Association of vitamin D 2 and D 3 with type 2 diabetes complications
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RESEARCH ARTICLE
Open Access
Association of vitamin D2 and D3 with type 2 diabetes complications Lina H. M. Ahmed1, Alexandra E. Butler2* , Soha R. Dargham1, Aishah Latif3, Amal Robay1, Omar M. Chidiac1, Amin Jayyousi4, Jassim Al Suwaidi4, Ronald G. Crystal5, Stephen L. Atkin1,6† and Charbel Abi Khalil1,5†
Abstract Aims: Vitamin D measurement is a composite of vitamin D2 (25(OH)D2) and D3 (25(OH)D3) levels, and its deficiency is associated with the development of type 2 diabetes (T2DM) and diabetic complications; vitamin D deficiency may be treated with vitamin D2 supplements. This study was undertaken to determine if vitamin D2 and D3 levels differed between those with and without T2DM in this Middle Eastern population, and the relationship between diabetic microvascular complications and vitamin D2 and vitamin D3 levels in subjects with T2DM. Methods: Four hundred ninety-six Qatari subjects, 274 with and 222 without T2DM participated in the study. Plasma levels of total vitamin D2 and D3 were measured by LC-MS/MS analysis. Results: All subjects were taking vitamin D2 and none were taking D3 supplements. Vitamin D2 levels were higher in diabetics, particularly in females, and higher levels were associated with hypertension and dyslipidemia in the diabetic subjects (p < 0.001), but were not related to diabetic retinopathy or nephropathy. Vitamin D3 levels measured in the same subjects were lower in diabetics, particularly in females (p < 0.001), were unrelated to dyslipidemia or hypertension, but were associated with retinopathy (p < 0.014). Neither vitamin D2 nor vitamin D3 were associated with neuropathy. For those subjects with hypertension, dyslipidemia, retinopathy or neuropathy, comparison of highest with lowest tertiles for vitamin D2 and vitamin D3 showed no difference. Conclusions: In this Qatari cohort, vitamin D2 was associated with hypertension and dyslipidemia, whilst vitamin D3 levels were associated with diabetic retinopathy. Vitamin D2 levels were higher, whilst vitamin D3 were lower in diabetics and females, likely due to ingestion of vitamin D2 supplements. Keywords: Vitamin D, Vitamin D metabolites, Type 2 diabetics, Diabetic complications, Vitamin D deficiency, Vitamin D2, Vitamin D3
Introduction Vitamin D measurement is a composite of both vitamin D2 (25(OH)D2) and D3 (25(OH)D3) levels. Vitamin D deficiency has been suggested to increase the risk of type 2 diabetes (T2DM) with an inverse relationship between vitamin D levels and the onset of diabetics seen in a * Correspondence: [email protected]; [email protected] † Stephen L. Atkin and Charbel Abi Khalil are joint senior authors. 2 Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar Full list of author information is available at the end of the article
large prospective study [1], though in a study in prediabetes patients 4000 IU daily of vitamin D3 supplementation did not significantly lower the risk of diabetes [2]. Deficien
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