GENTOFTE, Denmark—According to Danish researchers, in patients with type 2 diabetes, severe vitamin D deficiency predicts increased risk of all-cause and cardiovascular mortality, independent of urinary albumin excretion rate (UAER) and conventional cardiovascular risk factors (Diabetes Care. July 6, 2010).
In a longitudinal observational follow-up study, 289 type 2 diabetic patients with normoalbuminuria (n=172), microalbuminuria (n=73) and macroalbuminuria (n=44) at baseline, were followed for a median (range) of 15 years.
Median (range) vitamin D level was 35.7 (5 to 136.7)nmol/l. Vitamin D levels were not associated with age, sex, estimated glomerular filtration rate (eGFR), UAER or HbA1c at baseline, but low levels were weakly associated with elevated systolic blood pressure (R=0.13, P=0.03).
During follow-up, 196 (68 percent) patients died. All-cause mortality was increased in patients with severe vitamin D deficiency. The association persisted after adjustment for UAER, HbA1c, diabetes duration and conventional cardiovascular risk factors. Severe vitamin D deficiency was associated with increased cardiovascular mortality. The association persisted after adjustment. Severe vitamin D deficiency at baseline did not predict progression to micro- or macroalbuminuria.
