Skip to main content

Advertisement

SpringerLink
Log in

An inverse association between serum vitamin D levels with the presence and severity of impaired nerve conduction velocity and large fiber peripheral neuropathy in diabetic subjects

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Diabetic neuropathy (DN) is the most common complication of diabetes mellitus (DM) and also the major cause of morbidity and mortality in diabetic patients. There have been recent speculations that circulating   25-hydroxyvitamin D (25(OH)-D) could be involved in DN development and progression. This study explored the association between serum 25(OH)-D and DN in diabetic subjects by performing strict matching of possible confounders. Overall, 33 diabetic subjects with DN and 29 controls matched in terms of age, sex, BMI, height and disease duration entered this study. Nerve conduction velocity (NCV) was performed to determine the existence and severity of large fiber neuropathy. 25(OH)-D had significantly lower value in DN group (21.2 ± 11.5 vs. 13.5 ± 5.1 ng/mL, P = 0.001). None of the other observed variables showed a significant association with existence and severity of DN. After adjustment for all studied variables, serum vitamin D had an independent and inverse association with both DN presence and severity, as each 1 ng/mL increase in serum 25(OH)-D was correlated with 2.2 and 3.4 % decrease in the presence and severity of NCV impairment, respectively.  While adjusted for demographic variables, comorbidities and treatment of DM, our results imply that decreased levels of circulating 25(OH)-D may contribute to increased risk of large fiber neuropathy in type 2 diabetic subjects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Calvo MS, Whiting SJ, Barton CN (2005) Vitamin D intake: a global perspective of current status. J Nutr 135(2):310–316

    CAS  PubMed  Google Scholar 

  2. Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15(9):1856–1862. doi:10.1359/jbmr.2000.15.9.1856

    Article  CAS  PubMed  Google Scholar 

  3. Forrest KY, Stuhldreher WL (2011) Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res 31(1):48–54. doi:10.1016/j.nutres.2010.12.001

    Article  CAS  PubMed  Google Scholar 

  4. Allali F, El Aichaoui S, Khazani H, Benyahia B, Saoud B, El Kabbaj S, Bahiri R, Abouqal R, Hajjaj-Hassouni N (2009) High prevalence of hypovitaminosis D in Morocco: relationship to lifestyle, physical performance, bone markers, and bone mineral density. Semin Arthritis Rheum 38(6):444–451. doi:10.1016/j.semarthrit.2008.01.009

    Article  CAS  PubMed  Google Scholar 

  5. Baz-Hecht M, Goldfine AB (2010) The impact of vitamin D deficiency on diabetes and cardiovascular risk. Curr Opin Endocrinol Diabetes Obes 17(2):113–119. doi:10.1097/MED.0b013e3283372859

    Article  CAS  PubMed  Google Scholar 

  6. Mezza T, Muscogiuri G, Sorice GP, Prioletta A, Salomone E, Pontecorvi A, Giaccari A (2012) Vitamin D deficiency: a new risk factor for type 2 diabetes? Ann Nutr Metab 61(4):337–348. doi:10.1159/000342771

    Article  CAS  PubMed  Google Scholar 

  7. Hirani V, Cumming RG, Le Couteur DG, Naganathan V, Blyth F, Handelsman DJ, Waite LM, Seibel MJ (2014) Low levels of 25-hydroxy vitamin D and active 1,25-dihydroxyvitamin D independently associated with type 2 diabetes mellitus in older Australian men: the concord health and ageing in men project. J Am Geriatr Soc. doi:10.1111/jgs.12975

    Google Scholar 

  8. Min B (2013) Effects of vitamin D on blood pressure and endothelial function. Korean J Physiol Pharmacol 17(5):385–392. doi:10.4196/kjpp.2013.17.5.385

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Ku YC, Liu ME, Ku CS, Liu TY, Lin SL (2013) Relationship between vitamin D deficiency and cardiovascular disease. World J Cardiol 5(9):337–346. doi:10.4330/wjc.v5.i9.337

    Article  PubMed Central  PubMed  Google Scholar 

  10. Espie M, Wassermann J, de Kermadec E, Lalloum M, Coussy F (2013) Vitamin D and cancers. Presse Med 42(10):1405–1411. doi:10.1016/j.lpm.2013.07.013

