Publication details

Correlation between vitamin D serum levels and severity of diabetic retinopathy in patients with type 2 diabetes mellitus

Authors

NADRI G. SAXENA S. KAUR A. AHMAD K. GARG P. MAHDI A. A. AKDUMAN L. GAZDIKOVA K. CAPRNDA M. VESELY P. KRUŽLIAK Peter KRASNIK V.

Year of publication 2021
Type Article in Periodical
Magazine / Source JOURNAL OF ENDOCRINOLOGY METABOLISM AND DIABETES OF SOUTH AFRICA
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.tandfonline.com/doi/full/10.1080/16089677.2021.1903170
Doi http://dx.doi.org/10.1080/16089677.2021.1903170
Keywords Diabetic retinopathy (DR); disorganization of retinal inner layer (DRIL); spectral domain optical coherence tomography (SD-OCT); vitamin D
Description Purpose: To study the correlation of serum vitamin D levels with quantitative (central subfield thickness [CST], cube average thickness [CAT]), cross-sectional (disorganisation of retinal inner layer [DRIL] and ellipsoid zone [EZ]) and topographic parameters (retinal pigment epithelium [RPE]) on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR), for the first time. Methods: Eighty-eight consecutive cases of type 2 diabetes mellitus with no retinopathy (No DR; n = 22); non-proliferative DR (NPDR; n = 22); proliferative DR (PDR; n = 22) and healthy controls (n = 22) were included, after sample size calculation. On SDOCT, physician-friendly grading systems were created for DRIL, EZ disruption and RPE alterations. Serum vitamin D was analysed using a standard protocol. Statistical analysis was done using Pearson correlation, Student's t-test, ANOVA, Newman-Keuls test, chi-square test and univariate ordinal logistic regression analysis. Results: Mean serum vitamin D levels (ng/ml) were: No DR = 23.36 +/- 2.00, NPDR = 17.88 +/- 1.86, PDR = 14.07 +/- 1.21, and controls = 25.11 +/- 1.59. Low vitamin D levels correlated significantly with severity of retinopathy, VA (r = 0.50), CST (r = 0.36), CAT (r = 0.41), DRIL (r = 0.35), EZ disruption (r =0.40) and RPE alterations (r=0.37), respectively (p <0.01). Significantly low vitamin D levels were observed in subjects with DRIL present versus DRIL absent; EZ disruption, focal versus global versus intact; RPE alterations, focal versus global versus none, respectively (p < 0.05). Conclusions: Low serum vitamin D levels correlate with the presence of DRIL, EZ disruption and RPE alterations and increased severity of DR.

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