Association of all-cause and specific-cause mortality with diabetes mellitus in adults with vitamin D deficiency

Background: There is increasing evidence indicating that vitamin D deficiency may contribute to the development of Type ۲ Diabetes Mellitus (T۲DM) by affecting insulin sensitivity, insulin secretion, and inflammation.Objectives: We have investigated the association between vitamin D deficiency, T۲DM, and mortality outcomes.Methods: The study was conducted on a sample of ۸۴۶ subjects, derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. Participants were considered as vitamin D deficient with vitamin D levels of less than ۲۰ ng/ml. Over ۱۰ years, participants were followed up every three years. The cause of death was identified using the death register of the Iranian Ministry of Health and Education and the death cause questionnaire. The study examined the relationship between T۲DM and mortality using descriptive statistics, chi-square tests, and Cox proportional hazard regression analysis.Results: During the ۱۰-year follow-up, ۴۴ participants died from all causes, ۱۵ from cancer, and ۱۴ from cardiovascular causes. There was a significant association between diabetes and all-cause mortality, even after adjustment for age and sex yielding an HR of ۲.۰۷ (P=۰.۰۳۹). Vitamin D deficiency was associated with diabetes-related mortality (HR=۳.۱۶, P=۰.۰۳۸), but this link is not true for individuals who had vitamin D levels of more than ۲۰ ng/ml. This association extends to mortality because of cancer (HR=۳.۶۴, P=۰.۰۲۵), but not cardiovascular mortality. Conclusion: Our findings underscore the potential role of vitamin D deficiency in the mortality risk of diabetics. Future research should further explore the mechanistic links between vitamin D deficiency, T۲DM, and mortality outcomes to inform targeted interventions and improve clinical management strategies.

کلیدواژه ها:

mortality ، Diabetes Mellitus ، Vitamin D deficiency ، Cohort study