CAN 25-HYDROXYVITAMIND LEVELS AND PTH PREDICT CARDIOVASCULAR COMPLICATION IN TYPE 2 DIABETES?

초록

Aims: Primary or secondary hyperparathyroidism is associated with increased risk of cardiovascular disease. Vitamin D has been known to predictor of mortality. To find out whether parathyroid or vitamin D might be related to the development of atherosclerosis in type 2 diabetic patients, we measured serum level of 25- hydroxyvitamin D[25(OH) D3], PTH and the carotid intima-media thickness (IMT). Methods: This cross-sectional study includes one hundreds type 2 diabetic patients aged 40-80 years without history of coronary heart disease, revascularization or stroke. The serum level of PTH was measure by immunoradiometric assay, and carotid IMT was measured with high resolution B-mode ultrasonography Results: The mean 25(OH) D3 was 54.9±34.5 ng/ml, 26% of patients have Vitamin D deficiency. PTH was 39.7 (12.4-172.9) pg/ml. Age (r=0.453), systolic Bp (r=0.230) were related to mean carotid IMT. On the basis of linear regression analysis, the age, HbA1c and microalbuminuria predict mean carotid IMT. Serum calcium and albumin were different among 3 groups classified by the tertile of 25(OH)D3. PTH was correlated with serum creatinine, microalbuminuria and systolic blood pressure. In the lowest tertile patients have higher microalbuminuria, CRP and PTH concentrations independently serum creatinine level. Conclusions: Our results have demonstrated that serum PTH and 25(OH)D3 are not the determinant of carotid IMT in type 2 diabetic patients. This result suggests that PTH and vitamin D might be affect the complication of diabetes differently.