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Prevalence of 25-hydroxy vitamin D deficiency among type 2 diabetic subjects of South India

  • Sabitha Palazhy
  • Vijay ViswanathanEmail author
  • A. Muruganathan
Original Article

Abstract

Vitamin D levels have been documented to have significant inverse relationship with type 2 diabetes. However, data on the extent of vitamin D deficiency among type 2 diabetes subjects of India is lacking. The present study was undertaken among diabetic subjects of South India to address this lacuna. This retrospective study was conducted among patients attending a diabetes specialty hospital who had established type 2 diabetes mellitus. Demographic data and data on laboratory parameters such as vitamin D, HbA1c, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and serum calcium were obtained from the hospital information system. Vitamin D levels were classified as normal (≥30 ng/mL), insufficient (>20 to 29.9 ng/mL), and deficient (≤20 ng/mL). We included 4628 subjects with diabetes. Among them, 71.4 % were vitamin D deficient, 15 % were vitamin D insufficient, and 13.6 % were found to have normal vitamin D levels. On comparing the two genders, it was seen that the percentage of men and women with these conditions were similar. The proportion of subjects with these conditions across different age groups (30–50, 50–70, >70) were also similar. BMI, age, calcium levels, and HbA1c were found to be the major confounders for vitamin D status. Our study, done among type 2 diabetes people, show that vitamin D deficiency was highly prevalent among them. Considering such high prevalence, screening of diabetic patients for vitamin D deficiency would be beneficial in this population.

Keywords

Serum calcium Gender HbA1c South India Type 2 diabetes mellitus Vitamin D 

Notes

Acknowledgments

We thank Mr. Sriram Ramachandran for statistical analysis and Mr. Selvakumar D, IT Department, for help in data collection.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

No funding was received for this study from any source.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

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

References

  1. 1.
    Joshi SR, Parikh RM. India—diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323–4.PubMedGoogle Scholar
  2. 2.
    Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.CrossRefPubMedGoogle Scholar
  3. 3.
    Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australasian Med J. 2014;7(1):45–8.CrossRefGoogle Scholar
  4. 4.
    Lind L, Hanni A, Lithell H, Hvarfner A, Sorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8:894–901.CrossRefPubMedGoogle Scholar
  5. 5.
    Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol1990; 19:559–563.Google Scholar
  6. 6.
    Grimnes G, Emaus N, Joakimsen RM, Figenschau Y, Jenssen T, Njølstad I, et al. Baseline serum 25-hydroxyvitamin D concentrations in the Tromsø Study 1994-95 and risk of developing type 2 diabetes mellitus during 11 years of follow-up. Diabet Med. 2010;27:1107–15.CrossRefPubMedGoogle Scholar
  7. 7.
    Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, et al. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010;106:963–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Gomez JM: The role of insulin-like growth factor I components in the regulation of vitamin D. Curr Pharm Biotechnol2006; 7:125–132.Google Scholar
  9. 9.
    Ogunkolade BW, Boucher BJ, Prahl JM, Bustin SA, Burrin JM, Noonan K, et al. Vitamin D receptor (VDR) mRNA and VDR protein levels in relation to vitamin D status, insulin secretory capacity, and VDR genotype in Bangladeshi Asians. Diabetes2002; 51:2294–2300.Google Scholar
  10. 10.
    Ortlepp JR, Metrikat J, Albrecht M, von KA, Hanrath P, Hoffmann R. The vitamin D receptor gene variant and physical activity predicts fasting glucose levels in healthy young men. Diabet Med2003; 20:451–454.Google Scholar
  11. 11.
    Zittermann A: Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr2003; 89:552–572.Google Scholar
  12. 12.
    Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N. Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J ClinNutr. 2000;72:472–5.Google Scholar
  13. 13.
    Harinarayan CV, Ramalakshmi T, Venkata PV. High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J ClinNutr. 2000;72:690–3.Google Scholar
  14. 14.
    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. Clin Endocrinol Metab. 2011;96:1911–0.CrossRefGoogle Scholar
  15. 15.
    Ritu G, Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6:729–75. doi: 10.3390/nu6020729.CrossRefGoogle Scholar
  16. 16.
    Kumar A, Haria JM. Vitamin D status and type 2 diabetes mellitus in Indians: a case-control study. Int J of Scientific Study. 2014;2:104–7.Google Scholar
  17. 17.
    Dutta D, Maisnam I, Shrivastava A, Sinha A, Ghosh S, Mukhopadhyay P, et al. Serum vitamin-D predicts insulin resistance in individuals with prediabetes. Indian J Med Res. 2013;138:853–60.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Scragg R, Sowers MF, Bell C. Serum 25-hydroxyvitamin D, diabetes and ethnicity in the third National Health and Nutrition Examination Survey. Diabetes Care. 2004;27:2813–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. AJCN. 2004;80:16785–885.Google Scholar
  20. 20.
    Jones G, Prosser DE, Kaufmann M. 25-Hydroxyvitamin D-24-hydroxylase (CYP24A1): its important role in the degradation of vitamin D. Arch Biochem Biophys. 2012;523:9–18.CrossRefPubMedGoogle Scholar
  21. 21.
    Baradaran A, Behradmanesh S, Nasri H. Association of body mass index and serum vitamin D level in healthy Iranian adolescents. Endokrynol Pol. 2012;63:29–33.PubMedGoogle Scholar
  22. 22.
    Khashayar P, Meybodi HR, Soltani A, Taheri E, Homami MR, Heshmat R, Dimai HP, Larijani B. Association between vitamin D levels and BMI values in an Iranian population. Clin Lab. 2014;60:383–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Lagunova Z, Porojnicu AC, Lindberg F, Hexeberg S, Moan J. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res. 2009;29:3713–20.PubMedGoogle Scholar
  24. 24.
    Dalgård C, Petersen MS, Weihe P, GrandjeanP. Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians. Diabetes Care 2011; 34:1284–1288.Google Scholar
  25. 25.
    Green RT, Gambhir KK, Nunlee-Bland G, Odonkor WA, Ganta VA. Maintenance of long-term adequate levels of vitamin d lowers HbA1c in African American patients with type 2 diabetes. Ethn Dis. 2014;24:335–41.PubMedGoogle Scholar
  26. 26.
    Madar AM, Knutsen KV, Stene LC, Brekke M, Meyer HE, Lagerløv P. Effect of vitamin D3 supplementation on glycated hemoglobin (HbA1c), fructosamine, serum lipids, and body mass index: a randomized, double-blinded, placebo-controlled trial among healthy immigrants living in Norway. BMJ Open Diabetes Res Care. 2014; 2:e000026. doi: 10.1136/bmjdrc-2014-000026. eCollection 2014.
  27. 27.
    Doddamani GB, Boke U, Kora S, Chickmath R. Serum vitamin D levels in newly detected type 2 diabetes. Sch J App Med Sci. 2013;1:786–8.Google Scholar

Copyright information

© Research Society for Study of Diabetes in India 2016

Authors and Affiliations

  • Sabitha Palazhy
    • 1
  • Vijay Viswanathan
    • 1
    Email author
  • A. Muruganathan
    • 1
  1. 1.M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research CentreChennaiIndia

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