Prevalence of Vitamin D Deficiency and it’s Correlation with HbA1c in Type 2 Diabetes Mellitus

Prevalence of Vitamin D Deficiency and it’s Correlation with HbA1c in Type 2 Diabetes Mellitus | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Prevalence of Vitamin D Deficiency and it’s Correlation with HbA1c in Type 2 Diabetes Mellitus Srinath Kenkere Marulaiah, Likitha Nadendla, Paramahans V Salimath, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7684637/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Vitamin D deficiency is known as an important factor involved in pathogenesis and progression of type 2 diabetes mellitus to complications of diabetes. The study is aimed to assess level and severity of vitamin D deficiency and its association with clinico -demographic and glucose and lipid profile parameters among diabetic and diabetic nephropathy patients. The study was conducted with 252 study subjects divided in three groups: Individuals with Type 2 Diabetes Mellitus, those with Diabetic Nephropathy and Healthy controls. Sociodemographic factors, clinical profile, serum 25 – hydroxy vitamin D, glucose and lipid profile were assessed across the three groups. Vitamin D deficiency was observed in 67.9% of controls, 81% of patients with diabetes mellitus and 88.1% of patients with diabetic nephropathy (p = 0.004). Vitamin D levels showed significant negative association with HbA1c and positively with HDL levels. No significant statistical associations were found for vitamin D with gender or geographical area. Vitamin D deficiency was significantly associated with poor glycemic control with HbA1c more than 8% and 87.7% had vitamin D levels < 20ng/ml ( p = 0.042). More than two third of the diabetics and nephropathy patients had vitamin D deficiency and it was associated with poor glycemic control and altered lipid parameters. Screening and supplementation of Vitamin D may have beneficial role in the management of diabetes mellitus and also prevention of complications. Health sciences/Diseases Health sciences/Endocrinology Health sciences/Medical research Health sciences/Nephrology Diabetic Nephropathy Type 2 Diabetes Mellitus Vitamin D HbA1c Lipid Profile Figures Figure 1 Introduction Vitamin D, a seco-steroidal hormone, is known for the essential role in calcium-phosphate metabolism and skeletal health. Growing research evidence is now implicated in various non-skeletal effects [1,2]. Calcitriol - active form of vitamin D is shown to have a wide range of effects on the body impacting immune functions, muscle functions, inflammation and its deficiency is also associated with risk of certain diseases including cardiovascular and metabolic diseases [2]. Presence of vitamin D receptors (VDR) in pancreatic cells and various insulin-sensitive tissues implicate the biological plausibility in glucose metabolism and insulin secretion [3]. In India, the burden of both Vitamin D deficiency and metabolic disorders including T2 Diabetes Mellitus has reached significant levels, despite abundant sunlight a paradox that undermines underlying complexity. Factors that contribute may include changing lifestyle, dietary habits, urbanization, skin pigmentation and limited awareness among the public [4]. Most studies are predominantly based on Western populations, whose genetic, dietary and environmental contexts differ significantly from those in Mysuru region, southern part of Karnataka. Given this context, it is essential to assess the role of vitamin D in metabolic health especially in diabetes mellitus within the Indian context. Population specific research is imperative to understand local patterns to guide policy makers for tailor made targeted interventions and preventive measures, unique to demographic and epidemiological profile of the regional or local population. This study was undertaken to assess the magnitude of vitamin D deficiency among diabetic and nephropathy patients and analyze the associations of vitamin D with glucose and lipid profile parameters. Results Table 1 describes that males comprised of 40.5% of the control group, 53.6% of diabetic group and 70.2% of the nephropathy group (p < 0.001). A significant age gradient was observed with the nephropathy group skewing older (p < 0.001). Most participants resided in urban areas. Around 16.7% were smokers and 15.5% were alcoholics. Table 1 Sociodemographic characteristics of the study subjects Variable Category Control group (n = 84) Diabetic (n = 84) Diabetic nephropathy (n = 84) Chi Square value p-value n (%) n (%) n (%) Gender Male 34 (40.5) 45 (53.6) 59 (70.2) 15.08 0.001 Female 50 (59.5) 39 (46.4) 25 (29.8) Age group 21–40 years 29 (34.5) 19 (22.6) 1 (1.2) 41–60 years 46 (54.8) 47 (56) 37 (44) > 60 years 9 (10.7) 18 (21.4) 46 (54.8) Residence Rural 11 (13.1) 11 (13.1) 11 (13.1) 0.06 0.96 Urban 73 (86.9) 73 (86.9) 73 (86.9) Smokers No 84 (100) 75 (89.3) 69 (82.1) 15.75 0.001 Yes - 6 (7.1) 14 (16.7) Previously - 3 (3.6) 1 (1.2) Alcoholic No 84 (100) 76 (90.5) 69 (82.1) 16.17 0.001 Yes - 7 (8.3) 13 (15.5) Previously - 1 (1.2) 2 (2.4) From Table 2 and Fig. 1 , we have observed that vitamin D deficiency ( 30ng/ml) compared to 14.3% in controls. Table 2 Vitamin D deficiency distribution among study subjects Vitamin D Deficiency Control group (n = 84) Diabetic (n = 84) Diabetic nephropathy (n = 84) n (%) n (%) n (%) Below 20 57 (67.9) 68 (81) 74 (88.1) 21–30 15 (17.9) 13 (15.5) 8 (9.5) Above 30 12 (14.3) 3 (3.6) 2 (2.4) It can be observed from Table 3 that diabetic and nephropathy groups had significantly elevated FBS, PPBS and HbA1c levels (< 0.01). HDL was lowest in the nephropathy group (29.79 ± 13.5 mg/dl), while LDL and total cholesterol were reduced in nephropathy compared to diabetics (p < 0.001). Triglycerides were highest among