Aims

To investigate vitamin D deficiency as a risk marker for complications in individuals with type 1 and type 2 diabetes.

Methods

A cohort study including 1448 adults with type 1 and 770 with type 2 diabetes. Individuals in the decile with lowest vitamin D level were classified as vitamin D deficient. Outcomes based on medical records and registers included mortality, major adverse cardiovascular event (MACE), heart failure, a composite kidney endpoint, albuminuria progression and sight-threatening eye disease. Risk in individuals with vitamin D deficiency was compared to the remaining using adjusted Cox proportional hazards models.

Results

Vitamin D deficiency was associated with higher risk of MACE (adjusted hazard ratio (HR): 2.6; 95 % confidence interval (CI): 1.3–5.2) in type 1, but not in type 2 diabetes. Risk of heart failure was higher in individuals with vitamin D deficiency in both cohorts (HR (95%CI): 16 (4.8–50) in type 1 and 2.4 (1.1–5.5) in type 2 diabetes). Vitamin D deficiency was not associated with development of microvascular complications or mortality.

Conclusions

Vitamin D deficiency was a risk marker for MACE and heart failure in type 1 and for heart failure in type 2 diabetes, but not for microvascular complications or all-cause mortality.

中文翻译：

---

1 型和 2 型糖尿病患者维生素 D 缺乏和并发症的发生：一项队列研究

目标

调查维生素 D 缺乏症作为 1 型和 2 型糖尿病患者并发症的风险标志。

方法

一项队列研究包括 1448 名 1 型糖尿病成人和 770 名 2 型糖尿病成人。维生素 D 水平最低的十分之一的个体被归类为维生素 D 缺乏症。基于医疗记录和登记的结果包括死亡率、主要不良心血管事件（MACE）、心力衰竭、复合肾脏终点、蛋白尿进展和威胁视力的眼病。使用调整后的 Cox 比例风险模型将维生素 D 缺乏症患者的风险与其余患者进行比较。

结果

维生素 D 缺乏与 1 型糖尿病中较高的 MACE 风险相关（调整后的风险比 (HR)：2.6；95% 置信区间 (CI)：1.3–5.2），但与 2 型糖尿病无关。两个队列中维生素 D 缺乏的个体发生心力衰竭的风险较高（HR (95%CI)：1 型糖尿病为 16 (4.8–50)，2 型糖尿病为 2.4 (1.1–5.5)）。维生素 D 缺乏与微血管并发症或死亡率的发生无关。

结论

维生素 D 缺乏是 1 型糖尿病 MACE 和心力衰竭以及 2 型糖尿病心力衰竭的风险标志物，但不是微血管并发症或全因死亡率的风险标志物。