Document Detail


Circulating vitamin D metabolites and kidney disease in type 1 diabetes.
MedLine Citation:
PMID:  22990096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Impaired vitamin D metabolism may contribute to the development and progression of diabetic kidney disease.
OBJECTIVE: The aim of the study was to test associations of circulating vitamin D metabolites with risks of incident microalbuminuria, impaired glomerular filtration rate (GFR), and hypertension in type 1 diabetes.
DESIGN: We performed a cohort study of 1193 participants in the Diabetes Control and Complications Trial (DCCT), a randomized clinical trial of intensive diabetes therapy, and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) Study. We measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT and tested associations with incident microalbuminuria, impaired GFR, and hypertension over up to 16 yr of EDIC follow-up.
RESULTS: At the time metabolites were measured, mean age was 32.4 yr; mean duration of diabetes, 7.5 yr; mean iothalamate GFR, 132.9 ml/min/1.73 m(2); and geometric mean albumin excretion rate, 11.8 mg/24 h. Over follow-up, 166 cases of microalbuminuria, 54 cases of impaired GFR, and 541 cases of hypertension were observed. Compared with 25(OH)D of at least 30 ng/ml, 25(OH)D below 20 ng/ml was associated with a 65% higher risk of microalbuminuria (95% confidence interval, 7 to 154%) in adjusted analyses. Low concentrations of 24,25-dihydroxyvitamin D, but not 1,25-dihydroxyvitamin D, were also associated with increased risk of microalbuminuria. No circulating vitamin D metabolite was associated with risk of impaired GFR or hypertension.
CONCLUSIONS: Low plasma concentrations of 25(OH)D and 24,25-dihydroxyvitamin D are associated with increased risk of microalbuminuria in type 1 diabetes. In contrast, we did not find evidence linking impaired vitamin D metabolism to early GFR loss or the development of hypertension.
Authors:
Ian H de Boer; Michael C Sachs; Patricia A Cleary; Andrew N Hoofnagle; John M Lachin; Mark E Molitch; Michael W Steffes; Wanjie Sun; Bernard Zinman; John D Brunzell;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-09-18
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  97     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-12     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4780-8     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00360815;  NCT00360893
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MeSH Terms
Descriptor/Qualifier:
Adult
Albuminuria / blood,  complications,  epidemiology,  metabolism
Cohort Studies
Diabetes Mellitus, Type 1 / blood*,  complications,  epidemiology,  metabolism*
Diabetic Nephropathies / blood*,  complications,  epidemiology,  metabolism*
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension / blood,  complications,  epidemiology,  metabolism
Incidence
Male
Randomized Controlled Trials as Topic
Vitamin D / analysis,  blood*,  metabolism
Grant Support
ID/Acronym/Agency:
KL2 TR000421/TR/NCATS NIH HHS; P01DK02456/DK/NIDDK NIH HHS; P30DK035816/DK/NIDDK NIH HHS; R01 DK088762/DK/NIDDK NIH HHS; R01DK088762/DK/NIDDK NIH HHS; R01HL096875/HL/NHLBI NIH HHS; RC4DK090766/DK/NIDDK NIH HHS; U01 DK094157/DK/NIDDK NIH HHS; U01 DK094176/DK/NIDDK NIH HHS; UL1 TR000423/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
1406-16-2/Vitamin D
Comments/Corrections

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