Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle-aged patients

Diabetes Metab Res Rev. 2019 Sep;35(6):e3162. doi: 10.1002/dmrr.3162. Epub 2019 Apr 26.

Abstract

Background: The relationship between vitamin D and diabetes peripheral neuropathy (DPN) is not consistent among epidemiologic studies. Thus, we aimed to investigate this relationship in different age groups.

Methods: In this cross-sectional study, 1461 patients admitted to the Department of Endocrinology at Xinhua Hospital from June 2016 to September 2017 were divided into three age groups: a Youth group (24-44 years, n = 127), a Middle-age group (45-64 years, n = 779), and an Elderly group (≥65 years, n = 555). Basic information and laboratory results were collected from medical records.

Results: Among the patients, 32.72% had DPN, with 12.59% in the Youth group, 33.63% in the Middle-age group, and 36.04% in the Elderly group. For the total sample and the Elderly group, serum 25(OH)D concentrations in DPN patients were lower than in non-DPN patients (P < .05). The results of multivariate logistic regression indicated a low vitamin D concentration to be a risk factor for DPN in the Elderly group (P < .05), but such relationship was not found in the Youth or Middle-age groups. Moreover, according to ROC analysis, a serum 25(OH)D level < 34.87 nmol/L suggests the occurrence of DPN in elderly patients with type 2 diabetes (P < .001).

Conclusions: This study is the first to report that a low vitamin D level is associated with DPN in diabetic patients over 65 years of age and might be used as a predictor of DPN in this population. The interaction between vitamin D and age in the development of DPN and its underlying mechanisms need to be further explored.

Keywords: age; diabetic peripheral neuropathy; type 2 diabetes; vitamin D.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers / analysis*
  • Blood Glucose / analysis
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Neuropathies / blood
  • Diabetic Neuropathies / etiology*
  • Diabetic Neuropathies / pathology
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Risk Factors
  • Vitamin D / blood*
  • Vitamin D Deficiency / complications*
  • Vitamins / blood*
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Vitamins
  • hemoglobin A1c protein, human
  • Vitamin D