diabetics. Table 3 Glucose and lipid profile parameters among study subjects Variable Control group (n = 84) Diabetic (n = 84) Diabetic nephropathy (n = 84) p-value Mean ± SD Mean ± SD Mean ± SD Fasting Blood Sugar (mg/dl) 90.9 ± 11.7 169.56 ± 63.5 169.6 ± 69.6 < 0.0001 Post Prandial Blood Sugar (mg/dl) 112.4 ± 21.6 246.36 ± 90.32 255.4 ± 82.8 < 0.0001 HBA1C 5.62 ± 1.45 8.79 ± 1.71 8.78 ± 2.15 < 0.0001 Total Cholesterol (mg/dl) 168.36 ± 38.07 183.4 ± 40.1 132.9 ± 61.4 < 0.0001 Low Density Level Lipoprotein (mg/dl) 116.4 ± 29.3 122.7 ± 34.4 73.6 ± 50.1 < 0.0001 Very Low-Density Lipoprotein (mg/dl) 30.06 ± 12.44 34.4 ± 16.1 32.5 ± 17.7 0.248 High Density Lipoprotein (mg/dl) 40.28 ± 9.12 38.7 ± 9.2 29.79 ± 13.5 < 0.0001 Triglycerides (mg/dl) 139.48 ± 69.5 172.9 ± 92.2 160.5 ± 85.9 0.019 Table 4 shows that vitamin D deficiency had no significant association with gender, age or geographical area within individual groups, although males and older subjects tended to have higher deficiency rates. Table 4 Association between Vitamin D deficiency levels with respect to gender Variable Category Levels of Vitamin D deficiency Control group (n = 84) Diabetic (n = 84) Diabetic nephropathy (n = 84) 30 p-value 30 p-value 30 p-value N (%) N (%) N (%) N (%) N(%) N (%) N(%) N (%) N (%) Gender Male 15 (44.1) 13 (38.2) 6 (17.6) 0.121 36 (80) 7 (15.6) 2 (4.4) 0.897 51 (86.4) 7 (11.9) 1 (1.7) 0.451 Female 42 (84) 2 ( 4 ) 6 ( 12 ) 32 (82.1) 6 (15.4) 1 (2.6) 23 (92) 1 ( 4 ) 1 ( 4 ) Residence Rural 10 (90.0) 0 (0.0) 1 (9.1) 0.175 8 (72.7) 3 (27.3) 0 (0.0) 0.428 9 (81.8) 2 (18.2) 0 (0.0) 0.508 Urban 47 (64.4) 15 (20.5) 11 (15.1) 60 (82.2) 10 (13.7) 3 (4.1) 65 (89) 6 (8.2) 2 (2.7) Age group 21–40 20 (69) 6 (20.7) 3 (10.3) 0.395 17 (89.5) 1 (5.3) 1 (5.3) 0.113 1 (100) - - 1.000 41–60 33 (71.7) 7 (15.2) 6 ( 13 ) 38 (80.9) 9 (19.1) 0 (0.0) 32 (86.5) 4 (10.8) 1 (2.7) > 60 4 (44.4) 2 (22.2) 3 (33.3) 13 (72.2) 3 (16.7) 2 (11.1) 41 (89.1) 4 (8.7) 1 (2.2) Table 5 shows vitamin D deficiency was significantly associated with poor glycemic control among those with HbA1c more than 8% and 87.7% had vitamin D levels of 8 Total P value n (%) n (%) n (%) 0.042 Below 20 ng/ml 25 (71.4) 43 (87.7) 68 (81) Above 21 ng/ml 10 (28.5) 6 (12.2) 16 ( 19 ) Total 35(41.6) 49(58.3) 84 (100) Discussion Vitamin D plays a crucial role beyond bone and skeletal health, particularly in modulating immune and Metabolic functions [8]. Critical role of Vitamin D is being examined in several endocrine, paracrine and autocrine functions [9]. In this study, we investigated the levels vitamin D and its relationship with glucose and lipid profiles among individuals with diabetes and diabetic nephropathy. This study highlights high prevalence of vitamin D deficiency in diabetic individuals and the deficiency was further worsened particularly in subjects with Diabetic Nephropathy. The gradient of deficiency from control to diabetes and further to nephropathy suggests a progressive decline in vitamin D status with disease severity. Our observations are consistent with prior studies conducted in different regions as well. ( 10 – 13 ) The association of vitamin deficiency with elevated HbA1c in our study supports its role in glucose metabolism and insulin function. Systematic Review and meta-analysis revealed high vitamin D levels with lower risk of insulin resistance and probability of developing insulin resistance reduced with each additional supplementation of vitamin D ( 14 ). Many studies have investigated the role of vitamin D in diabetes and observed an association between low levels of vitamin D and increased risk for Type 2 diabetes and its complications ( 15 – 19 ). Systematic reviews, have shown that Vitamin D plays a key role in maintaining the optimal release of insulin by the pancreatic beta cells (β -cells). Diabetes disease starts with the onset of insulin resistance. Beta cells may overcome this resistance with release of more insulin to prevent hyperglycemia. However, as the activity of Beta cells increases, Beta cells need excessive Ca2 + and signaling of the Reactive Oxygen Species (ROS), which in turn results in beta cell death and onset of diabetes. Vitamin D acts to maintain normal resting levels of Ca2 + and ROS that are elevated within beta cells during the diabetes process. Vitamin D also plays a significant role in maintaining epigenomes and prevents hypermethylation. Thus, when Vitamin D is deficient, many of these cellular processes decline and set the stage for the onset of diabetes and its progression to complications ( 20 – 21 ) In our study, Low HDL levels in vitamin D deficient patients may further reflect vitamin D’s role in lipid metabolism and cardiovascular risk reduction. Similar to our study findings, several other studies have shown that lower vitamin D levels is associated with low HDL cholesterol levels ( 22 – 24 ). Interestingly, demographic variables such as gender and geographical area were not statistically significant, suggesting that metabolic factors, rather than social factors influence vitamin D deficiency and it is evident that Vitamin D deficiency is an important public health problem affecting individuals across all age groups among both genders in urban and rural areas. With changing lifestyles and growing burden of metabolic diseases, screening for vitamin D deficiency and supplementation of Vitamin D can be an additional essential component in managing the metabolic diseases like diabetes, dyslipidemia and preventing the complications of diabetes. Conclusion Despite the growing evidences of deficiency of vitamin D, the need for regular measurement in general population as well as among diabetics is emphasized and such deficiencies have to be managed effectively to gain skeletal as well as immune-metabolic benefits