Abstract. Aim: Determination of the 25(OH) vitamin D levels in Greek-born Diabetic distal sensorimotor neuropathy (DSPN) is the most frequent type of polyneuropathy and the most frequent complication of diabetes affecting up to 50% of patients (1, 2). In several European studies, large-fiber neuropathy (LFN) and small-fiber neuropathy (SFN) seem to be less prevalent in Asian than in European patients with diabetes and this is attributed to their lower height, less smoking, and better skin microvascularization (3, 4). Vitamin D deficiency has also been recently implicated in the pathogenesis of diabetic neuropathy (DN) (5-7).In a previous study, we showed that vitamin D levels were lower in Bangladeshi immigrants with diabetes in Greece compared to indigenous Greek patients with diabetes (8). In this study, we investigated the 25 (OH) vitamin D level in patients with diabetes with and without polyneuropathy in both ethnic groups.
Materials and MethodsThe study sample consisted of Greek and Bangladeshi patients recruited from the outpatient diabetic clinic of a general hospital and were matched as to age, sex and diabetes duration. This sample is part of that previously described (8). The following clinical and diabetes related factors were taken into consideration: Age, sex, type of diabetes, age at diabetes diagnosis, duration of diabetes, diabetes treatment, episodes of hypoglycemia, body mass index (BMI), glycated hemoglobin (HbA1c) and 25(OH) vitamin D levels. Patients treated for vitamin D deficiency, those taking vitamin D supplements and those treated with medicines known to affect bone metabolism were excluded from this study. The patients were recruited between January 2012 and December 2014, over a period of time that included all seasons. Serum 25(OH) vitamin D levels were measured using an assay kit from Roche Diagnostics GmbH (Mannheim, Germany) and the measurement was performed once, at the first appointment.All patients gave their written consent and the study was approved by our local Ethics Committee (approval number 445/30-11-2011).The electrophysiological study for the detection and staging of polyneuropathy has been described elsewhere (9): The diagnosis of polyneuropathy required the combination of abnormal findings from the Neuropathy Symptoms Score (NSS), Neuropathy Disability Score (NDS), nerve conduction velocities (NCV) and Quantitative Sensory Tests (QST). The classification proposed by Dyck for patients with diabetes was used (10).Student's t-test analysis was used to assess the statistical significance of the differences between groups. A value of p<0.05 was considered significant.
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