The Impact of Vitamin D Deficiency on Retinopathy and Hearing Loss among Type 2 Diabetic Patients

Abstract

Aim The current study was aiming to investigate the relation between vitamin D, retinopathy, and hearing loss among type 2 diabetes mellitus (T2DM) patients. Methods Cross-sectional study carried on 638 subjects aged between 20 and 60 years who visited the Endocrinology, Ophthalmology, and ENT Outpatient Clinics of the Medipol Hospital during the period from March 2016 to May 2017. Two audiometers Grason Stadler GSI 61 and Interacoustics AC40 Clinical audiometer were used to evaluate the hearing loss. Risk factors for diabetic retinopathy were evaluated, including age, sex, diabetes duration, glycated hemoglobin (HbA1c), hypertension, and lipid profiles. Results The mean age (± SD, in years) for retinopathy with hearing loss versus normal subjects was 47.7 ±10.2 versus 48.5±9.1. The associated risk factors were significantly higher in T2DM with hearing loss, hypertension (32.6% versus 15.7%), tinnitus (40.0% versus 18.0%), vertigo (59.7% versus 26.8%), and headache (54.9% versus 45.3%), than in normal hearing diabetes. There were statistically significant differences between hearing impairment versus normal hearing for vitamin D [19.40±9.71 ng/ml versus 22.67±9.28 ng/ml; p<0.001], calcium, magnesium, phosphorous, cholesterol, HDL-C, LDL-C, albumin, systolic blood pressure [131.70±9.25 Hg versus 127.73±11.98 Hg], diastolic blood pressure [82.20±8.60 mm Hg versus 79.80±8.20 mm Hg], and microalbuminuria. Multivariate logistic regression analysis revealed that variables such as vertigo, duration of DM, mobile/I pad phone, vitamin D deficiency, sleeping disturbance, headache, frequently TV watching, tinnitus, cigarette smokers, and hypertension were considered at higher risk as a predictors of retinopathy with hearing loss among diabetic patients. Conclusion Vitamin D deficiency is considered as a risk factor for diabetic retinopathy and hearing loss among diabetic patients. Meanwhile, hyperglycemia could be considered as a modifiable risk factor for diabetic retinopathy; tight glycemic control may be the most effective and important therapy for improving quality of life and substantially reducing the incidence of retinopathy and in T2DM patients.

Assessment of the Role of Serum 25-Hydroxy Vitamin D Level on Coronary Heart Disease Risk With Stratification Among Patients With Type 2 Diabetes Mellitus

“…This observation warrant further investigation since hepcidin is directly regulated by vitamin D as it contains a vitamin D response element binding site on its promoter. 36 Those previous reports 6,15 –17,32 –34 lend support to our current study.…”

“…33 Furthermore, vitamin D levels <21 ng/mL is associated with an increased risk of hypertension, T2DM, obesity, and triglycerides that contribute to increased cardiovascular mortality. 6,[15][16][17] Overall, vitamin D deficiency has been found to contribute to various cardiac conditions, such as hypertension, CHD, stroke, and atherosclerosis. 15,34 In addition, several studies considered evidence as adequate to establish low vitamin D levels as a CVD risk factor.…”

“…6,[15][16][17] Overall, vitamin D deficiency has been found to contribute to various cardiac conditions, such as hypertension, CHD, stroke, and atherosclerosis. 15,34 In addition, several studies considered evidence as adequate to establish low vitamin D levels as a CVD risk factor. [16][17]35 Further, due to its immune modulator activity vitamin D exerts extraskeletal functions.…”

“…[13][14] Vitamin D deficiency can contribute to various conditions, such as hypertension, coronary artery disease, stroke, and atherosclerosis. 15 Some studies consider evidence as adequate to establish low vitamin D levels as a cardiovascular disease (CVD) risk factor. 16,17 Furthermore, several studies have investigated the association between vitamin D deficiency, MetS, obesity, insulin resistance, dyslipidemia, hypertension, and the risk of CVDs and/or T2DM.…”

Protection by vitamin D against high-glucose-induced damage in retinal pigment epithelial cells

“…VITD deficiency has been associated with ageing and with a range of diseases [14]. VITD deficiency is also linked with higher risk of retinopathy in type1 and 2 diabetic patients [15][16][17]. Lower serum VITD concentration is associated with increased severity of retinopathy in patients with proliferative DR [18,19].…”