Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2017; 8(7): 346-350
Published online Jul 15, 2017. doi: 10.4239/wjd.v8.i7.346
Vitamin D levels in subjects with or without chronic kidney disease among Veterans with diabetes in North East United States
Subhashini Yaturu, Barbara Youngberg, Sonya Zdunek
Subhashini Yaturu, WJB Dorn VA Medical Center/USC School of Medicine, Columbia, SC 29029, United States
Barbara Youngberg, Former Research Assistant atStratton VA MC at Albany, NY 29029, Unites States
Sonya Zdunek, Stratton VA MC at Albany, NY 29029, Unites States
Author contributions: Yaturu S contributed to protocol writing, analysis of data, preparation of manuscript; Youngberg B contributed to administrative paper work for IRB submission, data organization, and chart reviews; Zdunek S contributed to data retrieval.
Institutional review board statement: The study protocol was reviewed and approved by the Institutional Review Board as well as the Institutional Research and Development Committee.
Informed consent statement: Not applicable as it is a retrospective data.
Conflict-of-interest statement: The author declares that the preparation of the manuscript was carried out in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Subhashini Yaturu, MD, Professor, WJB Dorn VA Medical Center/USC School of Medicine, 6439 Garners Ferry Road, Columbia, SC 29029, Unites States. subhashini.yaturu@va.gov
Telephone: +1-803-7764000-6092
Received: August 26, 2016
Peer-review started: September 1, 2016
First decision: November 11, 2016
Revised: May 9, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: July 15, 2017
Processing time: 310 Days and 4.7 Hours
Abstract
AIM

To evaluate the prevalence of vitamin D deficiency and its relation to diabetes and kidney disease in Veterans residing in the North East United States (VISN 2).

METHODS

In this retrospective study, we used data from the computerized patient record system at Stratton Veterans Administration Medical Center at Albany, NY (VHA) for those patients who had 25-hydroxyvitamin D levels and 1,25 (OH) vitamin D levels measured between 2007 and 2010. We collected demographic information including age, sex, body mass index and race; clinical data including diabetes, hypertension and CAD; and laboratory data including calcium, creatinine and parathyroid hormone (PTH) (intact). Vitamin D deficiency is defined as a serum 25-hydroxyvitamin D level of less than 20 ng/mL (50 nmol/L), and insufficiency is defined as a serum 25-hydroxyvitamin D level of 20 to 30 ng/mL (50 to 75 nmol/L).

RESULTS

Data was available for approximately 68000 subjects. We identified 64144 subjects for analysis after exclusion of duplicates. Among them, 27098 had diabetes. The mean age of subjects with diabetes was 68 ± 11 with a mean body mass index (BMI) of 32 ± 7 and duration of diabetes of 5.6 ± 3.2 years. The mean 25 (OH) vitamin D level among subjects with diabetes was 27 ± 11.6. There was no significant difference in 25 (OH) vitamin D levels between subjects with diabetes and glomerular filtration rate (e-GFR) < 60 compared to those with e-GFR ≥ 60. As expected, subjects with e-GFR < 60 had significantly lower 1,25 (OH) vitamin D levels and significantly elevated PTH-intact. Of the 64144 subjects, 580 had end-stage renal disease. Of those, 407 had diabetes and 173 did not. Vitamin D levels in both groups were in the insufficiency range and there was no significant difference irrespective of presence or absence of diabetes. Subjects with vitamin D levels less than 20 ng/mL had a higher BMI and elevated PTH, and higher HbA1C levels compared to those with vitamin D levels more than 20 ng/mL.

CONCLUSION

We conclude that we need to keep a close eye on vitamin D levels in subjects with mild chronic kidney disease as well as those with moderate control of diabetes.

Keywords: Vitamin D; Type 2 diabetes; Men; Chronic kidney disease; End stage renal disease

Core tip: This retrospective study evaluated the prevalence of vitamin D deficiency among Veterans in the North East United States, for those patients who had vitamin D levels measured between 2007 and 2010. The data collected include the data of 27098 subjects with diabetes with mean age of 68 and mean duration of diabetes of 5.6 years. There was no significant difference in 25 (OH) vitamin D levels between subjects with > glomerular filtration rate (e-GFR) < 60 and eGFR ≥ 60 but with decreased levels of 1,25 (OH) vitamin D and elevated parathyroid hormone. Vitamin D levels did not differ between subjects with or without diabetes.