Vitamin D Status and Cardiovascular Risk Factors in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in a Tertiary-Level Hospital in Antananarivo, Madagascar

Sitraka Angelo Raharinavalona,1 Rija Eric Raherison,2 Rija Mikhaël Miandrisoa,1 Radonirina Lazasoa Andrianasolo,2 Andrianirina Dave Patrick Rakotomalala2 1Cardiovascular Diseases and Internal Medicine Departments, Soavinandriana Hospital Center, Antananarivo, Madagascar; 2Endocrinology Department, Joseph Raseta Befelatanana University Hospital Center, Antananarivo, MadagascarCorrespondence: Sitraka Angelo Raharinavalona, Cardiovascular Diseases and Internal Medicine departments, Soavinandriana Hospital Center, Antananarivo, Madagascar, Email sitrakarah@gmail.comBackground: Diabetes mellitus is already a major cardiovascular risk factor (CRF). Hypovitaminosis D is common in patients with type 2 diabetes mellitus (T2DM). It also increases the cardiovascular risk of these subjects.Objective: To determine the vitamin D status of Malagasy with T2DM seen at the Soavinandriana Hospital Center, and the association between hypovitaminosis D and CRF.Methods: This was a cross-sectional study, carried out over a period of 2 years. Assayed by the chemiluminescence technique, vitamin D was “normal”, “insufficient” and “deficient” if the 25-hydroxyvitamin D plasma was ≥ 30 ng/mL, 20– 29 ng/mL and ≤ 19 ng/mL, respectively. Hypovitaminosis D was the set of vitamin D insufficiency and deficiency.Results: Among the 318 T2DM, the prevalence of hypovitaminosis D was 66.0% (45.2% insufficiency and 20.8% deficiency). Their factors associated were age ≥ 70 years (OR = 2.15 [1.26– 3.66]), glycated haemoglobin ≥ 7% (4.97 [2.97– 8.39]), and retinopathy (OR = 4.15 [1.85– 9.32]). After adjustment for age, Hb A1c ≥ 7% and retinopathy, hypovitaminosis D was associated with hypertension (OR = 8.77 [4.76– 16.2]), dyslipidaemia (OR = 8.05 [3.98– 14.5]), ex-smoking (OR = 6.07 [2.78– 13.3]), microalbuminuria (OR = 2.95 [1.25– 6.97]) and carotid atherosclerosis (OR = 2.96 [1.83– 4.35]).Conclusion: Hypovitaminosis D was common in T2DM. Its treatment is primarily preventive. It is also important to control associated CRF, diabetes and its complications.Keywords: 25-hydroxyvitamin D, cardiovascular risk factors, hypovitaminosis D, Madagascar, type 2 diabetes mellitus