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Association between Serum Vitamin D and Diabetic Retinopathy in Portuguese Patients with Type 1 Diabetes

Authors: Miguel Lopes; Rita Laiginhas; Carolina Madeira; João Sérgio Neves; Margarida Barbosa; Vitor Rosas; Davide Carvalho; +2 Authors

Association between Serum Vitamin D and Diabetic Retinopathy in Portuguese Patients with Type 1 Diabetes

Abstract

Introduction: Recently, vitamin D has gained importance as a diabetes risk modifier. Our aim was to assess the association between serum vitamin D levels and the prevalence of diabetic retinopathy in patients with type 1 diabetes.Material and Methods: Retrospective review of a population of patients with type 1 diabetes followed in a Portuguese tertiary center. Patients were included if they had an ophthalmological evaluation and a serum 25-hydroxyvitamin D level determination within the same year. Logistic regression analysis was used to adjust for possible confounders.Results: We included 182 patients (47% male), and 57% (n = 103) had signs of diabetic retinopathy. We found a significant association between lower circulating levels of 25-hydroxyvitamin D levels and a greater prevalence of diabetic retinopathy after adjusting for confounders (duration of diabetes, estimated glomerular filtration rate, age, sex, metabolic control, season, dyslipidemia and hypertension) (OR = 0.94; 95% CI 0.90 - 0.99, p = 0.023). Longer duration of diabetes and worse metabolic control also remained associated with diabetic retinopathy in the multivariate analysis (OR = 1.20; 95% CI 1.13 - 1.27, p < 0.001 and OR = 4.13; 95% CI 1.34 - 12.7, p = 0.013, respectively).Conclusion: Lower levels of vitamin D were associated with an increased prevalence of diabetic retinopathy in patients with type 1 diabetes, after adjusting for possible confounders. Future controlled studies may elucidate the molecular routes for this association as well as the role of supplementation in the prevention of diabetes microvascular complications.

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Keywords

Adult, Male, Vitamin D / analogs & derivatives, Medicine (General), Diabetes Mellitus, Type 1 / complications, R5-920, Risk Factors, Diabetes Mellitus, Humans, Portugal / epidemiology, Vitamin D / blood, Vitamin D, Retrospective Studies, Diabetic Retinopathy, Portugal, Diabetic Retinopathy / blood, R, Diabetic Retinopathy / complications, Middle Aged, Vitamin D Deficiency / blood, Vitamin D Deficiency, Vitamin D Deficiency / epidemiology, Diabetes Mellitus, Type 1 / epidemiology, Diabetic Retinopathy / epidemiology, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 1 / blood, Medicine, Female, Type 1

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
13
Top 10%
Average
Top 10%
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Published in a Diamond OA journal