3. Dietary intake of vitamin D was assessed at visit 1 (1987–1989). Logistic regression was used to estimate odds ratios (ORs) and 95?% confidence intervals (CIs) for diabetic retinopathy by categories of season-adjusted 25(OH)D (1c and hypertension to examine if 25(OH)D influenced diabetic retinopathy via its effects on either glycemic control or blood pressure. Results ORs (95?% CIs) for retinopathy, adjusted for race and duration, were 0.77 (0.45–1.32), 0.64 (0.37–1.10), and 0.39 (0.20–0.75), p for trend?=?0.001, for participants with 25(OH)D of 30–1c attenuated the OR among those with 25(OH)D ≥75 (0.47 [0.23–0.96], p for trend?=?0.030). No statistically significant association was observed between vitamin D intake from foods or supplements and retinopathy. Conclusions 25(OH)D concentrations ≥75?nmol/L were associated with lower odds of any retinopathy assessed 3?years later. We speculate this may be due in part to vitamin D’s influence on blood glucose control.