Vitamin D deficiency tied to death risk in diabetic foot ulcer

In patients with diabetic foot ulcers (DFU), vitamin D deficiency appears to aggravate the risk of all-cause mortality, reports a recent China study.

Researchers conducted a retrospective analysis of 275 adult DFU patients (mean age 66.97 years, 66.9 percent men), in whom vitamin D status was determined using electrochemiluminescence immunoassay. Those with 25-hydroxyvitamin D (25(OH)D) levels >30 nmol/L were deemed to be deficient in vitamin D.

At baseline, participants showed a median serum vitamin D concentration of 37.78 nmol/L, with 31.6 percent satisfying the criterion for deficiency. Those with lower vitamin D levels were more likely to sustain Wagner grade ≥3 wounds (p=0.017).

Over a median follow-up of 52 months, 65 patients died resulting in a mortality rate of 23.64 percent. Vitamin D levels were significantly lower in this subgroup (33.42 vs 38.99 nmol/L; p=0.006).

Cox proportional hazards analysis found that vitamin D deficiency was a significant risk factor for all-cause mortality, increasing such risk by around 50 percent as compared to those without deficiency (hazard ratio [HR], 0.571, 95 percent confidence interval [CI], 0.329–0.991; p=0.03). Meanwhile, vitamin D sufficiency seemed to exert a protective effect against all-cause death but did not reach statistical significance.

“Vitamin D supplementation, as a potential therapeutic for DFUs, has possible benefits in the postponement of premature death and the improvement of outcomes among individuals with DFUs,” the researchers said.