on glucose and lipid profiles. Methodology A cross-sectional study was conducted in a tertiary care hospital in Mysuru. Study participants included 252 individuals, divided into three groups: Group 1: Controls (n = 84) Group 2: Diagnosed T2DM patients (n = 84) Group 3: T2DM patients with diagnosed diabetic nephropathy (n = 84) Based on the previous study that reported mean serum vitamin D levels of 19.66 ± 6.75 ng/ml among diabetics, 31.78 ± 2.0 ng/ml among non-diabetics [5] and 19.82 ± 5.05 ng/ml among diabetic nephropathy, [6,7] Sample size was estimated assuming a 5% level of significance (α = 0.05), a statistical power of 80%( β = 0.20), and an absolute standardized mean difference of 0.5, the total sample size required was calculated to be 252, with 84 participants per group. Inclusion Criteria Cases 1. Diabetic Nephropathy was diagnosed based on; Diabetes was diagnosed, if a patient was known diabetic on treatment and /or fasting blood sugar more than 126mg/dl or post prandial blood sugar more than 200mg/dl or HbA1C more than 6.5 Calculation of eGFR using the MDRD 4 revised Equation. eGFR = 175 x (S Cr)-1.154 x(age)-0.203 x0.742 [if female] x1.212 [if Black] Where, eGFR (estimated glomerular filtration rate) = mL/min/1.73 m2 S Cr (serum creatinine) = mg/dL age in years eGFR < 89 ml/min/1.73 m2 was included as diabetic nephropathy cases. Diabetes without nephropathy was considered if; The patient was known diabetic on treatment and /or Fasting Blood Sugar of more than 126 mg/dl or postprandial blood sugar of more than 200mg/dl or HbA1c of more than 6.5 And eGFR > 90ml/min/1.73m 2 were included as diabetic cases. Controls : Normal Subjects without any disorder were included as controls. Exclusion Criteria: Patients with Type 1 DM Patients of Nephrotic Syndrome Malignancy prone to developing bone metastasis Derangement in Calcium, Phosphorus, mineral metabolism Chronic Liver Disease Malabsorption Syndrome Patients on medications with anticonvulsants, rifampicin, isoniazid, glucocorticoids and theophylline. Methods of data collection: After taking informed written consent from patients, data was collected using structured interviews and medical records were used to gather data on socio-demographic details like age, gender, residence, smoking, alcohol use, past, personal history, drug history, clinical history of diabetes and other existing co-morbidities, height, weight, blood pressure were recorded. All methods were carried out in accordance with relevant guidelines and regulations. Informed Consent was obtained from all subjects and/or their legal guardian(s). All experimental protocols were approved by JSS Institutional Ethics Committee (JSSMC/IEC/3110/20 NCT/2019-20 Dated 05/11/2019). c) Collection of Blood Samples: Fasting venous blood samples (8 ml) were collected from the study participants and were analyzed for; Fasting Blood Sugar (FBS) using GOD-POD Method Postprandial Blood Sugar (PPBS) using GOD-POD Method HbA1c estimation was done by the High-Performance Liquid Chromatography (HPLC) method Creatinine in serum was measured by the enzymatic method. eGFR was calculated by the abbreviated MDRD equation. Lipid Profile that included total cholesterol, LDL, HDL, VLDL, triglycerides were estimated spectrophotometrically using Rosche-Cobas fully automated integrated analyzer Serum 25(OH)D was measured by chemiluminescent immunoassay Vitamin D status was classified as Vitamin D Deficient: if Vitamin D levels were 30ng/ml. Statistical Analysis: Data was analyzed using SPSS software version 28.0 licensed to JSS AHER. Descriptive Statistics like Mean and standard deviation was calculated to present continuous variables. Chi-square test was applied to test the association between categorical factors. If the p-value was < 0.05, it was considered to be statistically significant. Declarations FUNDING: We Sincerely Thank Science and Engineering Research Board (SERB) Author Contribution •SRINATH K M: Conceptualization, Methodology, Data collection, Formal analysis & interpretation, Writing original draft•LIKHITHA NADENDLA: Data Collection and Curation, Formal analysis•PARAMAHANS V SALIMATH: Conceptualization, Funding Acquisition, Editing•MANJUNATH S SHETTY: Draft Review and Editing•AKILA PRASHANT: Data Curation and Editing•BASAVANA GOWDAPPA H: Conceptualization, Funding Acquisition, Editing and Supervision Acknowledgement We Sincerely Thank Science and Engineering Research Board(SERB) (a statutory body of the Department of Science and Technology, Government of India), for the Academic Grant provided. 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P. & de Novaes, J. F. Lower vitamin D intake is associated with low HDL cholesterol and vitamin D insufficiency/deficiency in Brazilian children. Public Health. Nutr. 21 (11), 2004–2012 (2018). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 03 Nov, 2025 Reviewers agreed at journal 30 Oct, 2025 Reviewers invited by journal 27 Oct, 2025 Editor assigned by journal 27 Oct, 2025 Editor invited by journal 06 Oct, 2025 Submission checks completed at journal 03 Oct, 2025 First submitted to journal 03 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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1","display":"","copyAsset":false,"role":"figure","size":159004,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of Vitamin D levels among study subjects\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7684637/v1/f40fa7726faf87136561d750.jpeg"},{"id":95531618,"identity":"fcb9f8fc-c1d3-437d-a1e6-214aa71a733c","added_by":"auto","created_at":"2025-11-10 10:23:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":887903,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7684637/v1/d9c32187-a260-4a83-b546-4ebc473e4506.