Authors :
Dr. Dumpa Ravindra reddy; Dr. Srikar Bharadwaj SPVS; Dr. A. Nanda Gopal
Volume/Issue :
Volume 8 - 2023, Issue 3 - March
Google Scholar :
https://bit.ly/3TmGbDi
Scribd :
https://bit.ly/3G2thVO
DOI :
https://doi.org/10.5281/zenodo.7789131
Abstract :
Vitamin D has important actions on glucose
metabolism. These include improved insulin exocytosis,
direct stimulation of insulin receptor, improved uptake
of glucose by peripheral tissues, improving insulin
resistance. It has got various pleiotropic effects like
suppression of cell mediated immunity, regulation of
cell proliferation, stimulation of neurotropic factors
such as nerve growth factor, Glial cell line-derived
neurotrophic factor, neurotropin, suppression of RAAS,
reduction of albuminuria, immunomodulatory effects,
and anti-inflammatory effects. Thus, vitamin D is
implicated in many ways in the pathogenesis of
retinopathy, neuropathy and nephropathy.
Aim of the Study :
The purpose of the study is to assess the levels of
25- hydroxyl vitamin D in patients with type 2 diabetes
mellitus and its association with diabetic nephropathy.
Materials and Methods :
In this cross sectional study, the association
between circulating 25-hydroxy vitamin D level and the
presence of diabetic nephropathy in type 2 diabetes
mellitus who attended medicine outpatient clinic and
inpatients of medical wards.
Our study included 206 patients which includes
two groups, one group with 25(OH) D <30ng/ml of 72
patients and another group with 134 patients who had
25(OH)D>30ng/ml. Venous blood was drawn from the
patients after an overnight fasting and serum creatinine
was calculated using Jaffe method, Glycated
haemoglobin - HbA1c was measured by an automated
High performance liquid chromatography analyser.
Serum 25(OH)D concentrations were measured using
chemiluminescent immunoassay. Estimated Glomerular
Filtration Rate e-GFR was estimated with the Four
variable Modification of Diet in Renal Disease (MDRD)
study equation.
Observation and Results :
In our study total of 206 patients, 104 patients were
female and 102 were males. With gender comparison,
there occurs a statistically significant ‘p value’in female
patients with Vit D<30ng/ml a mean of 61.2%
compared with males with a mean of 38.8%. Here 71
patients with vitamin D deficiency which constitutes
about 53% found to have diabetic nephropathy and in
vitamin D sufficient patients, 30 patients which
constitutes about 41.7% found to have diabetic which is
statistically insignificant.
Conclusion :
Vitamin D is found to have both direct action
through vitamin D receptor activation and indirect
action through regulation of calcium homeostasis and
its effects on various pathogenesis and type2 diabetes
which includes dysfunction of pancreatic beta cells,
insulin action impairment and systematic information.
Vitamin D is considered to be an important factor in
modifying the risk of type2 diabetes mellitus and In type
2 Diabetes mellitus about 65% people found to have
vitamin D deficiency according to our study
Vitamin D has important actions on glucose
metabolism. These include improved insulin exocytosis,
direct stimulation of insulin receptor, improved uptake
of glucose by peripheral tissues, improving insulin
resistance. It has got various pleiotropic effects like
suppression of cell mediated immunity, regulation of
cell proliferation, stimulation of neurotropic factors
such as nerve growth factor, Glial cell line-derived
neurotrophic factor, neurotropin, suppression of RAAS,
reduction of albuminuria, immunomodulatory effects,
and anti-inflammatory effects. Thus, vitamin D is
implicated in many ways in the pathogenesis of
retinopathy, neuropathy and nephropathy.
Aim of the Study :
The purpose of the study is to assess the levels of
25- hydroxyl vitamin D in patients with type 2 diabetes
mellitus and its association with diabetic nephropathy.
Materials and Methods :
In this cross sectional study, the association
between circulating 25-hydroxy vitamin D level and the
presence of diabetic nephropathy in type 2 diabetes
mellitus who attended medicine outpatient clinic and
inpatients of medical wards.
Our study included 206 patients which includes
two groups, one group with 25(OH) D <30ng/ml of 72
patients and another group with 134 patients who had
25(OH)D>30ng/ml. Venous blood was drawn from the
patients after an overnight fasting and serum creatinine
was calculated using Jaffe method, Glycated
haemoglobin - HbA1c was measured by an automated
High performance liquid chromatography analyser.
Serum 25(OH)D concentrations were measured using
chemiluminescent immunoassay. Estimated Glomerular
Filtration Rate e-GFR was estimated with the Four
variable Modification of Diet in Renal Disease (MDRD)
study equation.
Observation and Results :
In our study total of 206 patients, 104 patients were
female and 102 were males. With gender comparison,
there occurs a statistically significant ‘p value’in female
patients with Vit D<30ng/ml a mean of 61.2%
compared with males with a mean of 38.8%. Here 71
patients with vitamin D deficiency which constitutes
about 53% found to have diabetic nephropathy and in
vitamin D sufficient patients, 30 patients which
constitutes about 41.7% found to have diabetic which is
statistically insignificant.
Conclusion :
Vitamin D is found to have both direct action
through vitamin D receptor activation and indirect
action through regulation of calcium homeostasis and
its effects on various pathogenesis and type2 diabetes
which includes dysfunction of pancreatic beta cells,
insulin action impairment and systematic information.
Vitamin D is considered to be an important factor in
modifying the risk of type2 diabetes mellitus and In type
2 Diabetes mellitus about 65% people found to have
vitamin D deficiency according to our study