    Article  PubMed  Google Scholar 

  11. Holick MF (2008) Diabetes and the vitamin d connection. Curr Diab Rep 8(5):393–398

    Article  CAS  PubMed  Google Scholar 

  12. Chiu KC, Chu A, Go VL, Saad MF (2004) Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 79(5):820–825

    CAS  PubMed  Google Scholar 

  13. Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R (2003) The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract 57(4):258–261

    CAS  PubMed  Google Scholar 

  14. Washington RE,  Andrews RM, Mutter R (2013) Emergency Department Visits for Adults with Diabetes, 2010. HCUP Statistical Brief #167. Agency for Healthcare Research and Quality, Rockville

  15. Peltier A, Goutman SA, Callaghan BC (2014) Painful diabetic neuropathy. BMJ (Clinical research ed) 348:g1799. doi:10.1136/bmj.g1799

    Google Scholar 

  16. Argoff CE, Cole BE, Fishbain DA, Irving GA (2006) Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc 81(4 Suppl):S3–11

    Article  PubMed  Google Scholar 

  17. Handevidt F (2001) Peripheral neuropathy in persons with diabetes. Clin Excell Nurse Pract 5(1):17–20

    CAS  PubMed  Google Scholar 

  18. Pasnoor M, Dimachkie MM, Kluding P, Barohn RJ (2013) Diabetic neuropathy part 1: overview and symmetric phenotypes. Neurol Clin 31(2):425–445. doi:10.1016/j.ncl.2013.02.004

    Article  PubMed Central  PubMed  Google Scholar 

  19. (1995) Effect of intensive diabetes treatment on nerve conduction in the diabetes control and complications trial. Ann Neurol 38 (6):869–880. doi:10.1002/ana.410380607

  20. Soderstrom LH, Johnson SP, Diaz VA, Mainous AG 3rd (2012) Association between vitamin D and diabetic neuropathy in a nationally representative sample: results from 2001–2004 NHANES. Diabet Med 29(1):50–55. doi:10.1111/j.1464-5491.2011.03379.x

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Shehab D, Al-Jarallah K, Mojiminiyi OA, Al Mohamedy H, Abdella NA (2012) Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes? Diabet Med 29(1):43–49. doi:10.1111/j.1464-5491.2011.03510.x

    Article  CAS  PubMed  Google Scholar 

  22. Celikbilek A, Gocmen AY, Tanik N, Borekci E, Adam M, Celikbilek M, Suher M, Delibas N (2014) Decreased serum vitamin D levels are associated with diabetic peripheral neuropathy in a rural area of Turkey. Acta Neurol Belg. doi:10.1007/s13760-014-0304-0

    Google Scholar 

  23. Bajaj S, Singh RP, Dwivedi NC, Singh K, Gupta A, Mathur M (2014) Vitamin D levels and microvascular complications in type 2 diabetes. Indian J Endocrinol Metab 18(4):537–541. doi:10.4103/2230-8210.137512

    Article  PubMed Central  PubMed  Google Scholar 

  24. American Diabetes Association (2012) Standards of medical care in diabetes—2012. Diabetes Care 35(Suppl 1):S11–S63. doi:10.2337/dc12-s011

    Google Scholar 

  25. Esteghamati A, Hafezi-Nejad N, Zandieh A, Sheikhbahaei S, Emamzadeh-Fard S, Nakhjavani M (2014) CA 19-9 is associated with poor glycemic control in diabetic patients: role of insulin resistance. Clin Lab 60(3):441–447

    CAS  PubMed  Google Scholar 

  26. Kimura J (1978) A method for determining median nerve conduction velocity across the carpal tunnel. J Neurol Sci 38(1):1–10

    Article  CAS  PubMed  Google Scholar 

  27. Preston DC, Shapiro BE (2013) Basic nerve conduction studies. In: Shapiro DCPE (ed) Electromyography and Neuromuscular Disorders, 3rd edn. W.B. Saunders, London, pp 19–35

  28. Dyck PJ, Carter RE, Litchy WJ (2011) Modeling nerve conduction criteria for diagnosis of diabetic polyneuropathy. Muscle Nerve 44(3):340–345. doi:10.1002/mus.22074

    PubMed Central  PubMed  Google Scholar 

  29. Skalli S, Muller M, Pradines S, Halimi S, Wion-Barbot N (2012) Vitamin D deficiency and peripheral diabetic neuropathy. Eur J Intern Med 23(2):e67–e68. doi:10.1016/j.ejim.2011.11.008