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of Vitamin D Deficiency and it’s Correlation with HbA1c in Type 2 Diabetes Mellitus","fulltext":[{"header":"Introduction","content":"\u003cp\u003eVitamin D, a seco-steroidal hormone, is known for the essential role in calcium-phosphate metabolism and skeletal health. Growing research evidence is now implicated in various non-skeletal effects [1,2]. Calcitriol - active form of vitamin D is shown to have a wide range of effects on the body impacting immune functions, muscle functions, inflammation and its deficiency is also associated with risk of certain diseases including cardiovascular and metabolic diseases [2]. Presence of vitamin D receptors (VDR) in pancreatic cells and various insulin-sensitive tissues implicate the biological plausibility in glucose metabolism and insulin secretion [3].\u003c/p\u003e\u003cp\u003eIn India, the burden of both Vitamin D deficiency and metabolic disorders including T2 Diabetes Mellitus has reached significant levels, despite abundant sunlight a paradox that undermines underlying complexity. Factors that contribute may include changing lifestyle, dietary habits, urbanization, skin pigmentation and limited awareness among the public [4]. Most studies are predominantly based on Western populations, whose genetic, dietary and environmental contexts differ significantly from those in Mysuru region, southern part of Karnataka.\u003c/p\u003e\u003cp\u003eGiven this context, it is essential to assess the role of vitamin D in metabolic health especially in diabetes mellitus within the Indian context. Population specific research is imperative to understand local patterns to guide policy makers for tailor made targeted interventions and preventive measures, unique to demographic and epidemiological profile of the regional or local population.\u003c/p\u003e\u003cp\u003eThis study was undertaken to assess the magnitude of vitamin D deficiency among diabetic and nephropathy patients and analyze the associations of vitamin D with glucose and lipid profile parameters.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e describes that males comprised of 40.5% of the control group, 53.6% of diabetic group and 70.2% of the nephropathy group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significant age gradient was observed with the nephropathy group skewing older (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Most participants resided in urban areas. Around 16.7% were smokers and 15.5% were alcoholics.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic characteristics of the study subjects\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDiabetic (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDiabetic nephropathy (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eChi Square value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34 (40.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45 (53.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e59 (70.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e15.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50 (59.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39 (46.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25 (29.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u0026ndash;40 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19 (22.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41\u0026ndash;60 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46 (54.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47 (56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37 (44)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9 (10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18 (21.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e46 (54.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (13.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 (13.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11 (13.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.96\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73 (86.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e73 (86.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e73 (86.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eSmokers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75 (89.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e69 (82.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e15.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6 (7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14 (16.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePreviously\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (3.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (1.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAlcoholic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e76 (90.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e69 (82.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e16.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 (8.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13 (15.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePreviously\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (2.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFrom Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, we have observed that vitamin D deficiency (\u0026lt;\u0026thinsp;20ng/ml) was present among 67.9% of controls, 81.0% of diabetics and 88.1% among nephropathy patients (p\u0026thinsp;=\u0026thinsp;0.04). Only 2.4% of nephropathy patients had sufficient vitamin D levels (\u0026gt;\u0026thinsp;30ng/ml) compared to 14.3% in controls.