Vitamin D Associated With Increased Vascular Disease Risk in Diabetes

the Endocrinology Advisor take:

In patients with type 2 diabetes, low blood 25-hydroxyvitamin D (25[OH]D) is associated with an increased risk for vascular disease, according to a study published in Diabetes Care.

In particular, the risk for macrovascular complications increased significantly with lower levels of blood 25(OH)D, reported Markus Herrmann, MD, FRCPA, of the Royal Prince Alfred Hospital in Sydney, and colleagues.

The study looked at the relationship between blood 25(OH)D levels at baseline and the incidence of vascular disease after a 5-year follow-up of patients in the Fenofibrate Intervention and Event Lowering in Diabetes trial. Macrovascular conditions included myocardial infarction (MI) and stroke, and microvascular conditions included retinopathy, nephropathy, neuropathy and amputation.

Participants with a blood 25(OH)D concentration <50 nmol/L had greater incidences of both macrovascular and microvascular diseases compared with participants whose blood 25(OH)D concentration was ≥50 nmol/L. A 50-nmol/L difference in blood 25(OH)D was associated with a 23% change in the risk for macrovascular events. 

Adjusting for HbA1c, seasonality and physical activity had little effect on the incidence of macrovascular events. After adjusting for HbA1c, seasonality and physical activity, the change in risk for microvascular events fell from 18% to 11% to 14%.

These results indicate that blood 25(OH)D levels affect the rate of vascular disease, especially macrovascular events, in patients with type 2 diabetes.