The Relationship Between Serum 25-hydroxyvitamin D And Painful Diabetic Peripheral Neuropathy In Patients With Type 2 Diabetes Mellitus

Objective: Several studies have found that 25(OH)D is associated with diabetic peripheral neuropathy(DPN)in patients with type 2 diabetes mellitus(T2DM),but many of these have not differentiate between people with painful diabetic peripheral neuropathy and those with painless diabetic peripheral neuropathy.Meanwhile,studies have found that 25(OH)D has a correlation with chronic pain.However,the relationship between painful diabetic peripheral neuropathy(PDPN)and 25(OH)D in patients with T2 DM remains unclear.This cross-sectional study was aimed to evaluate the relationship between PDPN and 25(OH)D in Chinese patients with T2 DM.Methods: A total of 478 inpatients with T2 DM in a tertiary hospital were enrolled in this cross-sectional study from May 2018 to January 2019.Detailed data including basic information,anthropometric measurements,laboratory examinations,neurological assessments and pain scores were collected for all patients by a self-made case report from(CRF).Patients’ life and sleep quality were also assessed.According to the patients’ neurological assessments and pain score,they were divided into PDPN group and painless DPN group.Logistic regression analysis was performed to identify the relationship between related factors and PDPN.A receiver-operating characteristic curve(ROC)was used to find the best cut-off of 25(OH)D for screening of PDPN.Results: A total of 127 patients diagnosed with PDPN were included in this study,the prevalence of PDPN was 26.57%.25(OH)D levels were significantly lower in patients with PDPN than patients with painless DPN(p=0.012).Pain scores,neuropathy symptom score(NSS)and neuropathy disability score(NDS)were negatively associated with 25(OH)D levels,while motor nerve conduction velocities,motor and sensory nerve amplitudes were positively associated with 25(OH)D levels(all p<0.05).Patients’ life quality and sleep quality index decreased with the increase of pain scores(all p<0.05).After gradually adjusting for multiple factors,serum 25(OH)D levels were independently associated with PDPN based on logistic regression assessments(p=0.016,OR=0.954,95% CI:0.918-0.991).According to the results of ROC analysis,the maximum Youden’s index was 0.26,and the corresponding 25(OH)D levels of10.3ng/mL could be the best cut-off for screening of PDPN.Conclusion: Lower serum 25(OH)D levels were significantly associated with PDPN in patients with T2 DM.Serum 25(OH)D levels<10.3 ng/mL could be used for screening of PDPN.