ASSESSMENT OF THE IMPACT OF VITAMIN D SUPPLEMENTATION ON PROTEINURIA IN INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS

Main Article Content

Syed Bakht Ruidar
Wang Ning
Abulikam Tuerdi
Wang Fei

Keywords

Type 2 Diabetes Mellitus, Vitamin D supplementation, proteinuria, urinary albumin/creatinine ratio (UACR), randomized controlled trial, renal complications

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder associated with various complications, including proteinuria, which is a key indicator of renal dysfunction.


Aim: The main goal of this research is to assess whether Vitamin D supplementation can effectively mitigate proteinuria in patients diagnosed with T2DM. The research seeks to elucidate potential role of Vitamin D in ameliorating renal complications and improving overall kidney health in this patient population.


Place of Study: The first Affiliated Hospital Of Xinjiang Medical university.


Methods: A randomized controlled trial conducted involving individuals diagnosed with T2DM and exhibiting proteinuria. Individuals  randomized at random to the intervention group, who get Vitamin D supplements, and the control group, who receive a placebo. A total of 150 individuals with type 2 Diabetes Mellitus recruited from the outpatient department of the First Affiliated Hospital of Xinjiang Medical University. The intervention group receive a specified dose of Vitamin D for a predetermined duration. UACR measured at baseline and regularly during the study period to assess changes in proteinuria. SPSS 24.0 was used to analyze all data.


Results: The gender distribution was 53.3% males and 46.7% females. The mean age of the participants was 52.4 ± 7.8years. The mean Body Mass Index (BMI) was 29.1 ± 3.4 kg/m² and the average diabetes duration 6.2 ± 2.1. Preliminary data presented, including the average alteration in UACR levels, providing insights into effect of Vitamin D supplementation on proteinuria in individuals with T2DM.


Conclusion: In this study, the influence of Vitamin D supplementation on proteinuria in individuals with type 2 Diabetes Mellitus, with a focus on the average alteration in urinary albumin/creatinine ratio (UACR), suggests a potential positive effect. While additional research is warranted to establish a definitive link, preliminary findings indicate that Vitamin D supplementation may contribute to mitigating proteinuria in this population.

