Yılmaz YILDIRIMER, Emine KARTAL BALKAN, İbrahim DURMAZATAR

Tip 2 diyabetli bireylerde serum vitamin D düzeyleri ile mikroalbüminüri arasındaki ilişkinin değerlendirilmesi

Amaç: D vitamin eksikliği, birçok çalışmada diyabet gelişimi için önemli bir risk faktörü olarak gösterilmiştir. Tip 2 diabetes mellitus’lu hastalarında, D vitamin eksikliği sık görülmektedir. Bu çalışmada Tip 2 diyabetli bireylerde serum vitamin D düzeyleri ile mikroalbüminüri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Tip 2 diabetes mellitus tanısı ile izlenen 18 ile 75 yaş aralığında 177 kadın, 205 erkek toplam 382 hasta çalışmaya alındı. Hastaların, D vitamin, idrar mikroalbumin/kreatinin, homosistein ve biyokimyasal parametreleri değerlendirildi. Bulgular: Diyabetik nefropatisi olan grupta 182 hasta ve diyabetik nefropati olmayan grupta 200 hasta mevcuttu. Nefropati olan grupta D vitamin ortalaması:11.8 ng/ml, nefropati olmayan grupta D vitamin ortalaması:14,4 ng/ml, iki grup arasındaki fark istatiksel olarak anlamlıydı. Pearson kolerasyon analizinde D vitamin ile mikroalbuminüri (p:0,028, r:-0,87) arasında güçlü negatif kolerasyon saptandı. Logistik regresyon analizde nefropati gelişiminde D vitamin eksikliğinin etkisi anlamlı saptandı (p:0,000, OR:1,060, % 95 CI 1,028-1,93). D vitamini eksikliği açısından değerlendirildiğinde Hba1c ile anlamlı ilişki bulunmazken (p:0,258, OR:934, %95 CI 0,830-1,051), mikroalbuminüri ile anlamlı ilişki saptandı (p:0,040, OR:996, %95 CI 0,993-1,000). Nefropati olan grupta homosistein düzeyi 21,8 ± 1,5 μmol/L, nefropati olmayan grupta homosistein düzeyi 14,5 ± 2,5 μmol/L, iki grup arasındaki fark istatiksel olarak anlamlıydı (P:0,017). D vitamin ile homosistein (p:0,018, r:-0,910) arasında güçlü negatif kolerasyon mevcuttu. Sonuç: Çalışmamızın sonuçlarına göre D vitamin eksikliğinin mikroalbuminüri ve hiperhomosisteinemiye neden olarak diyabetik nefropatiyi artırdığını söyleyebiliriz.

Evaluation of the relationship of serum vitamin D levels and microalbuminuria in individuals with type 2 diabetes

Aim: Vitamin D deficiency has been shown as a risk factor for diabetes mellitus in many studies. We aimed to investigate the relationship between serum vitamin D levels and microalbuminuria in individuals with type 2 diabetes. Material and Methods: A total of 382 patients, 177 females and 205 males, between the ages of 18 and 75 with a diagnosis of type 2 diabetes mellitus were included in the study. Vitamin D, homocysteine, microalbumin/creatinine and biochemical parameters were evaluated. Results: There were 182 patients in the group with diabetes nephropathy and 200 patients in the group without nephropathy. Mean vitamin D levels were significantly higher in the group without nephropathy (nephropathy group 11.8 ng/ml, group without nephropathy 14.4 ng/ml p: 0.001). Negative correlation was observed between vitamin D and microalbuminuria in Pearson correlation analysis (p: 0.028, r:-0.87). In logistic regression analysis, the effect of vitamin D deficiency on the development of nephropathy was found to be significant(p:0.000, OR:1.060, %95 CI-1.028- 1.93).When evaluated in terms of vitamin D deficiency, there was no significant relationship with Hba1c(p:0.258, OR:934, 95%, CI-0.830-1.051), while a significant relationship was found with microalbuminuria(p:0.040, OR: 996, 95% CI-0.993-1.000).Homocysteine level was 21.8 ± 1.5 μmol/L in the group with nephropathy, 14.5 ± 2.5 μmol/L in the group without nephropathy, and the difference between the two groups was statistically significant (P:0.017). Conclusion: Vitamin D deficiency worsens diabetic nephropathy by causing microalbuminuria and hyperhomocysteinemia.

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