Progression of Diabetic Nephropathy and Vitamin D Serum Levels: A Pooled Analysis of 7722 Patients

Overview

Journal Endocrinol Diabetes Metab

Specialty Endocrinology

Date 2023 Sep 25

PMID 37743677

Authors

Yomna E Dean

Sameh Samir Elawady

Wangpan Shi

Ahmed A Salem

Arinnan Chotwatanapong

Haya Ashraf

Tharun Reddi

Prashant Obed Reddy Dundi

Waleed Yasser Habash

Mohamed Yasser Habash

Safaa Ahmed

Hana M Samir

Ahmed Elsayed

Aryan Arora

Abhinav Arora

Abdelrahman Elsayed

Tamer Mady

Yousef Tanas

Yusef Hazimeh

Mohamed Alazmy

Hani Aiash

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Low serum Vitamin D levels have been associated with diabetic nephropathy (DN). Our study aimed to analyse the serum levels of vitamin D in patients suffering from DN and the subsequent changes in serum vitamin D levels as the disease progresses.

Methods: PubMed, Embase, SCOPUS and Web of Science were searched using keywords such as '25 hydroxyvitamin D' and 'diabetic nephropathy'. We included observational studies that reported the association between the serum 25 hydroxy vitamin D levels and diabetic nephropathy without restriction to age, gender, and location. R Version 4.1.2 was used to perform the meta-analysis. The continuous outcomes were represented as mean difference (MD) and standard deviation (SD) and dichotomous outcomes as risk ratios (RR) with their 95% confidence interval (CI).

Results: Twenty-three studies were included in our analysis with 7722 patients. Our analysis revealed that vitamin D was significantly lower in diabetic patients with nephropathy than those without nephropathy (MD: -4.32, 95% CI: 7.91-0.74, p-value = .0228). On comparing diabetic patients suffering from normoalbuminuria, microalbuminuria, or macroalbuminuria, we found a significant difference in serum vitamin D levels across different groups. Normoalbuminuria versus microalbuminuria showed a MD of -1.69 (95% CI: -2.28 to -1.10, p-value = .0002), while microalbuminuria versus macroalbuminuria showed a MD of (3.75, 95% CI: 1.43-6.06, p-value = .0058), proving that serum vitamin D levels keep declining as the disease progresses. Notwithstanding, we detected an insignificant association between Grade 4 and Grade 5 DN (MD: 2.29, 95% CI: -2.69-7.28, p-value = .1862).

Conclusion: Serum Vitamin D levels are lower among DN patients and keep declining as the disease progresses, suggesting its potential benefit as a prognostic marker. However, on reaching the macroalbuminuria stage (Grades 4 and 5), vitamin D is no longer a discriminating factor.

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Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients.

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