Key result
Lower vitamin D levels linked to ~11% higher odds of silent myocardial ischemia in type 2 diabetes.
Why the study?
Vitamin D deficiency has a pathogenetic and prognostic role in coronary artery disease and pain transmission, while diabetic patients carry an increased risk of silent myocardial ischemia.
Do low serum vitamin D levels correlate with the presence of silent myocardial ischemia and mortality in type 2 diabetic patients?
Observational (n=303)
No
Do low serum vitamin D levels correlate with the presence of silent myocardial ischemia and mortality in type 2 diabetic patients?
Low serum vitamin D is independently associated with silent myocardial ischemia in type 2 diabetic patients, identifying a high-risk cohort with worse long-term survival.
Answers are grounded in this paper and cite their sources.
Low vitamin D levels were associated with silent ischemia and worse survival in type 2 diabetes; hypothesis-generating and should not yet change practice.
Vitamin D deficiency has a pathogenetic and prognostic role in coronary artery disease and a key role in pain transmission. Diabetic patients have a higher risk of silent myocardial ischemia (SMI) due to diabetic neuropathy. We evaluated the correlation between SMI and Vitamin D serum levels in type 2 diabetic patients and assessed whether SMI patients had a worse survival rate than their symptomatic counterpart. We enrolled 253 patients admitted in our Cardiology Unit and compared them with 50 healthy volunteers. We created three sub-groups: symptomatic MI group (125, 32.4%); SMI group (78, 25.7%), and no-MI group (50, 41.9%). 25(OH)D levels (nmol/L) were lower in the SMI group (34.9 ± 5.8) compared to those in the symptomatic MI (49.6 ± 6.1; p = 0.01), no MI (53.1 ± 6.2; p = 0.001), and control groups (62.1 ± 6.7; p = 0.0001). 25(OH)D levels predicted SMI in diabetic patients, with an inverted odds ratio of 1.11 (p = 0.01). Symptomatic MI group survival was higher than the SMI one (6-year survival rate: 83 vs. 69%; p = 0.01). Diabetic patients with SMI had a higher mortality risk and showed lower 25(OH)D levels than the symptomatic group. This suggests the crucial role that vitamin D has in the pathogenesis of SMI.
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Rossi et al. (2022) conducted an observational in Type 2 diabetes with suspected coronary artery disease (n=303). Serum 25(OH)D levels vs. Higher 25(OH)D levels (symptomatic MI, no MI, and healthy volunteers) was evaluated on Presence of silent myocardial ischemia (SMI) (Inverted OR 1.11, 95% CI 1.06-1.17, p=0.01). Lower 25(OH)D serum levels independently predicted the presence of silent myocardial ischemia in type 2 diabetic patients, who also exhibited a worse 6-year survival rate compared to patients with symptomatic MI.
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