AUTHOR=Felício João Soares , de Rider Britto Hana Andrade , Cortez Pedro Celeira , de Souza Resende Fabrício , de Lemos Manuela Nascimento , de Moraes Lorena Vilhena , de Aquino Vitória Teixeira , de Souza Parente Fernanda , de Queiroz Natércia Neves Marques , Abrahão Neto João Felício , de Alcântara Angélica Leite , da Silva Wanderson Maia , de Souza Neto Norberto Jorge Kzan , Freire Piani Pedro Paulo , de Souza Ícaro José Araújo , Silva Lilian de Souza D’Albuquerque , de Oliveira Maria Clara Neres Iunes , Said Nivin Mazen , Nascimento de Lemos Gabriela , de Melo Franciane Trindade Cunha , Gomes Daniela Lopes , Contente Braga de Souza Ana Carolina , de Sá Oliveira dos Reis Melissa , Leal Valéria Suênya Galvão , Lobato Isabel Jane Campos , Felício Karem Miléo TITLE=Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON) JOURNAL=Frontiers in Endocrinology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.723502 DOI=10.3389/fendo.2021.723502 ISSN=1664-2392 ABSTRACT=Background

The effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified.

Objective

Evaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM).

Patients and Methods

Cross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function.

Results

Patients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 – 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently.

Conclusion

Our study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.