THE PREVALENCE AND DETERMINANT FACTORS OF LOW VITAMIN D LEVELS IN PATIENTS WITH PAINFUL DIABETIC NEUROPATHY

  • RIZALDY TASLIM PINZON Department of Neurology, Duta Wacana Christian University, School of Medicine, Yogyakarta, Indonesia. http://orcid.org/0000-0002-3357-9907
  • ANDRYAWAN WAHYU PRADANA Department of Neurology, Duta Wacana Christian University, School of Medicine, Yogyakarta, Indonesia.
  • ANGELA Department of Neurology, Duta Wacana Christian University, School of Medicine, Yogyakarta, Indonesia.

Abstract

Objective: Type 2 diabetes mellitus is a major public health problem. Diabetic neuropathy is one of the major diabetes microvascular complications. The previous study suggests that Vitamin D deficiency plays an important role in the development and progression of diabetes and the data in Indonesia are very limited. This study aims to measure the prevalence of Vitamin D deficiency and its determinant factors in patients with painful diabetic neuropathy (PDN).


Methods: This study is a cross-sectional study. The data were obtained from 53 subjects with diabetic peripheral neuropathy. A pre-designed questionnaire was used to collect data on the patient’s age, gender, duration of diabetes, comorbidities, any diabetic complications, and current treatment for diabetes mellitus. The Vitamin D levels were measured by a standardized method in the Prodia Research Laboratory.


Results: Study findings showed that from 53 study subjects, most of them were female (79.2%). The mean age of subjects was 57.83±8.79 years. We found a high prevalence of low Vitamin D levels in the Indonesian population as many as 98.11% and only 1.9% has sufficiency Vitamin D levels. Gender (p=0.028), hypertension (p=0.027), and controlled complications (p=0.005) were significantly associated with Vitamin D levels.


Conclusion: All patients with PDN in this study had a high prevalence of Vitamin D deficiency. This high prevalence of Vitamin D deficiency also has been reported worldwide. Physician should be aware and continue to treat patients with Vitamin D deficiency.

Keywords: Diabetes mellitus, Vitamin D deficiency, Low Vitamin D levels, Painful diabetic neuropathy

