Aims/IntroductionResearch has suggested that vitamin D deficiency is associated with diabetic retinopathy (DR). Our study aimed to determine whether vitamin D deficiency is the cause of diabetic retinopathy or if diabetic retinopathy reduces vitamin D levels.Materials and MethodsParticipants with type‐2 diabetes were recruited for this prospective observational clinical study and were divided into a diabetic group without retinopathy and a diabetic group with retinopathy, with additional healthy volunteers serving as a control group. The differences in clinical characteristics among the three groups were also compared. Patients without retinopathy were then followed for 1 year to monitor the incidence of diabetic retinopathy. After follow‐up, participants were divided into subgroups based on whether diabetic retinopathy occurred. The baseline data of the subgroups were compared, and the independent risk factors were analyzed.ResultsVitamin D levels were generally low. Participants with diabetic retinopathy had significantly lower vitamin D levels than did those without retinopathy (P < 0.01). A comparison of the two subgroups revealed lower baseline vitamin D concentrations in the new‐DR subgroup than in the non‐DR subgroup (P < 0.01). Vitamin D deficiency and elevated HbA1c levels were found to be independent risk factors for diabetic retinopathy (OR = 0.935, 95% CI: 0.867–0.981, P = 0.006; OR = 2.208, 95% CI: 1.764–2.764, P < 0.01). The limit of vitamin D intake according to the receiver‐operating characteristic (ROC) curve was 26.01 ng/mL, and the area under the ROC curve was 0.603 (95% CI: 0.559–0.706, P = 0.002).ConclusionsVitamin D levels were significantly lower in patients diagnosed with diabetic retinopathy. More importantly, vitamin D deficiency may accelerate the onset of diabetic retinopathy.

中文翻译：

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糖尿病视网膜病变患者血清维生素 D 显着降低并预示病情加重

目的/简介研究表明，维生素 D 缺乏与糖尿病视网膜病变 (DR) 相关。我们的研究旨在确定维生素 D 缺乏是否是糖尿病视网膜病变的原因，或者糖尿病视网膜病变是否会降低维生素 D 水平。 材料和方法 2 型糖尿病患者被招募参加这项前瞻性观察性临床研究，并被分为无视网膜病变的糖尿病组和患有视网膜病变的糖尿病组，以及额外的健康志愿者作为对照组。还比较了三组之间临床特征的差异。然后对没有视网膜病变的患者进行为期一年的随访，以监测糖尿病视网膜病变的发生率。随访后，根据是否发生糖尿病视网膜病变将参与者分为亚组。比较各亚组基线数据，分析独立危险因素。结果维生素D水平普遍较低。患有糖尿病视网膜病变的参与者的维生素 D 水平显着低于没有视网膜病变的参与者。磷< 0.01）。两个亚组的比较显示，新 DR 亚组的基线维生素 D 浓度低于非 DR 亚组（磷< 0.01）。维生素 D 缺乏和 HbA1c 水平升高被发现是糖尿病视网膜病变的独立危险因素（OR = 0.935，95% CI：0.867–0.981，磷= 0.006; OR = 2.208，95% CI：1.764–2.764，磷< 0.01）。根据受试者工作特征（ROC）曲线，维生素 D 摄入限值为 26.01 ng/mL，ROC 曲线下面积为 0.603（95% CI：0.559–0.706，磷= 0.002)。结论诊断为糖尿病视网膜病变的患者维生素 D 水平显着较低。更重要的是，维生素D缺乏可能会加速糖尿病视网膜病变的发病。