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High prevalence of vitamin D deficiency and lack of association with subclinical atherosclerosis in asymptomatic patients with Type 1 Diabetes Mellitus from a Mediterranean area

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Abstract

Aims

Several studies linked vitamin D deficiency with coronary artery disease (CAD). The aim of this study was to evaluate the relationship between the concentrations of 25-hydroxyvitamin D (25OHD) and the presence of early atherosclerosis in asymptomatic Type 1 Diabetes (T1D) patients with no previous history of ischemic heart disease.

Methods

One hundred and forty-five patients with T1D (age 37.8 ± 8 years, 57 % male, all Caucasian, disease duration 20.6 ± 8.3 years, HbA1c 7.6 ± 1.4 % (60.2 ± 11.1 mmol/mol), body mass index (BMI) 25.2 ± 3.5 kg/m2, 52.4 % smokers, 23 % retinopathy, 10 % nephropathy) and 48 controls matched for age, sex, BMI and smoking habit were studied. 25OHD deficiency was defined for values ≤20 ng/mL. A sun exposure questionnaire, carotid ultrasonography to determine carotid intima-media thickness (CIMT) and the presence of atheroma plaques and cardiac computed tomography for evaluation of calcium artery calcification (CACS) were performed.

Results

T1D subjects showed a high proportion of 25OHD deficiency (43.2 % vs. 21.7 %, p = 0.032). Of all, 82 % of T1D patients and 92 % of controls had a calcium score of 0. CIMT was greater in patients with T1D (0.55 ± 0.14 mm vs 0.48 ± 0.15, p = 0.01) compared with controls. T1D subjects showed no differences in the results of CACS or CIMT according to the vitamin D concentrations.

Conclusions

T1D patients have lower concentrations and twice more prevalence of 25OHD deficiency than controls. There was no association between 25OHD concentrations and subclinical CAD.

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Abbreviations

CAD:

Coronary artery disease

T1D:

Type 1 diabetes

hs CRP:

High-sensitive C-reactive protein

BMI:

Body mass index

25OHD:

25-Hydroxyvitamin D

CT:

Computed tomography

CU:

Carotid ultrasound

CIMT:

Carotid intima-media thickness

CVD:

Cardiovascular disease

CACS:

Coronary artery calcification score

CHD:

Cardiac heart disease

HDL:

High density lipoprotein cholesterol

LDL:

Low density lipoprotein cholesterol

Ca:

Calcium

Ph:

Phosphate

PTH:

Parathormone

CV:

Coefficient of variation

AU:

Agatston units

SD:

Standard desviation

EDTA:

Ethylenediaminetetraacetic acid

HPLC:

High-performance liquid chromatographic

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Acknowledgments

This study has been supported by a grant “Ajut en la Recerca en Diabetis Gonçal Lloveras” from the Catalan Association of Diabetes. D. Mauricio is supported by a grant from Instituto de Salud Carlos III (No. PI12-00183). We thank the nursing staff of the Endocrinology Unit of Hospital Germans Trias i Pujol in Badalona (Maribel Cuadrado, Isabel Ordoñez and Carme Perez) for their technical assistance. We thank also Nicki van Berckel from the editorial staff of the Journal of Hepatology for reviewing the English version of this manuscript.

Conflict of interest

Serra-Planas E, Aguilera E, Granada ML, Soldevila B, Salinas I, Reverter JL, Pizarro E, Pellitero S, Alonso N, Mauricio D and Puig-Domingo M declare that there is no conflict of interest regarding to this work.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent disclosure

Informed consent was obtained from all participants for being included in the study.

Author information

Authors and Affiliations

  1. Endocrinology and Nutrition Unit, Department of Medicine, Institute of Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain

    Enric Serra-Planas, Eva Aguilera, Berta Soldevila, Isabel Salinas, Jorge Luis Reverter, Silvia Pellitero, Núria Alonso, Dídac Mauricio & Manel Puig-Domingo

  2. Biochemistry Unit, Institute of Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain

    M. Luisa Granada

  3. Service of Endocrinology, Hospital de Mataró, Mataró, Spain

    Edu Pizarro

Authors
  1. Enric Serra-Planas
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  2. Eva Aguilera
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  3. M. Luisa Granada
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  4. Berta Soldevila
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  5. Isabel Salinas
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  8. Silvia Pellitero
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  9. Núria Alonso
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  10. Dídac Mauricio
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Correspondence to Enric Serra-Planas.

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Serra-Planas, E., Aguilera, E., Granada, M.L. et al. High prevalence of vitamin D deficiency and lack of association with subclinical atherosclerosis in asymptomatic patients with Type 1 Diabetes Mellitus from a Mediterranean area. Acta Diabetol 52, 773–779 (2015). https://doi.org/10.1007/s00592-014-0699-3

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