The worse the diabetic foot, the lower the vitamin D level

Correlation Analysis between Serum Vitamin D Levels and Lower Extremity Macrovascular Complications in Individuals with Type 2 Diabetes Mellitus

Journal of Diabetes Research, Volume 2019, Article ID 4251829, https://doi.org/10.1155/2019/4251829

NGR: normal glucose regulation;     T2DM:     Mi: = mild;    Mo = moderate;     Se = severe

The severity of many diseases is associated with lower levels of Vitamin D Supplementing with Vitamin D will sometimes treat the disease, but will always reduce the incidence of other diseases * Diabetic Foot Ulcers helped by Vitamin D - meta-analyses many studies * Diabetic Foot Ulcer patients had low vitamin D (half had less than 10 ng) – July 2018 * Diabetic foot ulcer 1.7 times more likely if poor Vitamin D Receptor – Jan 2017 1. Overview Diabetes and vitamin D contains the following {include} Diabetic Epidemic {include} --- 1. A diabetic foot severity grade from the web

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Mengxue Yang yangmengx123@163.com,1,2 Jun Liu,1 Xue Zhou,2 Heyuan Ding,1 Jie Xu,3 Bo Yang,2 Bowen Sun,2 Dandan Xiao,2 Jie Yu,3 and Qihai Gong4

• 1Department of Endocrinology, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China

• 2Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China

• 3School of Public Health, Zunyi Medical University, Zunyi 563000, China

• 4Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China

The correlation between serum 25-hydroxy vitamin D (25(OH)D) levels and lower extremity atherosclerotic disease and the predictive value of 25(OH)D for early-stage lower extremity atherosclerotic disease in patients with type 2 diabetes mellitus (T2DM) were explored. In total, 620 subjects (590 T2DM patients and 30 healthy subjects) completed a questionnaire. All subjects were divided into four groups according to serum 25(OH)D concentration quartile: Q1 (<12.18 ng/ml), Q2 (12.18~20.65 ng/ml), Q3 (20.65~31.97 ng/ml), and Q4 (>31.97 ng/ml). Participants were also divided into four groups based on the degree of lower extremity arteriostenosis:

• A1 (T2DM),

• A2 (T2DM with mild lower extremity vascular lesions (LEVL)),

• A3 (T2DM with moderate LEVL), and

• A4 (T2DM with severe LEVL).

The incidence of lower extremity artery plaque was significantly higher in groups Q1 and Q2 than in group Q4 (both p <.0.05 ). The concentration of 25(OH)D was significantly lower in group A4 than in groups A1 and A2. Pearson correlation analysis revealed that the degree of lower extremity vascular stenosis was positively correlated with age, smoking, and HbA1c, CRP, and LDL-C levels and negatively correlated with 25(OH)D concentrations. Logistic regression analysis demonstrated that 25(OH)D concentrations exerted a protective effect against LEVL in T2DM patients. Serum 25(OH)D concentrations may be correlated with the incidence of macrovascular disease in T2DM patients. A low serum 25(OH)D concentration is an independent risk factor for lower extremity vascular pathological changes and acts as a prognostic index for lower extremity atherosclerotic disease.