References

1. Boulton A, Malik R, Arezzo J, Sosenko J. Diabetic somatic neuropathies (technical review). Diabetes Care 2004;27:1458-86.
2. Indonesian Ministry of Health. Indonesian Health Profile Survey. Indonesia: Indonesian Ministry of Health; 2017.
3. Dang C, Boulton A. Changing perspectives in diabetic foot ulcer management. Int J Low Extrem Wounds 2003;2:4-12.
4. Tesfaye S, Boulton A, Dyck P, Freeman R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 2010;33:2285-93.
5. Al-Timimi D, Ali A. Serum 25(OH) D in diabetes mellitus Type 2: Relation to glycaemic control. J Clin Diagn Res 2013;7:2686-8.
6. Olt S. Relationship between Vitamin D and glycemic control in patients with Type 2 diabetes mellitus. Int J Clin Exp Med 2015;8:19180-3.
7. Ahmadieh H, Azar ST, Lakkis N, Arabi A. Hypovitaminosis d in patients with Type 2 diabetes mellitus: A relation to disease control and complications. ISRN Endocrinol 2013;2013:641098.
8. Palazhy S, Viswanathan V, Muruganathan A. Prevalence of 25-hydroxy Vitamin D deficiency among Type 2 diabetic subjects of South India. Int J Diabetes Dev Ctries 2016;37:1-5.
9. Karau PB, Kirna B, Amayo E, Joshi M, Ngare S, Muriira G. The prevalence of Vitamin D deficiency among patients with Type 2 diabetes seen at a referral hospital in Kenya. Pan Afr Med J 2019;34:38.
10. Abbott CA, Malik RA, Van RE, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community based diabetic population in the UK. Diabetes Care 2011;34:2220-4.
11. Darraj H, Badedi M, Poore KR, Hummadi A, Khawaji A, Solan Y, et al. Vitamin D deficiency and glycemic control among patients with Type 2 diabetes mellitus in Jazan City, Saudi Arabia. Diabetes Metab Syndr Obes 2019;12:853-62.
12. Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus Type 2. Ther Adv Endocrinol Metab 2013;4:122-8.
13. Tahrani A, Ball A, Shepherd L, Rahim A, Jones A, Bates A. The prevalence of Vitamin D abnormalities in South Asians with Type 2 diabetes mellitus in the UK. Int J Clin Pract 2010;64:351-5.
14. Lee J, Oh S, Ha W, Kwon H, Sohn T, Son H, et al. Serum 25-hydroxyvitaminD concentration and arterial stiffness among Type 2 diabetes. Diabetes Res Clin Pract 2012;95:42-7.
15. Al-Zaharani M. The Prevalence of Vitamin D deficiency in Type 2 diabetic patients. Majmaah J Health Sci 2013;1:18-22.
16. Bayani M, Akbari R, Banasaz B, Saeedi F. Status of Vitamin-D indiabeticpatients. Caspian J Int Med 2014;5:40-2.
17. He R, Hu Y, Zeng H, Zhao J, Chai Y, Liu F, et al. Vitamin D deficiency increases the risk of peripheral neuropathy in Chinese patients with Type 2 diabetes. Diabetes Metab Res Rev 2017;33:2820.
18. Khan H, Rajar I, Memon AR, Naeem N. Vitamin D deficiency in patients with diabetic peripheral neuropathy. J Islamabad Med Dent Coll 2019;7:291-4.
19. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third national health and nutrition examination survey. Diabetes Care 2004;27:2813-8.
20. Shillo P, Selvarajah D, Greig M, Gandhi R, Rao G, Wilkinson ID, et al. Reduced Vitamin D levels in painful diabetic peripheral neuropathy. Diabet Med 2018;36:44-51.
21. Zarooni AA, Marzouqi FI, Darmaki SH, Prinsloo EA, Nagelkerke N. Prevalence of Vitamin D deficiency and associated comorbidities among Abu Dhabi Emirates population. BMC Res Notes 2019;12:503.
22. Joergensen C, Hovind P, Schmedes A, Parving HH, Rossing P. Vitamin D levels, microvascular complications, and mortality in type diabetes. Diabetes Care 2011;34:1081-5.
23. Takiishi T, Gysemans C, Bouillon R, Mathieu C. Vitamin D and dia-betes. Endocrinol Metab Clin North Am 2010;39:419-46.
24. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782-7.
25. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, dia-betes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2813-8.
26. Fukuoka M, Sakurai K, Ohta T, Kiyoki M, Katayama I. Tacalcitol, an active Vitamin D3, induces Nerve growth factor production in human epidermal keratinocytes. Skin Pharmacol Appl Skin Physiol 2001;14:226-33.
27. Poisbeau P, Aouad M, Gazzo G, Lacaud A, Kemme V, Landel V, et al. Cholecalciferol (Vitamin D3) reduces rat neuropathic pain by modulating opioid signaling. Mol Neurobiol 2019;56:7208-21.
28. Lim S, Shin H, Kim MJ, Ahn HY, Kang SM, Yoon JW, et al. Vitamin D inadequacy is associated with significant coronary artery stenosis in a community-based elderly cohort: The Korean Longitudinal study on health and aging. J Clin Endocrinol Metab 2012;97:169-78.
29. Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, et al. The nonskeletal effects of Vitamin D: An endocrine society scientific statement. Endocr Rev 2012;33:456-92.
30. Park HY, Lim YH, Kim JH, Bae S, Oh SY, Hong YC. Association of serum 25-hydroxyvitamin D levels with markers for metabolic syndrome in the elderly: A repeated measure analysis. J Korean Med Sci 2012;27:653-60.
31. Qiao G, Kong J, Uskokovic M, Li YC. Analogs of 1?,25- dihydroxyvitamin D(3) as novel inhibitors of rennin biosynthesis. J Steroid Biochem Mol Biol 2005;96:59-66.
32. Rebsamen MC, Sun J, Norman AW, Liao JK. 1 ?,25-dihydroxyvitamin D3 induces vascular smooth muscle cell migration via activation of phosphatidylinositol 3-kinase. Circ Res 2002;91:17-24.
33. Chonchol M, Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third national health and nutrition examination survey. Kidney Int 2007;71:134-9.
34. Herrmann M, Sullivan DR, Veillard AS, McCorquodale T, Straub IR, Scott R, et al. Serum 25-hydroxyvitamin D: A predictor of macrovascular and microvascular complications in patients with Type 2 diabetes. Diabetes Care 2015;38:521-8.
35. Brijesh M, Saurav P, Prevalence of Vitamin D deficiency in Type-2 diabetes mellitus patients and its correlation with glycemic control. Int J Bioassays 2014;3:3313-7.
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PINZON, R. T., A. W. PRADANA, and ANGELA. “THE PREVALENCE AND DETERMINANT FACTORS OF LOW VITAMIN D LEVELS IN PATIENTS WITH PAINFUL DIABETIC NEUROPATHY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 14, no. 3, Mar. 2021, pp. 116-20, doi:10.22159/ajpcr.2021.v14i3.40203.
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