Role of vitamin D in diabetic retinopathy: Pathophysiological and clinical aspects
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Role of vitamin D in diabetic retinopathy: Pathophysiological and clinical aspects Francesco Tecilazich 1 & Anna Maria Formenti 1 & Andrea Giustina 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Epidemiological data predict a dramatic increase in the prevalence of diabetes and of diabetic retinopathy (DR) – the most common complication of diabetes-for which however we do not have so far effective tools for prevention and treatment. Since hypovitaminosis D is very frequent in patients with diabetes and vitamin D (VD) has vascular protective properties, several studies have addressed the association of VD deficiency with DR and its severity and progression, whereas the effects of VD supplementation on its natural history are largely unknown. Here we review the available evidence that supports the possible protective role of VD in DR and suggests to determine the VD levels in DR patients calling for a definitive randomized clinical trial to ascertain whether VD supplementation could protect against DR. Keywords Vitamin D . Diabetic retinopathy . Diabetes . Microvascular disease . Endothelium
Abbreviations VD Vitamin D DR Diabetic retinopathy PTH Parathyroid hormone VDR Vitamin D receptor mVDR membrane-located vitamin D receptor nVDR nuclear-located vitamin D receptor NHANES National Health and Nutrition Examination Survey T2DM type 2 diabetes mellitus BMI Body mass index RCTs Randomized controlled trials HbA1c glycated hemoglobin T1DM Type 1 diabetes mellitus DED diabetic eye disease OR odds ratio YKL-40 tyrosine (Y), lysine (K) and leucine (L)-40 MCP-1 Monocyte chemoattractant protein-1 IL-6 Interleukin 6
Francesco Tecilazich and Anna Maria Formenti contributed equally to this work. * Andrea Giustina [email protected] 1
Institute of Endocrine and Metabolic Sciences, San Raffaele Vita Salute University and IRCCS San Raffaele Hospital, Milan, Italy
HOMA-IR RHI EC VSMC eNOS NO MAO VEGF PGI2 PLCγ PKC ROS TXNIP NLRP3 TNF-α IL-17A CD3 CD28 LPS C3 RAAS AGEs NFκB RAGE GLO1 ICAM-1 ER
Homeostatic Model Assessment of Insulin Resistence reactive hyperemia index Endothelial cells Vascular smooth muscle cells Endothelial nitric oxyd synthase Nitric oxide Monoamine oxidases Vascular endothelial growth factor prostacyclin Phospholipase C-Gamma Phosphokinase C Reactive oxygen species Thioredoxin-Interacting Protein (NOD)-like receptor protein 3 Tumor necrosis factor α Interleukin 17A Cluster-Defined 3 Cluster-Defined 28 LipoPolySaccharide Complement 3 Renin-angiotensin aldosterone system Advanced glycation end products Nuclear factor-kappa B Advanced glycation end product receptor glyoxalase I enzyme Intercellular adhesion molecule-1 Endoplasmic reticulum
Rev Endocr Metab Disord
PERK eIF2a ATF4 CHOP GRP78 P I 3 K AKT
protein kinase RNA-like eukaryotic initiation factor 2 alpha Activating Transcription Factor 4 C/Ebp-Homologous Protein Glucose-Regulated Protein, 78-KD Phosphatidylinositol-3-Kinase and Protein Kinase B
1 Introduction Vitamin D (VD) is actually a steroid hormone produced
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