Role of Serum Vitamin D Level in Progression of Diabetic Foot Ulcer
BC15-BC17
Correspondence
Jalil Houshyar,
Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
E-mail: Jalilhoushyar@yahoo.com
Introduction: Diabetes mellitus (DM) is a metabolic disorder characterised by hyperglycemia. Deficiency of vitamin D has been shown to interfere with insulin production and secretion and therefore contribute to type 2 diabetes development. It has also been noted that vitamin D plays a role in diabetic neuropathy development, which might lead to diabetic foot ulcers (DFU). Vitamin D boosts the immune system, helps in the elimination of bacteria and thus accelerates wound healing and prevents ulcer formation. However, different studies report conflicting results on the association of level of vitamin D with diabetic foot ulcers in DM patients.
Aim: To evaluate the role of serum vitamin D levels with diabetic foot ulcer formation and progression.
Materials and Methods: In this study, 70 diabetic patients with or without DFU either in inpatient section or referring to Imam Reza Hospital Endocrinology Clinic of Tabriz University of Medical Sciences were enrolled. Apparently healthy (n=35) individuals were recruited as the control group. The general characteristics of patients were assessed. The foot ulcers were examined and classified as per Wagner ulcer classification system. Serum biochemical markers including 25-Hydroxy Vitamin D (25(OH)D) were analysed using in-vitro chemiluminescent immunoassay (CLIA). ANOVA and post-hoc (Tukey) tests were employed to compare the means among the groups. Multiple linear regression and bivariate correlation analysis were also conducted to assess the association between all clinical variables and 25(OH)D. The p-value <0.05 was considered as statistically significant.
Results: Serum 25(OH)D levels in diabetic patients with or without foot ulcers and healthy controls were 16.86±10, 23.9±15.24 and 27.11±19.35 ng/mL, respectively. Significant differences in 25(OH)D levels were observed between patients and healthy controls (p=0.035), and between diabetic patients with and without foot ulcers (p=0.029). Furthermore, a negative correlation between serum cholesterol and 25(OH)D levels were observed among patient without DFU (-0.401, p-value =0.017).
Conclusion: Low levels of vitamin D in diabetic patients may be related to DFU formation and development. Therefore, early estimation of 25(OH)D and prescription of appropriate vitamin D supplements are suggested in diabetic patients.