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eVitamin D deficiency distribution among study subjects\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVitamin D Deficiency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDiabetic\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDiabetic nephropathy\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBelow 20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57 (67.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68 (81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e74 (88.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e15 (17.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (15.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (9.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbove 30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12 (14.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (3.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (2.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIt can be observed from Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e that diabetic and nephropathy groups had significantly elevated FBS, PPBS and HbA1c levels (\u0026lt;\u0026thinsp;0.01). HDL was lowest in the nephropathy group (29.79\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5 mg/dl), while LDL and total cholesterol were reduced in nephropathy compared to diabetics (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Triglycerides were highest among diabetics.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGlucose and lipid profile parameters among study subjects\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDiabetic\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDiabetic nephropathy\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFasting Blood Sugar (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e90.9\u0026thinsp;\u0026plusmn;\u0026thinsp;11.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e169.56\u0026thinsp;\u0026plusmn;\u0026thinsp;63.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e169.6\u0026thinsp;\u0026plusmn;\u0026thinsp;69.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePost Prandial Blood Sugar (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e112.4\u0026thinsp;\u0026plusmn;\u0026thinsp;21.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e246.36\u0026thinsp;\u0026plusmn;\u0026thinsp;90.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e255.4\u0026thinsp;\u0026plusmn;\u0026thinsp;82.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHBA1C\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e8.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal Cholesterol (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e168.36\u0026thinsp;\u0026plusmn;\u0026thinsp;38.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e183.4\u0026thinsp;\u0026plusmn;\u0026thinsp;40.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e132.9\u0026thinsp;\u0026plusmn;\u0026thinsp;61.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow Density Level Lipoprotein (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e116.4\u0026thinsp;\u0026plusmn;\u0026thinsp;29.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e122.7\u0026thinsp;\u0026plusmn;\u0026thinsp;34.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e73.6\u0026thinsp;\u0026plusmn;\u0026thinsp;50.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery Low-Density Lipoprotein (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e30.06\u0026thinsp;\u0026plusmn;\u0026thinsp;12.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e34.4\u0026thinsp;\u0026plusmn;\u0026thinsp;16.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e32.5\u0026thinsp;\u0026plusmn;\u0026thinsp;17.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.248\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh Density Lipoprotein (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e40.28\u0026thinsp;\u0026plusmn;\u0026thinsp;9.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e38.7\u0026thinsp;\u0026plusmn;\u0026thinsp;9.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e29.79\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTriglycerides (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e139.48\u0026thinsp;\u0026plusmn;\u0026thinsp;69.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e172.9\u0026thinsp;\u0026plusmn;\u0026thinsp;92.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e160.5\u0026thinsp;\u0026plusmn;\u0026thinsp;85.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows that vitamin D deficiency had no significant association with gender, age or geographical area within individual groups, although males and older subjects tended to have higher deficiency rates.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between Vitamin D deficiency levels with respect to gender\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"14\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"12\" nameend=\"c14\" namest=\"c3\"\u003e\u003cp\u003eLevels of Vitamin D deficiency\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e\u003cb\u003eControl group (n\u0026thinsp;=\u0026thinsp;84)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003e\u003cb\u003eDiabetic (n\u0026thinsp;=\u0026thinsp;84)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c14\" namest=\"c11\"\u003e\u003cp\u003e\u003cb\u003eDiabetic nephropathy (n\u0026thinsp;=\u0026thinsp;84)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e21\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e21\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15 (44.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13 (38.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6 (17.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36 (80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e2 (4.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.897\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e51 (86.