Vitamin D and VEGF Serum Levels Association with Adult-onset Diabetes Complications

Background: Vitamin D insufficiency is defined as serum 25-hydroxyvitamin D (25(OH)D) levels
below 30 ng/mL and is common among patients with adult-onset diabetes and the elderly.
Aim & Objectives: The purpose of this study was to investigate clinically meaningful associations
implicating low Vitamin D blood levels and vascular endothelial growth factor (VEGF) levels in adultonset
diabetes (DM type 2).
Methods: Serum 25(OH)D and VEGF levels were determined in 40 patients with DM type 2. Their
correlation with markers of advanced diabetic disease (amputation, diabetic foot, proliferative diabetic
retinopathy, insulin dependence) as well as with serum biochemical parameters was examined.
Subanalysis was performed separately on men and women.
Results: Compared with males, female patients exhibited lower 25(OH)D levels (p<0.0001) but
higher serum VEGF (p=0.018). There was a trend towards an inverse Vitamin D - VEGF association.
Subanalysis on women showed low serum 25(OH)D levels strongly associated with amputation
(p=0.003). High serum VEGF levels were associated with amputation (p=0.038), and marginally with
diabetic foot (p=0.058), insulin dependence (p=0.084) and proliferative diabetic retinopathy (p=0.086).
Higher serum 25(OH)D levels were associated with serum uric acid (p=0.007), calcium (p=0.042) and
albumin levels (p=0.033). Subanalysis on men demonstrated positive correlation between 25(OH)D
levels, albumin (p=0.004) and calcium levels (p=0.060, borderline association).
Conclusion: The association between low serum 25(OH)D levels and amputation in women may be
inscribed into the wider context portraying vitamin D insufficiency as a poor prognostic factor. Vitamin
D insufficiency may exert gender-specific effects in the context of adult-onset diabetes.