Could Vitamin D be Associated with Proliferative Diabetic Retinopathy? Evidence from Pooling Studies

Abstract

Contrasting data about the association between proliferative diabetic retinopathy (PDR) and vitamin D status remain unknown. First, a hospital-based cross-sectional study consisting of 889 diabetic retinopathy (DR) and non-DR (NDR) patients was admitted. Further the accumulated evidence was performed to explore the association and dose-response relationship. Our study indicated that the odd ratio for PDR in vitamin D deficiency (VDD) individuals was significantly increased (1.60, 95% CI 1.06–2.42), compared with NDR in vitamin D sufficiency individuals, adjusted by age, sex, diabetic duration, and HbA1c. Four studies plus our study with data on vitamin D levels in 4970 patients with PDR and NDR subjects are compared. Association between vitamin D deficiency and risk of PDR exists (OR=1.69, 95% CI 1.40–2.05; I2=0%, p=0.61). Association between a nonlinear trend for vitamin D decrease with risk of DR was significant (chi2=16.53, p=0.0003). No significant heterogeneity in identified studies was found (goodness of fit chi2=2.98, p=0.225). It is concluded that vitamin D deficiency is significantly associated with risk of proliferative diabetic retinopathy.

The Roles of Vitamins in Diabetic Retinopathy: A Narrative Review

“…In addition, VDD was found to be associated with a higher prevalence of complications in patients with diabetes, such as neuropathy, nephropathy, and retinopathy [ 43 , 50 ]. Some studies found patients with DM and VDD had an increased risk of developing DR [ 47 , 51 , 52 , 53 , 54 ]. Another study also found higher odds of developing DR in patients with type 1 diabetes and VDD [ 55 ].…”

Vitamin D, the Vitamin D Receptor, Calcitriol Analogues and Their Link with Ocular Diseases

“…As of 2010, this eye disorder affected over 100 million patients worldwide, and this number is expected to almost double by the year 2030 [ 45 , 46 ]. Studies indicate that that patients with DR had lower serum levels of vitamin D compared with those without [ 47 ] and that vitamin D (25-hydroxyvitamin D) deficiency is significantly associated with an almost twofold greater risk of DR [ 48 , 49 , 50 , 51 , 52 , 53 ], especially the proliferative form [ 54 , 55 ]. This dependence has been observed for patients with type 1 and type 2 diabetes mellitus [ 56 , 57 , 58 ].…”

The role of vitamin D in the onset and progression of diabetic retinopathy

“…Vitamin D deficiency (VD) is a global problem, some studies reporting its presence in 82.5% of subjects, with an increased frequency even in countries with year-round sunlight. VD deficiency is given by serum levels of 25 (OH) D below 20 ng/ ml [ 10 , 11 ].…”