245929 Vitamin D and retinopathy in adults with diabetes

Sunday, October 30, 2011

Patricia A. Patrick, DrPH , Office of Health Outcomes Research, Winthrop University Hospital, Mineola, NY
Paul Visintainer, PhD , Division of Academic Affairs, Baystate Medical Center, Springfield, MA
Qiuhu Shi, PhD , Department of Epidemiology & Community Health, New York Medical College School of Health Sciences & Practice, Valhalla, NY
Irene Weiss, MD , Department of Medicine, New York Medical College, Valhalla, NY
Donald Brand, PhD , Office of Health Outcomes Research, Winthrop University Hospital, Mineola, NY

OBJECTIVE. Retinopathy is one of the most frequent complications of diabetes in adults. Results from animal studies have suggested that vitamin D may protect the diabetic retina. Given the possible protective effect of vitamin D on vascular health and the prevalence of inadequate vitamin D levels in adults, the hypothesized association between vitamin D inadequacy and diabetic retinopathy was explored.

RESEARCH DESIGN AND METHODS. This question was investigated by examining data from individuals aged 40 years and older with diabetes who participated in the interview and medical examination components of the National Health and Nutrition Examination Survey conducted from October 1988 through October 1994 (“NHANES III”).

RESULTS. A total of 1790 NHANES participants met the study's inclusion criteria. The proportion of subjects with vitamin D deficiency (25-OHD <20 ng/ml) increased with increasing severity of retinopathy: 27.9%, no retinopathy (n=1522); 28.2%, mild (n=168); 43.2%, moderate/severe (n=88); and, 64.6%, proliferative (n=12) (adjusted for age and obesity, p=0.01). Median vitamin D levels by retinopathy severity score were as follows: 25.8 ng/ml, no retinopathy; 26.6 ng/ml, mild; 21.5 ng/ml, moderate/severe; 13.6 ng/ml, proliferative (unadjusted, p=0.07; adjusted for age and obesity, p=0.13).

CONCLUSIONS. Results suggest an inverse relationship between the severity of diabetic retinopathy and serum vitamin D levels. Given previous evidence suggesting possible anti-angiogenic properties of vitamin D and the small number of subjects in this sample with proliferative retinopathy, this last finding warrants further study.

Learning Areas:
Chronic disease management and prevention
Public health or related research

Learning Objectives:
Describe the potential relationship between serum vitamin D and the severity of diabetic retinopathy.

Keywords: Diabetes, Vitamins

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because of my role as principal investigator on this project; I have been involved in the study conception and design, acqusition of data, analysis and interpretation of data, and drafting of a manuscript.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.