Vitamin D Deficiency Is Associated With Retinopathy in Children and Adolescents With Type 1 Diabetes

Kaur, Harleen; Donaghue, Kim C.; Chan, Albert; Benitez‐Aguirre, Paul; Hing, Stephen; Lloyd, Margaret; Cusumano, Janine; Pryke, Alison; Craig, Maria E.

doi:10.2337/dc11-0103

Cited by 99 publications

(88 citation statements)

References 13 publications

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“…In the National Health and Nutrition Examination Survey, for example, the diagnosis of peripheral neuropathy is based on self-reported symptoms of neuropathy, such as pain, tingling, numbness, or loss of feeling in hands or feet (19). In contrast, Kaur et al (20) reported a higher prevalence of vitamin D deficiency in patients with diabetic retinopathy but found no association between vitamin D deficiency and neuropathy or nephropathy.…”

Section: Discussionmentioning

confidence: 89%

Serum 25-Hydroxyvitamin D: A Predictor of Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes

et al. 2014

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OBJECTIVEPeople with diabetes frequently develop vascular disease. We investigated the relationship between blood 25-hydroxyvitamin D (25OH-D) concentration and vascular disease risk in type 2 diabetes. RESEARCH DESIGN AND METHODSThe relationships between blood 25OH-D concentration at baseline and the incidence of macrovascular (including myocardial infarction and stroke) and microvascular (retinopathy, nephropathy, neuropathy, and amputation) disease were analyzed with Cox proportional hazards models and logistic regression in an observational study of patients in the 5-year Fenofibrate Intervention and Event Lowering in Diabetes trial. RESULTSA total of 50% of the patients had low vitamin D concentrations, as indicated by median blood 25OH-D concentration of 49 nmol/L. These patients with a blood 25OH-D concentration <50 nmol/L had a higher cumulative incidence of macrovascular and microvascular events than those with levels ‡50 nmol/L. Multivariate analysis, stratified by treatment and adjusted for relevant confounders, identified blood 25OH-D concentration as an independent predictor of macrovascular events. A 50 nmol/L difference in blood 25OH-D concentration was associated with a 23% (P = 0.007) change in risk of macrovascular complications during the study, and further adjustments for seasonality, hs-CRP, and physical activity level had little impact. The unadjusted risk of microvascular complications was 18% (P = 0.006) higher during the study, though the excess risk declined to 11-14% and lost significance with adjustment for HbA 1c , seasonality, or physical activity. CONCLUSIONSLow blood 25OH-D concentrations are associated with an increased risk of macrovascular and microvascular disease events in type 2 diabetes. However, a causal link remains to be demonstrated.Diabetes is among the leading causes of death and affects 347 million people worldwide. The World Health Organization expects a 50% increase in deaths from diabetes over the next 10 years, and by 2030, diabetes is projected to be the seventh leading cause of death (1). Most major complications involve large vessel (macrovascular) or small vessel (microvascular) disease.

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Section: Discussionmentioning

confidence: 89%

Serum 25-Hydroxyvitamin D: A Predictor of Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes

et al. 2014

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“…1 Its deficiency has been associated with cancer, infection, asthma, dermopathies, 2 insulin resistance, diabetes and related microvascular complications 3 and retinopathy. 4 The effect in diabetes has been attributed to vitamin D action in promotion of the intestinal absorption of calcium and the secretion of insulin. 5 Vitamin D deficiency has even been postulated to be the factor underlying the health disparities often shown between African Americans and White Americans through the effect on paracrine and autocrine mechanisms that affect health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of vitamin D deficiency in Saudi married couples

2012

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BACKGROUND/OBJECTIVE: Vitamin D deficiency is highly prevalent in Saudi Arabia. The study objective was to compare vitamin D deficiency in Saudi married couples. SUBJECTS/METHODS: This cross-sectional study was carried out in the Royal Guard primary health care center in Riyadh, Saudi Arabia on a consecutive sample of 50 Saudi married couples attending the center without complaints related to vitamin D deficiency. Data were collected through an interview questionnaire addressing the risk factors and dietary habits. Quantitative determination of total 25-hydroxy vitamin D in blood was done by Electro-Chemical Luminescence assay. Fieldwork was carried out from December 2010 to January 2011. RESULTS: Men had higher sun exposure (P ¼ 0.001), more use of light clothes at home (P ¼ 0.002) and more intake of milk (P ¼ 0.023) and soft drinks (P ¼ 0.001). Vitamin D was higher in men with mean difference about 9 nmol/l (Po0.001). The prevalence of vitamin D deficiency (o25 nmol/l) was 70% in women, compared with 40% in men (P ¼ 0.001). Multivariate analysis identified male gender, physical activity and the intake of milk as statistically significant positive independent predictors of vitamin D level, adjusted for factors as age, sun exposure, clothing, skin color, BMI, soft drinks and animal protein intake. CONCLUSION: Vitamin D deficiency is very high among Saudi married couples, especially wives. Female gender is an independent predictor of lower vitamin D level, in addition to sedentary lifestyle and low milk consumption. There is a need to revise the levels set for the diagnosis of vitamin D deficiency or insufficiency in the study region.

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“…Most of them [255][256][257][258][259][260][261][262][263][264][265], including the larger ones, but not all [258,264], found associations between low vitamin D levels and the presence and severity of diabetic retinopathy. In a cross-sectional study of the Children's Hospital at Westmead type 1 diabetes cohort, vitamin D levels were inversely associated with the presence diabetic retinopathy, which was assessed based on vascular lesions [261]. However, vitamin D levels were not associated with earlier biomarkers of retinal vascular geometry [266].…”

Section: Nutrition-related Biomarkersmentioning

confidence: 99%

Biomarkers in Diabetic Retinopathy

et al. 2015

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■ AbstractThere is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat diabetic retinopathy, there is need to reliably identify and triage people with diabetes. Biomarkers may facilitate a better understanding of diabetic retinopathy, and contribute to the development of novel treatments and new clinical strategies to prevent vision loss in people with diabetes. This article reviews key aspects related to biomarker research, and focuses on some specific biomarkers relevant to diabetic retinopathy.

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Vitamin D Deficiency Is Associated With Retinopathy in Children and Adolescents With Type 1 Diabetes

Cited by 99 publications

References 13 publications

Serum 25-Hydroxyvitamin D: A Predictor of Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes

Serum 25-Hydroxyvitamin D: A Predictor of Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes

Comparison of vitamin D deficiency in Saudi married couples

Biomarkers in Diabetic Retinopathy

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