The Relationship Between HbA1c and 25-hidroxy Vitamin D Levels in Adult Diabetic Patients

Yıl 2023, , 25 - 29, 30.04.2023

Mehmet Özdin , Durhasan Mundan

https://doi.org/10.52976/vansaglik.1120424

Cited By: 1

Öz

Objective: The aim of this study was to determine vitamin D levels in patients with type II Diabetes Mellitus who applied to the internal medicine diabetes and endocrinology policlinic of a training and research hospital, and to determine the relationship between HbA1c and 25-hydroxy vitamin D levels.
Material and Method: Type II Diabetes Mellitus patients constituted the material of the study. The study was conducted between 2018-2019. The data were obtained from the hospital information management system. Those with bone-derived malignancies and pregnant women were excluded from the study. A total of 65 patients, 40 (61%) female and 25 (39%) males were included in the study. Statistical analyzes were made with the help of IBM SPSS for Windows 26.0 package program. The normal distribution was tested for the categories of factors affecting vitamin D levels. Accordingly, the hypothesis test was chosen and the descriptive statistics values suitable for the used hypothesis test were calculated. Variables indicated by measurement mean ± SD, smallest and largest; Variables that are represented by numbers are indicated by %. Pearson correlation coefficients were used to evaluate the correlations.
Results: HbA1c and 25-hydroxy vitamin D levels were determined in the patients included in the study. HbA1C levels were found to be 9,023 ± 1.72 (%) higher than the normal values. 25-hydroxy vitamin D levels were 13.94±4.12 ng/ml and were lower than normal values. HbA1c levels and 25-hydroxy vitamin D levels were found to be statistically significant in type II Diabetes Mellitus patients (p<0.05). A negative correlation was calculated between 25-hydroxy vitamin D levels and HbA1c levels (r=-0.51).
Conclusion: As a result, HbA1c values were found to be high as expected in patients with Type II Diabetes Mellitus. On the other hand, 25-hydroxy vitamin D levels were found to be low. In these patients, low 25-hydroxy vitamin D makes vitamin supplementation important. However, the permanent inclusion of 25-hydroxy vitamin D in treatment protocols necessitates further research.

Anahtar Kelimeler

Correlation, HbA1c, Type II Diabetes Mellitus, Vitamin D

Yetişkin Diyabetik Hastalarda HbA1c ve 25-hidroksi D Vitamini Düzeyleri Arasındaki İlişki

Öz

Amaç: Bu çalışmanın amacı, bir eğitim ve araştırma hastanesinin dahiliye diyabet ve endokrinoloji polikliniğine başvuran tip II Diabetes Mellituslu hastalarda D vitamini düzeylerini belirlemek ve HbA1c ile 25-hidroksi D vitamini düzeyleri arasındaki ilişkiyi belirlemektir.
Materyal ve Metot: Çalışmamızın materyalini hastanemiz dahiliye diyabet ve endokrinoloji polikliniğine başvuran tip II DM hastaları oluşturdu. Çalışmamıza dahil edilen hastaların verileri 2018-2019 yılları arasında hastane bilgi yönetim sisteminden elde edilmiştir.
Bulgular: Çalışmaya alınan hastalarda HbA1c ve 25-hidroksi D vitamini düzeyleri belirlendi. HbA1C düzeyleri belirlenen normal değerlerden 9.023 ± 1.72 (%) yüksek bulundu. 25-hidroksi D vitamini düzeyleri 13.94 ± 4.12 ng/ml idi ve normal değerlerden düşüktü. Tip II DM hastalarında HbA1c düzeyleri ve 25-hidroksi vitamin D düzeyleri istatistiksel olarak anlamlı bulundu (p<0.05). 25-hidroksi D vitamini düzeyleri ile HbA1c düzeyleri arasında negatif korelasyon vardı (r=-0,51).
Sonuç: Sonuç olarak; bizim çalışmamızda ise HbA1c değerleri ile 25-hidroksi vitamin D düzeyleri arasında orta düzeyde negatif korelasyon saptandı. Tip II DM'li hastalarda HbA1c değerleri yükselirken, 25-hidroksi vitamin D seviyeleri %50 düzeyinde düşmektedir. Tip II DM'li hastaların tedavisini düzenlemek ve hastalığın ilerlemesini azaltmak ve hastalığı kontrol altına almak için glukoz regülasyonu sağlayarak HbA1c değerlerinin normal seviyelere indirilmesi önemlidir.

