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Background <p>Vitamin D deficiency is common in patients with type 2 diabetes mellitus (T2DM), but its association with diabetic microvascular complications remains unclear. We investigated the relationships between serum 25-hydroxyvitamin D [25(OH)D] levels and urinary albumin-to-creatinine ratio (UACR) as well as diabetic retinopathy (DR) in patients with T2DM.</p> Methods <p>In total, 518 patients with T2DM were included and classified into vitamin D deficient (&lt; 20 ng/mL) and non-deficient (≥ 20 ng/mL) groups according to serum 25(OH)D levels. Missing covariate data were handled using multiple imputation. Baseline characteristics were compared between groups. The associations of serum 25(OH)D with ln-transformed UACR, UACR ≥ 30&#xa0;mg/g, and DR were evaluated using multivariable linear and logistic regression models. Subgroup analyses, interaction tests, and restricted cubic spline analyses were performed to examine effect modification and dose-response relationships. Seasonal variation in serum 25(OH)D was additionally assessed in an expanded cohort of 970 patients with T2DM.</p> Results <p>Patients with vitamin D deficiency had higher HbA1c, triglycerides, LDL-C, and UACR than those without deficiency. In the expanded seasonal analysis, serum 25(OH)D levels in patients with T2DM showed significant seasonal variation, with the lowest levels in autumn, while no significant differences were observed among spring, summer, and winter. Serum 25(OH)D was inversely associated with ln(UACR) in the multivariable model (adjusted B = − 0.070, 95% CI: −0.106 to − 0.033; <i>P</i> &lt; 0.001) and with UACR ≥ 30&#xa0;mg/g (adjusted OR = 0.933, 95% CI: 0.887–0.981; <i>P</i> = 0.006). This association was more evident in younger patients. Restricted cubic spline analysis suggested a non-linear inverse relationship between 25(OH)D and lnUACR. Serum 25(OH)D was also inversely associated with DR risk (adjusted OR = 0.932, 95% CI: 0.877–0.991; <i>P</i> = 0.024), although no significant interaction was observed in subgroup analyses.</p> Conclusions <p>Lower serum 25(OH)D levels were associated with higher UACR and showed a modest association with DR in hospitalized patients with T2DM, warranting further investigation in prospective studies.</p> Clinical trial number <p>Not applicable.</p>

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Association of serum 25-hydroxyvitamin D with urinary albumin-to-creatinine ratio and diabetic retinopathy in hospitalized patients with type 2 diabetes mellitus: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月11日

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  • Xiang-Yu Chen,
  • Fan-Rui Meng,
  • Yang Zhang,
  • Xiang-Xin Wang,
  • Mei Xue,
  • Wen-Hua Xiao

摘要

Background

Vitamin D deficiency is common in patients with type 2 diabetes mellitus (T2DM), but its association with diabetic microvascular complications remains unclear. We investigated the relationships between serum 25-hydroxyvitamin D [25(OH)D] levels and urinary albumin-to-creatinine ratio (UACR) as well as diabetic retinopathy (DR) in patients with T2DM.

Methods

In total, 518 patients with T2DM were included and classified into vitamin D deficient (< 20 ng/mL) and non-deficient (≥ 20 ng/mL) groups according to serum 25(OH)D levels. Missing covariate data were handled using multiple imputation. Baseline characteristics were compared between groups. The associations of serum 25(OH)D with ln-transformed UACR, UACR ≥ 30 mg/g, and DR were evaluated using multivariable linear and logistic regression models. Subgroup analyses, interaction tests, and restricted cubic spline analyses were performed to examine effect modification and dose-response relationships. Seasonal variation in serum 25(OH)D was additionally assessed in an expanded cohort of 970 patients with T2DM.

Results

Patients with vitamin D deficiency had higher HbA1c, triglycerides, LDL-C, and UACR than those without deficiency. In the expanded seasonal analysis, serum 25(OH)D levels in patients with T2DM showed significant seasonal variation, with the lowest levels in autumn, while no significant differences were observed among spring, summer, and winter. Serum 25(OH)D was inversely associated with ln(UACR) in the multivariable model (adjusted B = − 0.070, 95% CI: −0.106 to − 0.033; P < 0.001) and with UACR ≥ 30 mg/g (adjusted OR = 0.933, 95% CI: 0.887–0.981; P = 0.006). This association was more evident in younger patients. Restricted cubic spline analysis suggested a non-linear inverse relationship between 25(OH)D and lnUACR. Serum 25(OH)D was also inversely associated with DR risk (adjusted OR = 0.932, 95% CI: 0.877–0.991; P = 0.024), although no significant interaction was observed in subgroup analyses.

Conclusions

Lower serum 25(OH)D levels were associated with higher UACR and showed a modest association with DR in hospitalized patients with T2DM, warranting further investigation in prospective studies.

Clinical trial number

Not applicable.