THE RELATIONSHIP BETWEEN VITAMIN D LEVEL ANDPERIPHERAL ARTERY DISEASE AND CORONARY ARTERYDISEASE IN TYPE 2 DIABETES MELLITUS

Abstract

Background : The role of Vitamin D deficiency in microvascular complications has been
documented. However the effect of vitamin D deficiency on macrovascular complications are
not studied extensively. Hence this study evaluate the effect of vitamin D deficiency on
macrovascular complications; PERIPHERAL ARTERIAL DISEASE AND CORONARY
ARTERY DISEASE in type 2 diabetes mellitus.
Material and Methods : The study was conducted on 200 patients with type 2 diabetes
mellitus in which 100 patients were having macrovascular complications of diabetes(group 1)
and 100 patients without macrovascular complications(group 2). To compare the level of
vitamin D, 100 age-sex matched controls without diabetes (group 3) were taken. 25(OH)
vitamin D level was measured among all three groups from the serum by ELISA kit. All
vascular complications were measured by standard techniques used worldwide.
Results : The mean levels of vitamin D in group 1 , group 2 and group 3 were 7.53±2.14 ,
11.23±3.44 and 31.48±6.43 ng/ml respectively. The 25(OH) vitamin D deficient (<20ng/ml)
subjects in group 1 ,group 2 and group 3 were 79(79%) , 56(56%) and 14(14%) respectively.
The peripheral artery disease and coronary artery disease were higher in vitamin D deficiency
with vitamin D levels less than 30 ng/ml (P<0.05). The number of vascular complications
were significantly correlated with vitamin D deficiency severity (p=0.0001)
Conclusion : The study gives us an insight to identify the diabetics with vitamin D
deficiency which may be at higher risk of vascular complications. Vitamin D deficiency is
higher among patients with type 2 diabetes mellitus as compared to controls. Vitamin D
deficiency is also higher in patients with type 2 diabetes with vascular complications.
Vitamin D deficiency is also associated with severity of vascular complications in type 2
diabetes. Further, a need to undertake future prospective multicenter study with larger
number of subjects to find a cause effect relationship between vitamin D deficiency and
vascular complications in patients of type 2 diabetes mellitus. This may help us to initiate
interventional studies to see the reversal effect with supplementation of vitamin D to halt the
progression of vascular complications and atherosclerosis in patients of type 2 DM.