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e7 (11.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.451\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42 (84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e32 (82.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (15.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (2.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e23 (92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (90.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (9.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8 (72.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3 (27.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.428\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e9 (81.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e2 (18.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.508\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47 (64.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15 (20.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11 (15.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60 (82.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e10 (13.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3 (4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e65 (89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e6 (8.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e2 (2.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20 (69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6 (20.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3 (10.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.395\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e17 (89.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1 (5.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (5.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41\u0026ndash;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33 (71.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 (15.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e38 (80.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e9 (19.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e32 (86.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e4 (10.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1 (2.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3 (33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13 (72.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3 (16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e2 (11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e41 (89.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e4 (8.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1 (2.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows vitamin D deficiency was significantly associated with poor glycemic control among those with HbA1c more than 8% and 87.7% had vitamin D levels of \u0026lt;\u0026thinsp;20ng/ml (p\u0026thinsp;=\u0026thinsp;0.042)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation of Vitamin D status with Hb A1c levels among diabetics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVitamin D levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c 6 to 8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHbA1c\u0026thinsp;\u0026gt;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBelow 20 ng/ml\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25 (71.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43 (87.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e68 (81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbove 21 ng/ml\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10 (28.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (12.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16 (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35(41.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49(58.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eVitamin D plays a crucial role beyond bone and skeletal health, particularly in modulating immune and Metabolic functions [8]. Critical role of Vitamin D is being examined in several endocrine, paracrine and autocrine functions [9]. In this study, we investigated the levels vitamin D and its relationship with glucose and lipid profiles among individuals with diabetes and diabetic nephropathy.\u003c/p\u003e\u003cp\u003eThis study highlights high prevalence of vitamin D deficiency in diabetic individuals and the deficiency was further worsened particularly in subjects with Diabetic Nephropathy. The gradient of deficiency from control to diabetes and further to nephropathy suggests a progressive decline in vitamin D status with disease severity. Our observations are consistent with prior studies conducted in different regions as well. (\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eThe association of vitamin deficiency with elevated HbA1c in our study supports its role in glucose metabolism and insulin function. Systematic Review and meta-analysis revealed high vitamin D levels with lower risk of insulin resistance and probability of developing insulin resistance reduced with each additional supplementation of vitamin D (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMany studies have investigated the role of vitamin D in diabetes and observed an association between low levels of vitamin D and increased risk for Type 2 diabetes and its complications (\u003cspan additionalcitationids=\"CR16 CR17 CR18\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSystematic reviews, have shown that Vitamin D plays a key role in maintaining the optimal release of insulin by the pancreatic beta cells (β -cells). Diabetes disease starts with the onset of