    Article  CAS  PubMed  Google Scholar 

  30. Putz Z, Martos T, Nemeth N, Korei AE, Szabo M, Vagi OE, Kempler MS, Kempler P (2013) Vitamin D and neuropathy. Orv Hetil 154(51):2012–2015. doi:10.1556/oh.2013.29769

    Article  PubMed  Google Scholar 

  31. Lv WS, Zhao WJ, Gong SL, Fang DD, Wang B, Fu ZJ, Yan SL, Wang YG (2014) Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: a systematic review and meta-analysis. J Endocrinol Invest. doi:10.1007/s40618-014-0210-6

    PubMed  Google Scholar 

  32. Ahmadieh H, Azar ST, Lakkis N, Arabi A (2013) Hypovitaminosis d in patients with type 2 diabetes mellitus: a relation to disease control and complications. ISRN Endocrinol 2013:641098. doi:10.1155/2013/641098

    PubMed Central  PubMed  Google Scholar 

  33. Knekt P, Kilkkinen A, Rissanen H, Marniemi J, Saaksjarvi K, Heliovaara M (2010) Serum vitamin D and the risk of Parkinson disease. Arch Neurol 67(7):808–811. doi:10.1001/archneurol.2010.120

    Article  PubMed Central  PubMed  Google Scholar 

  34. Burton JM, Kimball S, Vieth R, Bar-Or A, Dosch HM, Cheung R, Gagne D, D’Souza C, Ursell M, O’Connor P (2010) A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis. Neurology 74(23):1852–1859. doi:10.1212/WNL.0b013e3181e1cec2

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  35. Riaz S, Malcangio M, Miller M, Tomlinson DR (1999) A vitamin D(3) derivative (CB1093) induces nerve growth factor and prevents neurotrophic deficits in streptozotocin-diabetic rats. Diabetologia 42(11):1308–1313. doi:10.1007/s001250051443

    Article  CAS  PubMed  Google Scholar 

  36. Samina Riaz S, Tomlinson DR (2000) Pharmacological modulation of nerve growth factor synthesis: a mechanistic comparison of vitamin D receptor and beta(2)-adrenoceptor agonists. Brain Res Mol Brain Res 85(1–2):179–188

    Article  CAS  PubMed  Google Scholar 

  37. Lee P, Chen R (2008) Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med 168(7):771–772. doi:10.1001/archinte.168.7.771

    Article  PubMed  Google Scholar 

  38. Valensi P, Le Devehat C, Richard JL, Farez C, Khodabandehlou T, Rosenbloom RA, LeFante C (2005) A multicenter, double-blind, safety study of QR-333 for the treatment of symptomatic diabetic peripheral neuropathy. A preliminary report. J Diabetes Complicat 19(5):247–253. doi:10.1016/j.jdiacomp.2005.05.011

    Article  PubMed  Google Scholar 

  39. Bell DS (2012) Reversal of the symptoms of diabetic neuropathy through correction of vitamin D deficiency in a type 1 diabetic patient. Case Rep Endocrinol 2012:165056. doi:10.1155/2012/165056

    PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

Authors declare no conflict of interest

Ethical approval

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.

Informed consent

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

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Science (TUMS), Tehran, Iran

    Azam Alamdari, Rambod Mozafari & Neda Naderi

  2. Iranian Center of Neurological Research (ICNR), Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Abbas Tafakhori & Sara Faghihi-Kashani

  3. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Sara Faghihi-Kashani, Nima Hafezi-Nejad, Sara Sheikhbahaei, Maryam Ebadi & Alireza Esteghamati

Authors
  1. Azam Alamdari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rambod Mozafari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abbas Tafakhori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Faghihi-Kashani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nima Hafezi-Nejad
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sara Sheikhbahaei
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Neda Naderi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Maryam Ebadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alireza Esteghamati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abbas Tafakhori.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alamdari, A., Mozafari, R., Tafakhori, A. et al. An inverse association between serum vitamin D levels with the presence and severity of impaired nerve conduction velocity and large fiber peripheral neuropathy in diabetic subjects. Neurol Sci 36, 1121–1126 (2015). https://doi.org/10.1007/s10072-015-2207-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-015-2207-0

Keywords

Search

Navigation