Vitamin D may be protective in type 2 diabetes with lower extremity arterial disease

Patients with type 2 diabetes (T2D) with lower extremity arterial disease (LEAD) show low vitamin D levels, which increase the likelihood of stenosis and occlusion, especially in inferior genicular artery, a study has found.

The analysis included 514 patients and 148 healthy individuals, grouped as follows: control group, T2D group (DM group), LEAD in T2D without vitamin D supplement group (DM1 group), and LEAD in T2D with vitamin D supplement group (DM2 group). The researchers analysed the characteristics of arterial lesions of lower extremities by digital subtraction angiography in DM1 and DM2 group, respectively.

Compared with controls, the DM group had decreased serum 25(OH)D levels (mean, 25.39 vs 19.43 ng/mL). The levels were even lower in DM1 and DM2 groups (mean, 14.22 and 17.36 ng/mL).

Looking at the two T2D groups with LEAD, patients who received vitamin D supplements had better outcomes than those who did not receive supplementation in terms of the disease rate of the inferior knee artery (39.3 percent vs 65 percent) and occlusion rate (3.7 percent vs 11.5 percent; p<0.05).

On multivariable logistic stepwise regression analysis, high serum 25(OH)D levels had a protective association with LEAD in T2D (odds ratio [OR], 0.898, 95 percent confidence interval [CI], 0.856–0.942). Other risk factors were increased systolic blood pressure (OR, 1.027, 95 percent CI, 1.008–1.046), fasting plasma glucose (OR, 1.709, 95 percent CI, 1.326–2.201), low-density lipoprotein (OR, 1.762, 95 percent CI, 1.122–2.767), C-reactive protein (OR, 1.833, 95 percent CI, 1.476–2.276), male sex (OR, 0.440, 95 percent CI, 0.223–0.869), and smoking (OR, 0.130, 95 percent CI, 0.064–0.265).

The present data suggest that vitamin D supplementation can increase serum 25(OH)D, which in turn can help mitigate the severity of T2D complicated with LEAD, the researchers said.