A Study on Association of Lower Levels of 25-Hydroxy Vitamin D3 in Type 2 Diabetes Mellitus and Diabetic Nephropathy and Retinopathy

Prabha, K (2020) A Study on Association of Lower Levels of 25-Hydroxy Vitamin D3 in Type 2 Diabetes Mellitus and Diabetic Nephropathy and Retinopathy. Masters thesis, Kilpauk Medical College, Chennai.


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BACKGROUND: Vitamin D has important actions on glucose metabolism. These include improved insulin exocytosis, direct stimulation of insulin receptor, improved uptake of glucose by peripheral tissues, improving insulin resistance. It has got various pleiotropic effects like suppression of cell mediated immunity, regulation of cell proliferation, suppression of RAAS, reduction of albuminuria, immunomodulatory effects, and anti-inflammatory effects. Thus, vitamin D is implicated in many ways in the pathogenesis of retinopathy and nephropathy. OBJECTIVES: To study the Association of vitamin D levels with microvascular Complications such as Diabetic Nephropathy and Retinopathy in type 2 Diabetes Mellitus. MATERIALS AND METHODS: Cross-sectional case-control study of 206 patients above 30 years of age who met the American Diabetes Association 2011 criteria for type 2 diabetes, was conducted. Age and sex matched healthy controls were taken. Subjects were evaluated for the presence of microvascular complications by clinical evaluation, urine examination, fundus examination, and various biochemical tests. 25-OH cholecalciferol levels were done for each. Cut off level for vitamin D deficiency was 30 ng/ml. RESULTS: Prevalence of vitamin D deficiency and insufficiency was found to significantly higher in diabetics when compared to healthy subjects. Lower levels of vitamin D were found to be associated with increasing prevalence of combinations of microvascular complications namely retinopathy (P = 0.005), and not with nephropathy (P = 0.121). We found an inverse and independent relationship between circulating 25(OH)D levels and the prevalence of microvascular complications in patients with type 2 diabetes. However, vitamin D may be simply a marker and causality cannot be implied from our cross-sectional study. Whether vitamin D supplementation in patients with type 2 diabetes may have beneficial effects on the risk of microvascular complications remains to be investigated. CONCLUSION: Vitamin D is found to have both direct action through vitamin D receptor activation and indirect action through regulation of calcium homeostasis and its effects on various pathogenesis and type2 diabetes which includes dysfunction of pancreatic beta cells, insulin action impairment and systematic information. ◈ Vitamin D is considered to be an important factor in modifying the risk of type2 diabetes mellitus and its microvascular complications especially Diabetic retinopathy. ◈ In type 2 Diabetes mellitus about 65% people found to have vitamin D deficiency according to our study.

Item Type: Thesis (Masters)
Additional Information: 201711159
Uncontrolled Keywords: Vitamin D, Diabetes Mellitus, Retinopathy, Nephropathy.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Jan 2021 16:46
Last Modified: 28 Jan 2021 16:46
URI: http://repository-tnmgrmu.ac.in/id/eprint/13270

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