Anahtar Kelimeler

Tip II diabetes mellitus, HbA1c, 25-hidroksi D vitamini, Korelasyon

Kaynakça

• Bani-Issa W, Eldeirawi K, Harfil S, Fakhry R (2017). Vitamin D Deficiency and Its Determinants in Adults: A Sample from Community-Based Settings in the United Arab Emirates. International Journal of Endocrinology, 3906306.
• Baykan EK, Yıldırımer Y, Durmazatar İ (2022). Evaluation of the relationship of serum vitamin D levels and microalbuminuria in individuals with type 2 diabetes, Ege Journal of Medicine, 61 (1): 73-79.
• Beaulieu C, Kestekian R, Havrankova J, Gascon-Barré M (1993). Calcium is essential in normalizing intolerance to glucose that accompanies vitamin D depletion in vivo. Diabetes, 42:35-43.
• Bringhurst FR, Demay MB, Krane SM, Kronenberg HM (2005). Bone and Mineral Metabolism in Health and Disease. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 16th edition. New York: MC Graw-Hill Companies; p.2238-86.
• Cetin EG, Demir N, Kalkan K, Öztürkmen YA, Nazif P, Yıldırım Yücelen S, et al (2020). The Compatibility of Hemoglobin A1c with Oral Glucose Tolerance Test and Fasting Plasma Glucose. The Medical Bulletin of Sisli Etfal Hospital, 54(3): 351–356.
• Champe PC, Harvey RA, Ferrier DR (2007). Biyokimya. Çeviri Editörü: Ulukaya E. Lippincott’s Illustrated Reviews Serisinden 3. Baskı. Nobel Tıp Kitap evleri; 2007.
• Di Cesar DJ, Ploutz-Snyder R, Weinstock RS (2006). Vitamin D deficiency is more common in type 2 than in type 1 diabetes. Diabetes Care, 29:174.
• Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham J (2008). Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely Prospective Study 1990-2000. Diabetes, 57:2619-2625.
• Gerdhem P, Ringsberg KA, Obrant KJ, Akesson K (2005). Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Intermedicine, 16:1425-31.
• Holick MF (2004). Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American Journal of Clinical Nutrition, 80(6 Suppl):1678-88.
• Holick MF (2005). Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. The Southern Medical Journal, 98:1024-1027.
• Hussain Gilani SY, Bibi S, Siddiqui A, Ali Shah SR, Akram F, Rehman M (2019). Obesity and Diabetes as Determinants of Vitamin D Deficiency. Journal of Ayub Medical College, Abbottabad: JAMC, 31(3):432-435, PMID: 31535522.
• Hyppönen E, Läärä E, Reunanen A, Järvelin MR (2001). Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: A birth-cohort study. Lancet, Nov 3; 358 (9292): 1500–3.
• Isaia G, Giorgino R, Adami S (2001). High prevalence of hypovitaminosis D in female type 2 diabetic population. Diabetes Care, 24:1496.
• Khaleeli AA, Johnson JN, Taylor WH (2007). Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy. Diabetes/Metabolism Research and Reviews, 23:43-8.
• Kim HK, Bae SJ, Choe J. (2012). Impact of HbA1c criterion on the detection of subjects with increased risk for diabetes among health check-up recipients in Korea. Diabetes Metabolism, 36:151–156.
• Kim KS, Kim SK, Lee YK (2008). Diagnostic value of glycated haemoglobin HbA (1c) for the early detection of diabetes in high-risk subjects. Diabetes Medication, 25: 997–1000.
• Knekt P, Laaksonen M, Mattila C, Härkänen T, Marniemi J, Heliövaara M, et al (2008). Serum vitamin D and subsequent occurrence of type 2 diabetes. Epidemiology, 19:666-71.
• Kull M Jr, Kallikorm R, Tamm A, Lember M (2009). Seasonal variance of 25-(OH) vitamin D in the general population of Estonia, a Northern European country. BMC Public Health, 9: 22.
• Liu E, Meigs JB, Pittas AG, Economos CD, McKeown NM, Booth SL, et al (2010). Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study. The American Journal of Clinical Nutrition, 91:1627-33.
• Mosekilde L (2005). Vitamin D and the elderly. Clinic Endocrinology, 62:265-81.
• Öner Ö, Binicier ÖB, Yaşar HY, Akar H (2016). Tip 2 diyabetes mellituslu hastalarda vitamin D düzeyi ve glisemik kontrol arasındaki ilişki, FNG & Bilim Tıp Dergisi, 2(2):69-75, doi: 10.5606/fng.btd.2016.015.
• Ozdin M, Yazar H, Mundan D (2019). HbA1c Testi için Maliyet Etkinlik Değerlendirmesi. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 5(1);1335-1341.
• Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE (2006). Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care, 29(3): 650-6.
• Pittas AG, Dawson-Hughes B (2010). Vitamin D and diabetes. The Journal of Steroid Biochemistry and Molecular Biology, 121:425-429.
• Pittas AG, Lau J, Hu FB (2007). The role of vitamin d and calcium in type 2 diabetes. A systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 92:2017-2029.
• Rafiq S, Jeppesen PB (2018). Is Hypovitaminosis D Related to Incidence of Type 2 Diabetes and High Fasting Glucose Level in Healthy Subjects: A Systematic Review and Meta- Analysis of Observational Studies. Nutrients, 10(1): E59.
• Satman İ (2007). The update criteria and the reasons of them in diagnosis and follow up of diabetes mellitus. Türkiye Klinikleri, International Journal Medical Science, 3:1-15.
• Sato KK, Hayashi T, Harita N (2009). Combined measurement of fasting plasma glucose and A1C is effective for the prediction of type 2 diabetes: the Kansai Healthcare Study. Diabetes Care, 32:644–646.
• Suzuki A, Kotake M, Ono Y, Kato T, Oda N, Hayakawa N, et al (2006). Hypovitaminosis D in type 2 diabetes mellitus: Association with microvascular complications and type of treatment. Endocronology Journal, 53:503-510.
• Tahrani AA, Ball A, Shepherd L (2010). The prevalence of vitamin D abnormalities in South Asians with type 2 diabetes mellitus in the UK. International Journal Clinic Practice, 64:351-355.
• World Health Organization (2011). Use of glycated hemoglobin (HbA1c) in the diagnosis of diabetes mellitus.
• Yarbag A, Yazar H, Akdoğan M, Pekgör A, Kaleli S (2015). Refractive errors in patients with newly diagnosed diabetes mellitus. Pakistan Journal Medical Science, 31(6):1481-4.
• Yılmaz KÖR (2018). The Relationship Between 25-Hydroxy Vitamin D Level and Metabolic Control in Type 1 Diabetes Mellitus Patients, Turkish Journal of Pediatric Disease, 4: 243-246.