Role of Serum Vitamin D Level in Progression of Diabetic Foot Ulcer (original) (raw)
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Iranian Journal of Diabetes and Obesity, 2016
iabetes mellitus is one of the most common endocrine disorders that is characterized by blood glucose increase and caused by deficient secretion or function of insulin or both. High blood glucose in diabetic patients is accompanied by the disorders and dysfunctions of different organs, especially eyes, feet, kidneys, nerves and D 1. Department of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2. Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 3. Division of Endocrinology and Metabolism, Department of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Sriwijaya Journal of Surgery, 2023
Background: Vitamin D has a role in diabetes mellitus. Low levels of vitamin D are associated with the development of diabetic foot infections. Effects of vitamin D supplementation on wound healing, insulin resistance, inflammatory biomarkers, and oxidative stress are mediated by effects on induction of phagocytosis and bacterial killing by macrophages, suppression of interferon-gamma mediating macrophage activation, activation of insulin receptor expression, and downregulation from cytokines. This study aimed to determine the correlation between serum vitamin D levels and the severity of diabetic foot ulcers in Dr.
Narra X, 2023
Serum vitamin D level is associated with the development of diabetic foot ulcer (DFU), and it is intriguing to determine if the vitamin supplementation could reverse the diabetic complication. The aim of this study was to investigate the efficacy of vitamin D supplementation in DFU management through qualitative and quantitative systematic review. A systematic search was conducted to screen the records identified in PubMed, Scopus, Embase, Scillit, Sci-Finder, LILACS, EuropePMC, medRxiv, bioRvix, Google Scholar, Semantic Scholar, and Garuda databases as of 10 March 2023. Studies investigating the efficacy of a single dose supplementation of vitamin D in DFU management were included. Quality of the included studies was appraised by Cochrane 'Risk of Bias' 2.0. Random-effects-based pooled analysis using Cohen's d was performed on the wound healing progress as the primary outcome. A sensitivity test with leave-oneout method and meta-regression were also conducted to analyze the effect of heterogenous data. Five studies with a total of 245 patients (123 versus 122 for experimental and control groups, respectively) were finally included in the qualitative and quantitative analysis. The pooled estimate suggested that administering vitamin D to DFU patients could reduce the wound area or depth significantly as compared to control group (p<0.001; Cohen's d: 2.72; 95% CI: 1.02 to 4.42). The value remained positive throughout the leave-one-out analysis. Vitamin D supplementation significantly contributed to the increased level of serum vitamin D (p=0.026, Cohen's d:-0.719; 95% CI:-1.35 to-0.09). Elevation of high-density lipoprotein was observed in pooled estimate with p=0.016 and Cohen'd: 1.34 (95% CI: 0.25 to 2.44). Qualitatively, significant reduction of HbA1C, total cholesterol, and Creactive protein were reported in at least two trials. Significantly improved quantitative insulin sensitivity check index (QUICKI) and decreased malondialdehyde, fructosamine, and fasting blood glucose were reported in at least one trial each. There were conflicting results on the change of low-density lipoprotein level. This study highlights that vitamin D supplementation promotes wound healing process among DFU patients; however, it is too premature to draw solid conclusions as the efficacy could be affected by multiple factors. Therefore, clinical trials from various demographics and ethnicities by using a high-versus low-dose model are needed.
Raised serum 25-hydroxyvitamin D levels in patients with active diabetic foot ulcers
British Journal of Nutrition, 2016
Studies have emerged to demonstrate bidirectional changes in circulating cytokines of inflammation in active diabetic foot ulcers (DFU). To further expand the understanding of inflammatory status present in chronic active DFU, we comparatively assessed the associations of selected pro-inflammatory cytokines and 25-hydroxyvitamin D (25(OH)D) with the presence of DFU. In a cross-sectional setting, thirty patients with type 2 diabetes and active DFU matched with thirty control non-ulcerative patients with type 2 diabetes and twenty-eight healthy subjects underwent anthropometric and biochemical assessment of study parameters. Recruited patients with DFU were selected from the grade II active chronic DFU at the time of hospitalisation according to the University of Texas wound classification system. Patients with DFU and controls had comparable age, sexual distribution, diastolic blood pressure and TAG, LDL-cholesterol and glycated Hb. The trend changes from healthy controls towards DFU...
Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection
The British journal of nutrition
The aim of the present research was to study the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Patients were enrolled in two groups: diabetic patients with foot infection (n 125) as cases and diabetic patients without the infection as controls (n 164). Serum 25-hydroxyvitamin D (25(OH)D) was measured by RIA. Data were presented as means and standard deviations unless otherwise indicated and were analysed by SPSS. Results revealed that 25(OH)D (nmol/l) was significantly lower (40·25 (sd 38·35) v. 50·75 (sd 33·00); P < 0·001) in cases than in controls. Vitamin D inadequacy (25(OH)D < 75 nmol/l) was equally common in cases and controls (OR 1·45, 95 % CI 0·8, 3·0; P = 0·32), but cases had a greater risk of vitamin D deficiency (25(OH)D < 50 nmol/l) than controls (OR 1·8, 95 % CI 1·1, 3·0; P = 0·02). Risk of severe vitamin D deficiency (25(OH)D < 25 nmol/l) was significantly higher in cases than in controls (OR 4·0, 95 % CI 2·4, 6·9...
Clinical Diabetology, 2021
Background. Oxidative balance and inflammatory processes affect wound healing phases, and their disruption is connected with delayed wound healing. The present study aimed to assess the association between serum hs-CRP, prooxidant-antioxidant Balance (PAB), and vitamin D with anthropometric and biochemical parameters in patients with diabetic foot ulcers (DFU). Methods. Thirty-two patients with DFU were included in this study. The Spearman correlation coefficient was used to evaluate the bivariate relationship between serum hs-CRP, PAB, and vitamin D with anthropometric characteristics, glycemic status, lipid profiles, homocysteine level, liver, and kidney function tests. Results. Our data showed a significant positive association between serum hs-CRP and insulin (r = 0.417, P = 0.027), uric acid (r = 0.629, P = 0.001), creatinine (r = 0.431, P = 0.022), erythema (r = 0.36, P = 0.049), and ESR (r = 0.560, P = 0.002). Moreover, hs-CRP negatively correlated with FBS (r = –0.427, P = 0...
Is there an association between vitamin D and diabetic foot disease? A meta-analysis
It has been demonstrated that Vitamin D (25(OH)D) deficiency is associated with diabetes and with diabetic neuropathy. Some reports stated that vitamin D deficiency is also associated with diabetic foot ulcer and/or infection. Knowing the beneficial effect of vitamin D on wound healing, a quantitative evidence synthesis is needed to look for such association. Medline, Embase, Scopus, CINAHL, Cochrane Library, and Google Scholar were searched for from inception. The outcomes were set to be either the serum 25(OH)D level or the prevalence of patients with 25(OH) D with severe deficiency. Ten studies met the inclusion criteria with 1,644 patients; 817 diabetic patients with foot ulcers and 827 patients having diabetes without foot complications. The weighted mean differences was −0.93 (95% CI = −1.684 to −0.174, I 2 = 97.8%, p = 0.01). The odds ratio of having severe vitamin D deficiency was 3.6 (95% CI = 2.940 to 4.415, I 2 = 40.9%, p < 0.0001), in favor of the foot group. The quality of the included studies was found to be good to excellent. Diabetic foot complications are associated with significantly lower levels of vitamin D. Patients with diabetic ulcers or diabetic infection are at higher risk of bearing severe vitamin D deficiency. Knowing the beneficial effect of vitamin D on wound healing, it is likely that recognizing and supplementing with vitamin D could prevent or improve the outcomes of diabetic foot complications.
International Surgery Journal
Background: With the increasing prevalence of diabetes mellitus (DM), vitamin D (vit D) deficiency and vascular calcification is frequently observed in DM and is an indicator of diabetic peripheral vascular disease with variable implications. Due to the current limited understanding, this research was initiated. Aims and objective was to critically assess the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection, the association between vascular calcification and vitamin D deficiency and effect on healing in diabetic foot patient with and without vitamin D deficiency.Methods: This observational study was conducted on 50 patients with diabetes mellitus. A detailed clinical history was recorded. Infection was confirmed by culture positivity and Doppler was used to detect vascular calcification. A follow-up for 3 weeks was done after which wound healing rate was assessed by change in wound surface area. Data was analyzed by Chi-square test and multiva...
2019
Background: The impact of diabetic foot infections is enormous in India. Studies on vitamin D levels in diabetes mellitus foot infections are scarce. The primary objective of the present study was to compare the serum vitamin D level between diabetics with foot infections and those without foot infections and the secondary objective was to assess the association between the vitamin D level and the severity of foot infections and outcomes. Methods: The study included 176 type 2 diabetics who attended Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, between September 2012 and June 2014. The serum vitamin D level was measured for 88 diabetics with foot infections (Group 1) and 88 without foot infections (Group 2) using the ELISA 25OH vitamin D DIAsource kit (DIAsource ImmunoAssays S.A., Belgium) and compared. Both groups were followed up for 6 months for outcomes. The qualitative variables were analyzed using the χ2 test and the quantitative vari...