Background: Several cardiovascular risk factors have been recognized in patients with diabetes and vitamin D deficiency is emerging as a new risk. The aim of this study was to determine the effect of vitamin D deficiency on the incidence of premature atherosclerosis in patients with type 2 diabetes. Methods: A total of 78 patients with type 2 diabetes were subjected to history taking, physical examination, fasting glucose level, homeostasis model assessment of insulin resistance, lipid profile, 25(OH) vitamin D measurement, and carotid Doppler. Results: Patients with normal carotid intima-media thickness (CIMT) had sufficient vitamin D. Of those with increased CIMT 23.1% had insufficient vitamin D while 76.9% had sufficient vitamin D (six patients had plaques, one of them had vitamin D insufficiency, and the other five patients had sufficient vitamin D). There was a statistically significant difference in the serum level of vitamin D between patients with increased CIMT, and those with normal intima, with a decreased level in the first group. There was a significant negative correlation between vitamin D and fasting blood glucose. There was a statistically significant correlation in left CIMT between the vitamin D sufficiency group and the vitamin D insufficiency group, with higher values in the second group. There was no statistically significant difference in serum cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol in patients with increased CIMT and those with normal intima. Conclusions: Decreased vitamin D levels in patients with diabetes lead to increased CIMT. The absence of a statistically significance difference in lipid profile between increased and normal CIMT groups raises the possibility of underlying causes for atherosclerosis in patients with diabetes other than dyslipidemia.

Background Fetuin-A is a hepatic secretory protein that binds to insulin receptors and inhibits insulin resistance (IR) kinase activity as well as IR autophosphorylation in vivo and in vitro. Aim This study aimed to investigate fetuin-A levels in patients with type 2 diabetes mellitus (T2DM) and their relation to microvascular complications. Patients and methods This descriptive study was conducted on 160 patients. Group 1 included (n=40) diabetic patients without microvascular complications, group 2 (n=40) included diabetic patients with nephropathy, group 3 (n=40) included diabetic patients with retinopathy, and group 4 represented (n=40) healthy control. Serum fetuin-A and insulin were measured by enzyme-linked immunosorbent assay. Glucose was measured, and homeostasis model assessment for IR (HOMA-IR) was estimated. Results Fetuin-A levels were significantly higher in all T2DM groups compared with controls. There was a significant positive correlation between fetuin-A, insulin, and HOMA-IR in all studied groups. There was a significant positive correlation between fetuin-A and some of metabolic syndrome criteria in all diabetic patients. There were high significant increases in the mean levels of fetuin-A, insulin, and HOMA-IR in the diabetic patients with nephropathy group than other groups. There was a nonsignificant increase in fetuin-A levels in diabetic patients with retinopathy than the diabetics without microvascular complications. Conclusion Fetuin-A may be used as a marker for microvascular complications in T2DM, especially the diabetic nephropathy. Antifetuin drugs may be invented to delay diabetic microvascular complications.