Adequate vitamin D levels can significantly reduce the risk of peripheral neuropathy, especially for patients with diabetes

Vitamin D insufficiency and deficiency are important public health issues facing the world today. As an endocrine hormone, vitamin D has potential anti-inflammatory, anti-oxidative stress and endothelial function protection effects, and may have neuroprotective functions. In addition, diabetes, as one of the most important risk factors for peripheral neuropathy, may affect the relationship between vitamin D levels and new-onset peripheral neuropathy. However, the relationship between serum 25-hydroxyvitamin D levels and new-onset peripheral neuropathy, and whether diabetic status affects this relationship, remains unclear.

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In response to this problem, the National Clinical Research Center for Kidney Diseases of Nanfang Hospital of Southern Medical University has carried out relevant work, and the research results were recently published in the journal Precision Nutrition . The study found that in diabetic participants, serum 25-hydroxyvitamin D levels were negatively correlated with the risk of new peripheral neuropathy , while in non-diabetic participants, this negative correlation was significantly weakened. Dr. Zhang Yuanyuan of the National Clinical Research Center for Kidney Diseases of Nanfang Hospital of Southern Medical University is the corresponding author of the article, and Dr. Zhou Chun is the first author.

The study included 386,715 participants with no history of peripheral neuropathy at baseline, with a mean age of 56.5 years and a median serum 25-hydroxyvitamin D level of 46.7 nmol/L.

Results showed that during the 12-year follow-up, 2,742 participants developed peripheral neuropathy. Overall, among participants with diabetes, serum 25-hydroxyvitamin D levels were significantly inversely associated with the risk of new-onset peripheral neuropathy, with a significant 18% decrease in the risk of peripheral neuropathy for every 1 standard deviation increase in serum 25-hydroxyvitamin D levels. However, among participants without diabetes, this inverse association was significantly attenuated, with a 7% decrease in the risk of peripheral neuropathy for every 1 standard deviation increase in serum 25-hydroxyvitamin D levels (Figure 1).

Figure 1 Association of serum 25-hydroxyvitamin D levels with new-onset peripheral neuropathy in (A) diabetic and (B) nondiabetic participants

When serum 25-hydroxyvitamin D levels were divided into three categories for evaluation: severe deficiency (<25 nmol/L; 13.5% of the population), moderate deficiency (25-<50 nmol/L; 42.0% of the population), and deficiency or above (≥50 nmol/L; 44.5% of the population), among participants with diabetes, the risk of peripheral neuropathy was reduced by 35% in participants with moderate deficiency and 40% in participants with deficiency or above compared with those with severe deficiency. This inverse association was significantly attenuated in participants without diabetes, with a risk reduction of 16% and 24%, respectively.

This prospective study revealed an inverse association between serum 25-hydroxyvitamin D levels and the risk of new-onset peripheral neuropathy, and this association was more significant in participants with diabetes. Peripheral neuropathy is one of the most common complications of diabetes. This study emphasizes the importance of maintaining adequate serum 25-hydroxyvitamin D levels and recommends maintaining adequate vitamin D levels through diet, supplement intake, or extended outdoor activity time (Figure 2) to achieve early prevention of peripheral neuropathy.

Figure 2 Main sources of vitamin D (Image source: Internet, copyright belongs to the original author)

References:

Zhou, Chun; Gan, Xiaoqin; Ye, Ziliang; He, Panpan; Zhang, Yanjun; Yang, Sisi; Wu, Qimeng; Liu, Mengyi; Zhang, Yuanyuan. Associations between serum 25-hydroxyvitamin D and risk of new-onset peripheral neuropathy: a modifying effect of diabetes. Precision Nutrition 3(1): p e00066, March 2024.

Editor | Zhang Yiwei and Huang Yu

Audit | Qin Xianhui