Abstract 114 | pdf Downloads 43

References

1. El Askary A, Gharib AF, Almehmadi M, Bakhuraysah MM, Al Hajjiahmed AA, Al-Hejji LI, Alharthi MS, Shafie A. The role of vitamin D deficiency and elevated inflammatory biomarkers as risk factors for the progression of diabetic nephropathy in patients with type 2 diabetes mellitus. Open Chemistry. 2021 Dec 8;19(1):1174-83.
2. Dean YE, Elawady SS, Shi W, Salem AA, Chotwatanapong A, Ashraf H, Reddi T, Dundi PO, Habash WY, Habash MY, Ahmed S. Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients. Endocrinology, Diabetes & Metabolism. 2023 Nov;6(6):e453.
3. Gameil MA, Marzouk RE, El-Sebaie AH, Ahmed Eldeeb AA. Influence of time factor and albuminuria on characteristics of patients with type 2 diabetes Mellitus before, during and 1 year after COVID-19 recovery. Diabetology & Metabolic Syndrome. 2023 Jun 13;15(1):126.
4. Kamel AA, Elnaggar MG, Hamad DA, Zakhary MM, Bakkar SM. The Role of Vitamin D, DKK1, Hepcidin and Oxidative Stress Biomarkers in Type 2 Diabetes Mellitus Patients With and Without Diabetic Nephropathy. The Egyptian Journal of Hospital Medicine. 2022 Oct 1;89(2):7137-46.
5. Huang HY, Lin TW, Hong ZX, Lim LM. Vitamin D and diabetic kidney disease. International Journal of Molecular Sciences. 2023 Feb 13;24(4):3751.
6. shamim Khan A, Zubair M, Khan S, Sultan K, Khan MK. The role of vitamin D deficiency and supplementation in onset and progression of diabetic nephropathy: A systematic review. Romanian Journal of Diabetes Nutrition and Metabolic Diseases. 2022 Mar 28;29(1):135-54.
7. Andrade-Sierra J, Pazarín-Villaseñor L, Yanowsky-Escatell FG, Díaz-de la Cruz EN, García-Sánchez A, Cardona-Muñoz EG, Munguía-Galaviz FJ, de Alba-Razo A, Miranda-Díaz AG. The Influence of the Severity of Early Chronic Kidney Disease on Oxidative Stress in Patients with and without Type 2 Diabetes Mellitus. International Journal of Molecular Sciences. 2022 Sep 23;23(19):11196.
8. Kang HS, Bae ES, Hur JY. A Cross-Sectional Study on the Microalbuminuria, glycated hemoglobin, and Vitamin C Intake of Patients with Type 2 Diabetes Mellitus.
9. Mahemuti N, Zou J, Liu C, Xiao Z, Liang F, Yang X. Urinary Albumin-to-Creatinine Ratio in Normal Range, Cardiovascular Health, and All-Cause Mortality. JAMA Network Open. 2023 Dec 1;6(12):e2348333-.
10. Kundu S, Dubey AK, Chakraborty S, Kumar P, Sinha DA, Banerjee S, Banerjee P. Comparison of serum folic acid and Vitamin B12 among type 2 diabetes mellitus patients with and without nephropathy; a cross sectional observational study from eastern India.
11. Elbarbary NS, Ismail EA, Mohamed SA. Omega-3 fatty acids supplementation improves early-stage diabetic nephropathy and subclinical atherosclerosis in pediatric patients with type 1 diabetes: A randomized controlled trial. Clinical Nutrition. 2023 Dec 1;42(12):2372-80.
12. Green JB, Mottl AK, Bakris G, Heerspink HJ, Mann JF, McGill JB, Nangaku M, Rossing P, Scott C, Gay A, Agarwal R. Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using a UACR Endpoint study (CONFIDENCE). Nephrology Dialysis Transplantation. 2023 Apr;38(4):894-903.
13. He X, Sun J, Liu C, Yu X, Li H, Zhang W, Li Y, Geng Y, Wang Z. Compositional alterations of gut microbiota in patients with diabetic kidney disease and type 2 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2022 Jan 1:755-65.
14. He A, Shi C, Wu X, Sheng Y, Zhu X, Yang J, Zhou Y. Clusters of Body Fat and Nutritional Parameters are Strongly Associated with Diabetic Kidney Disease in Adults with Type 2 Diabetes. Diabetes Therapy. 2023 Nov 14:1-4.
15. Abasheva D, Dolcet-Negre MM, Fernández-Seara MA, Mora-Gutiérrez JM, Orbe J, Escalada FJ, Garcia-Fernandez N. Association between Circulating Levels of 25-Hydroxyvitamin D3 and Matrix Metalloproteinase-10 (MMP-10) in Patients with Type 2 Diabetes. Nutrients. 2022 Aug 24;14(17):3484.
16. Samsu N. Diabetic nephropathy: challenges in pathogenesis, diagnosis, and treatment. BioMed research international. 2021 Jul 8;2021.
17. Fawzy MS, Toraih EA, Al Ageeli E, Mohamed AM, Abu AlSel BT, Kattan SW, Alelwani W. Group-specific component exon 11 haplotypes (D432E and T436K) and risk of albuminuria in type 2 diabetes mellitus patients. Archives of Physiology and Biochemistry. 2022 Jan 2;128(1):111-20.
18. American Diabetes Association Professional Practice Committee, American Diabetes Association Professional Practice Committee:. 11. Chronic kidney disease and risk management: Standards of Medical Care in Diabetes—2022. Diabetes care. 2022 Jan 1;45(Supplement_1):S175-84.
19. Bouazza A, Tahar A, AitAbderrhmane S, Saidani M, Koceir EA. Modulation of cardiometabolic risk and CardioRenal syndrome by oral vitamin D3 supplementation in Black and White Southern Sahara residents with chronic kidney disease Stage 3: focus on racial and ethnic disparities. Renal Failure. 2022 Dec 31;44(1):1244-63.
20. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S. 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2023. Diabetes Care. 2023 Jan 1;46(Supplement_1):S191-202.
21. Elsaeed G, Fadel F, El-Sonbaty M, Wafaey H, Abdel-Monem MA, Abdelhamid I, Fahmy YA, Elghoroury EA, Elshamaa MF. Zinc, Copper and Selenium in Children with Idiopathic Nephrotic Syndrome: Relationship to Parathyroid Hormone & Proteinuria. Current Science International. 2020;9:431-7.
22. Lui DT, Wu T, Tang EH, Au IC, Lee CH, Woo YC, Tan KC, Wong CK. Fracture risks associated with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients across eGFR and albuminuria categories: A population-based study in Hong Kong. Diabetes Research and Clinical Practice. 2023 Mar 1;197:110576.
23. He A, Shi C, Wu X, Sheng Y, Zhu X, Yang J, Zhou Y. Clusters of Body Fat and Nutritional Parameters are Strongly Associated with Diabetic Kidney Disease in Adults with Type 2 Diabetes. Diabetes Therapy. 2023 Nov 14:1-4.
24. Sun Y, Jin D, Zhang Z, Zhang Y, Zhang Y, Kang X, Jiang L, Tong X, Lian F. Effects of antioxidants on diabetic kidney diseases: mechanistic interpretations and clinical assessment. Chinese Medicine. 2023 Dec;18(1):1-21.
25. Chen TK, Sperati CJ, Thavarajah S, Grams ME. Reducing kidney function decline in patients with CKD: core curriculum 2021. American Journal of Kidney Diseases. 2021 Jun 1;77(6):969-83.