Background: Low levels of vitamin D have been related to increased mortality and morbidity in several non-diabetic\nstudies. We aimed to prospectively study relationships between serum 25-OH vitamin D3 (vitamin D) and of serum\nparathyroid hormone (PTH) to total mortality in type 2 diabetes. We also aimed to compare the levels of these potential\nrisk-factors in patients with and without diabetes.\nMethods: The main study design was prospective and observational. We used baseline data from 472 men and\n245 women who participated in the ââ?¬Å?Cardiovascular Risk factors in Patients with Diabetesââ?¬â?a Prospective study in\nPrimary careââ?¬Â study. Patients were 55ââ?¬â??66 years old at recruitment, and an age-matched non-diabetic sample of\n129 individuals constituted controls for the baseline data. Carotid-femoral pulse-wave velocity (PWV) was measured\nwith applanation-tonometry and carotid intima-media thickness (IMT) with ultrasound. Patients with diabetes were\nfollowed for all-cause mortality using the national Swedish Cause of Death Registry.\nResults: Levels of vitamin D were lower in patients with diabetes than in controls, also after correction for age and\nobesity, while PTH levels did not differ. Nine women and 24 men died during 6 years of median follow up of the final\ncohort (n = 698). Vitamin D levels were negatively related to all-cause mortality in men independently of age, PTH,\nHbA1c, waist circumference, 24-h systolic ambulatory-blood pressure (ABP) and serum-apoB (p = 0.049). This finding\nwas also statistically significant when PWV and IMT were added to the analyses (p = 0.028) and was not\naffected statistically when medications were also included in the regression-analysis (p = 0.01). In the women with type\n2 diabetes, levels of PTH were positively related with all-cause mortality in the corresponding calculations\n(p = 0.016 without PWV and IMT, p = 0.006 with PWV and IMT, p = 0.045 when also adding medications to the\nanalysis), while levels of vitamin D was without statistical significance (p >0.9).\nConclusions: Serum vitamin D in men and serum PTH in women give prognostic information in terms of total-mortality\nthat are independent of regular risk factors in addition to levels of ABP, IMT and PWV.
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