Vitamin D Status and Cardiovascular Risk Factors in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Sitraka Angelo Raharinavalona1, Rija Eric Raherison2, Rija Mikhaël Miandrisoa1
1Cardiovascular Diseases and Internal Medicine Departments, Soavinandriana Hospital Center, Antananarivo, Madagascar.
Background:
Diabetes mellitus is already a major cardiovascular risk factor (CRF). Hypovitaminosis D is common in patients with type 2 diabetes mellitus (T2DM). It also increases the cardiovascular risk of these subjects.
Objective:
To determine the vitamin D status of Malagasy with T2DM seen at the Soavinandriana Hospital Center, and the association between hypovitaminosis D and CRF.
Methods:
This was a cross-sectional study, carried out over a period of 2 years. Assayed by the chemiluminescence technique, vitamin D was "normal", "insufficient" and "deficient" if the 25-hydroxyvitamin D plasma was ≥30 ng/mL, 20-29 ng/mL and ≤19 ng/mL, respectively. Hypovitaminosis D was the set of vitamin D insufficiency and deficiency.
Results:
Among the 318 T2DM, the prevalence of hypovitaminosis D was 66.0% (45.2% insufficiency and 20.8% deficiency). Their factors associated were age ≥70 years (OR = 2.15 [1.26-3.66]), glycated haemoglobin ≥7% (4.97 [2.97-8.39]), and retinopathy (OR = 4.15 [1.85-9.32]). After adjustment for age, Hb A1c ≥7% and retinopathy, hypovitaminosis D was associated with hypertension (OR = 8.77 [4.76-16.2]), dyslipidaemia (OR = 8.05 [3.98-14.5]), ex-smoking (OR = 6.07 [2.78-13.3]), microalbuminuria (OR = 2.95 [1.25-6.97]) and carotid atherosclerosis (OR = 2.96 [1.83-4.35]).
Conclusion:
Hypovitaminosis D was common in T2DM. Its treatment is primarily preventive. It is also important to control associated CRF, diabetes and its complications.
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