insulin resistance. Beta cells may overcome this resistance with release of more insulin to prevent hyperglycemia. However, as the activity of Beta cells increases, Beta cells need excessive Ca2\u0026thinsp;+\u0026thinsp;and signaling of the Reactive Oxygen Species (ROS), which in turn results in beta cell death and onset of diabetes. Vitamin D acts to maintain normal resting levels of Ca2\u0026thinsp;+\u0026thinsp;and ROS that are elevated within beta cells during the diabetes process. Vitamin D also plays a significant role in maintaining epigenomes and prevents hypermethylation. Thus, when Vitamin D is deficient, many of these cellular processes decline and set the stage for the onset of diabetes and its progression to complications (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eIn our study, Low HDL levels in vitamin D deficient patients may further reflect vitamin D\u0026rsquo;s role in lipid metabolism and cardiovascular risk reduction. Similar to our study findings, several other studies have shown that lower vitamin D levels is associated with low HDL cholesterol levels (\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eInterestingly, demographic variables such as gender and geographical area were not statistically significant, suggesting that metabolic factors, rather than social factors influence vitamin D deficiency and it is evident that Vitamin D deficiency is an important public health problem affecting individuals across all age groups among both genders in urban and rural areas. With changing lifestyles and growing burden of metabolic diseases, screening for vitamin D deficiency and supplementation of Vitamin D can be an additional essential component in managing the metabolic diseases like diabetes, dyslipidemia and preventing the complications of diabetes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDespite the growing evidences of deficiency of vitamin D, the need for regular measurement in general population as well as among diabetics is emphasized and such deficiencies have to be managed effectively to gain skeletal as well as immune-metabolic benefits on glucose and lipid profiles.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e A cross-sectional study was conducted in a tertiary care hospital in Mysuru. Study participants included 252 individuals, divided into three groups:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eGroup 1: Controls (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eGroup 2: Diagnosed T2DM patients (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eGroup 3: T2DM patients with diagnosed diabetic nephropathy (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eBased on the previous study that reported mean serum vitamin D levels of 19.66\u0026thinsp;\u0026plusmn;\u0026thinsp;6.75 ng/ml among diabetics, 31.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0 ng/ml among non-diabetics [5] and 19.82\u0026thinsp;\u0026plusmn;\u0026thinsp;5.05 ng/ml among diabetic nephropathy, [6,7] Sample size was estimated assuming a 5% level of significance (α\u0026thinsp;=\u0026thinsp;0.05), a statistical power of 80%( β\u0026thinsp;=\u0026thinsp;0.20), and an absolute standardized mean difference of 0.5, the total sample size required was calculated to be 252, with 84 participants per group.\u003c/p\u003e\n\u003ch3\u003eInclusion Criteria\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eCases\u003c/strong\u003e\u003cp\u003e1. Diabetic Nephropathy was diagnosed based on;\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003col style=\"list-style-type:upper-roman;\"\u003e\n\u003cspan\u003e\u003cli\u003e\u003cp\u003eDiabetes was diagnosed, if a patient was known diabetic on treatment and /or fasting blood sugar more than 126mg/dl or post prandial blood sugar more than 200mg/dl or HbA1C more than 6.5\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eCalculation of eGFR using the MDRD 4 revised Equation.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eeGFR\u0026thinsp;=\u0026thinsp;175 x (S Cr)-1.154 x(age)-0.203 x0.742 [if female] x1.212 [if Black]\u003c/p\u003e\u003cp\u003eWhere, eGFR (estimated glomerular filtration rate)\u0026thinsp;=\u0026thinsp;mL/min/1.73 m2\u003c/p\u003e\u003cp\u003eS Cr (serum creatinine)\u0026thinsp;=\u0026thinsp;mg/dL\u003c/p\u003e\u003cp\u003eage in years\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eeGFR\u0026thinsp;\u0026lt;\u0026thinsp;89 ml/min/1.73 m2 was included as diabetic nephropathy cases.\u003c/p\u003e\u003cp\u003e\u003col start=\"2\"\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDiabetes without nephropathy was considered if;\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003e\u003col style=\"list-style-type:upper-roman;\"\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe patient was known diabetic on treatment and /or Fasting Blood Sugar of more than 126 mg/dl or postprandial blood sugar of more than 200mg/dl or HbA1c of more than 6.5\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eAnd eGFR\u0026thinsp;\u0026gt;\u0026thinsp;90ml/min/1.73m\u003csup\u003e2\u003c/sup\u003e were included as diabetic cases.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003e\u003col start=\"3\"\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eControls\u003c/b\u003e: Normal Subjects without any disorder were included as controls.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\n\u003ch3\u003eExclusion Criteria:\u003c/h3\u003e\n\u003cp\u003ePatients with Type 1 DM\u003c/p\u003e\u003cp\u003ePatients of Nephrotic Syndrome\u003c/p\u003e\u003cp\u003eMalignancy prone to developing bone metastasis\u003c/p\u003e\u003cp\u003eDerangement in Calcium, Phosphorus, mineral metabolism\u003c/p\u003e\u003cp\u003eChronic Liver Disease\u003c/p\u003e\u003cp\u003eMalabsorption Syndrome\u003c/p\u003e\u003cp\u003ePatients on medications with anticonvulsants, rifampicin, isoniazid, glucocorticoids and theophylline.