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Clinical Nutrition

Vitamin D status, body composition and glycemic control in an ambulatory population with diabetes and chronic kidney disease

European Journal of Clinical Nutrition volume 70, pages 743–749 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

To determine the interrelationships between body composition, glycemic control and vitamin D status in an ambulatory population with diabetes (DM) and chronic kidney disease (CKD).

Subjects/Methods:

Adult (18–80 years) patients (n=60) with DM and stage 1–4 CKD were recruited from the Northern Alberta Renal Program. Outcome variables included body composition (absolute/regional fat (FM)/lean soft tissue/total mass, percent fat/lean/fat-free (FFM) mass), glycemic control (glycated hemoglobin (HbA1c)), vitamin D intake (dietary/supplemental) and vitamin D status (25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D)) measured by validated methodologies. Sarcopenia was determined as an appendicular skeletal mass/height2 less than 7.26 kg/m2 (males) and 5.45 kg/m2 (females).

Results:

Suboptimal HbA1c (>7%), 25(OH)D (<50 nmol/l) and 1,25(OH)2D (<43 pmol/l) concentrations were present in 57, 8 and 11% of participants. Ten percent of subjects had sarcopenia. Gender/age/DM type, not CKD, significantly influenced regional/whole body composition. Females, older participants and those with type 2 DM had higher %FM. No significant interrelationships between vitamin D status and glycemic control were observed (P>0.05). Serum 25(OH)D concentrations were inversely associated with arm lean soft tissue/FFM/total mass, weight, appendicular skeletal mass, lean soft tissue/height2, FFM/height2, appendicular skeletal mass/height2 and body mass index (P<0.05). Sarcopenia occurred more frequently in patients with 25(OH)D concentrations ⩾100 nmol/l. Regional/whole body %FM was inversely related to 1,25(OH)2D, not 25(OH)D.

Conclusions:

Body composition, not glycemic control, is associated with vitamin D status in an ambulatory population of adults with DM and CKD.

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Acknowledgements

We gratefully acknowledge AS Alzaben, S Enns and P Li for their assistance with data collection and auditing. This research would not be possible without all the patients and their families who participated in this study, as well as the assistance from the NARP clinic teams and Janice MacKenzie. Funding for this study was provided by the Canadian Foundation of Dietetic Practice and Research. Personal funding provided by G Woodrow Wirtanen Studentship (Alberta Diabetes Institute; to MRH and STJ), University of Alberta Doctoral Recruitment Scholarship (to MRH), Dietitians of Canada Graduate Scholarship (to STJ) and CIHR MSc scholarship (to STJ) is gratefully acknowledged.

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Authors and Affiliations

  1. Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada

    M R Hoffmann, S T Jackson & D R Mager

  2. Department of Endocrinology, University of Alberta, Edmonton, Alberta, Canada

    P A Senior

  3. Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, Alberta, Canada

    P A Senior & K Jindal

  4. Northern Alberta Renal Program, Edmonton, Alberta, Canada

    K Jindal

  5. Department of Nephrology, University of Alberta, Edmonton, Alberta, Canada

    K Jindal

  6. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

    D R Mager

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Hoffmann, M., Senior, P., Jackson, S. et al. Vitamin D status, body composition and glycemic control in an ambulatory population with diabetes and chronic kidney disease. Eur J Clin Nutr 70, 743–749 (2016). https://doi.org/10.1038/ejcn.2015.185

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