A recent study published in the Journal of Diabetes and its Complications suggests an association between vitamin D deficiency and major adverse cardiovascular events and onset heart failure among patients with diabetes. 

According to the study, vitamin D deficiency was linked to an elevated risk of initial major adverse cardiovascular events (MACE) and the onset of heart failure among patients with type 1 diabetes. Similarly, in type 2 diabetes, vitamin D deficiency was associated with an increased risk of developing heart failure. However, the study shows that in both type 1 and type 2 diabetes, vitamin D deficiency did not serve as a risk marker for microvascular complications or all-cause mortality. 

The authors asserted that additional research was necessary to determine if vitamin D level is a risk marker for micro- and macrovascular complications to diabetes. The study investigated the association between vitamin D deficiency and development of distinct complications, including all-cause mortality, MACE, heart failure, kidney function decline and kidney failure, albuminuria progression, and sight-threatening diabetic eye disease including proliferative retinopathy and maculopathy in both type 1 and 2 diabetes. 

To investigate the potential of vitamin D deficiency as a predictor for complications in patients with both type 1 and type 2 diabetes, the researchers conducted a cohort study that involved 1,448 adults with type 1 diabetes and 770 with type 2 diabetes. The researchers categorized patients with the lowest levels of vitamin D as vitamin D deficient. 

Primary outcomes, based on medical records and registries, included mortality, MACE, heart failure, a composite kidney endpoint, albuminuria progression, and sight-threatening eye disease. The risk in individuals with vitamin D deficiency was compared to that of the rest of the population using adjusted Cox proportional hazards models. 

According to the results of the study, while vitamin D deficiency was associated with an increased risk of MACE in type 1 diabetes (hazard ratio [HR] = 2.6; 95% CI, 1.3-5.2), there was no link between vitamin D deficiency and type 2 diabetes. 

Patients with vitamin D deficiency exhibited a higher risk of heart failure in both cohorts (HR = 16; 95% CI, 4.8-5 in type 1 diabetes; HR = 2.4; 95% CI, 1.1-5.5 in type 2 diabetes). The researchers found no observed association between vitamin D deficiency and the development of microvascular complications or mortality. 

“This study strengthens the evidence of vitamin D deficiency as a risk marker for cardiovascular disease. As lower vitamin D level has an important role in several diseases, numerous attempts have been made to demonstrate a beneficial effect of vitamin D supplementation.”

- Ninna Hahn Tougaard, MD, from the Steno Diabetes Center, Copenhagen.

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Reference:

https://www.sciencedirect.com/science/article/abs/pii/S105687272300209X

Disclosures: Some authors declared financial ties to drugmakers. See full study for details.

By Dave Quaile, MD /alert Contributor

Photo Credit: Getty Images.