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.

Author (s) Details

Nikol Panou

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Sotirios Georgopoulos

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Marios Panou

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Theodoros N. Sergentanis

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Alexandros Papalampros

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Georgios Maropoulos

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Nikolaos Tentolouris

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

Frangiska Sigala

1st Department of Surgery, Athens University School of Medicine, Laikon General Hospital, 17 Ag. Thoma st, Athens, 11527, Greece and KAT Hospital, Laboratory of Metabolic Diseases of the Bones, 2 Nikis St., Athens, 14561, Greece.

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