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eMethods of data collection:\u003c/h2\u003e\u003cp\u003eAfter taking informed written consent from patients, data was collected using structured interviews and medical records were used to gather data on socio-demographic details like age, gender, residence, smoking, alcohol use, past, personal history, drug history, clinical history of diabetes and other existing co-morbidities, height, weight, blood pressure were recorded.\u003c/p\u003e\u003cp\u003e All methods were carried out in accordance with relevant guidelines and regulations.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e\u003cp\u003ewas obtained from all subjects and/or their legal guardian(s).\u003c/p\u003e\u003c/p\u003e\u003cp\u003e All experimental protocols were approved by JSS Institutional Ethics Committee (JSSMC/IEC/3110/20 NCT/2019-20 Dated 05/11/2019).\u003c/p\u003e\u003cp\u003ec) Collection of Blood Samples:\u003c/p\u003e\u003cp\u003eFasting venous blood samples (8 ml) were collected from the study participants and were analyzed for;\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eFasting Blood Sugar (FBS) using GOD-POD Method\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003ePostprandial Blood Sugar (PPBS) using GOD-POD Method\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eHbA1c estimation was done by the High-Performance Liquid Chromatography (HPLC) method\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCreatinine in serum was measured by the enzymatic method.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eeGFR was calculated by the abbreviated MDRD equation.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eLipid Profile that included total cholesterol, LDL, HDL, VLDL, triglycerides were estimated spectrophotometrically using Rosche-Cobas fully automated integrated analyzer\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eSerum 25(OH)D was measured by chemiluminescent immunoassay\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eVitamin D status was classified as Vitamin D Deficient: if Vitamin D levels were \u0026lt;\u0026thinsp;20ng/ml, Vitamin D Insufficient, if vitamin D levels were between 21-30ng/ml and Vitamin D Sufficient, if vitamin D levels were \u0026gt;\u0026thinsp;30ng/ml.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis:\u003c/h2\u003e\u003cp\u003eData was analyzed using SPSS software version 28.0 licensed to JSS AHER. Descriptive Statistics like Mean and standard deviation was calculated to present continuous variables. Chi-square test was applied to test the association between categorical factors. If the p-value was \u0026lt;\u0026thinsp;0.05, it was considered to be statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFUNDING:\u003c/h2\u003e\u003cp\u003eWe Sincerely Thank Science and Engineering Research Board (SERB)\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e\u0026bull;SRINATH K M: Conceptualization, Methodology, Data collection, Formal analysis \u0026amp; interpretation, Writing original draft\u0026bull;LIKHITHA NADENDLA: Data Collection and Curation, Formal analysis\u0026bull;PARAMAHANS V SALIMATH: Conceptualization, Funding Acquisition, Editing\u0026bull;MANJUNATH S SHETTY: Draft Review and Editing\u0026bull;AKILA PRASHANT: Data Curation and Editing\u0026bull;BASAVANA GOWDAPPA H: Conceptualization, Funding Acquisition, Editing and Supervision\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe Sincerely Thank Science and Engineering Research Board(SERB) (a statutory body of the Department of Science and Technology, Government of India), for the Academic Grant provided.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of the study are available from the corresponding author upon reasonable request\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHolick, M. F. Vitamin D deficiency. \u003cem\u003eN Engl. J. Med.\u003c/em\u003e \u003cb\u003e357\u003c/b\u003e (3), 266\u0026ndash;281 (2007).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePittas, A. G., Lau, J., Hu, F. B. \u0026amp; Dawson-Hughes, B. The role of vitamin D and calcium in type 2 diabetes. \u003cem\u003eJ. Clin. Endocrinol. Metab.\u003c/em\u003e \u003cb\u003e92\u003c/b\u003e (6), 2017\u0026ndash;2029 (2007).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlvarez, J. A. \u0026amp; Ashraf, A. Role of vitamin D in insulin secretion and insulin sensitivity for glucose homeostasis. \u003cem\u003eInt. J. Endocrinol.\u003c/em\u003e \u003cb\u003e2010\u003c/b\u003e (1), 351385 (2010).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBabhulkar, P., Tiwaskar, S. \u0026amp; Pathade, A. Deficiency of vitamin D in India. \u003cem\u003eJ. Pharm. Negat. Results\u003c/em\u003e. \u003cb\u003e114\u003c/b\u003e, 25 (2022).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSiddiqui, M. H., Saxena, R. \u0026amp; Verma, S. D. 1 25-Hydroxy Vitamin D level in Type 2 Diabetics and Non Diabetics: A Comparative Study. \u003cem\u003eInt. J. Pharm. Clin. Res.\u003c/em\u003e \u003cb\u003e8\u003c/b\u003e (4), 284\u0026ndash;288 (2016).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBajaj, S. et al. Vitamin D levels and microvascular complications in type 2 diabetes. \u003cem\u003eIndian J. Endocrinol. Metabol.\u003c/em\u003e \u003cb\u003e18\u003c/b\u003e (4), 537\u0026ndash;541. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/2230-8210.137512\u003c/span\u003e\u003cspan address=\"10.4103/2230-8210.137512\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrooks, G. P. \u0026amp; Johanson, G. A. Sample Size Considerations for Multiple Comparison Procedures in ANOVA, Journal of Modern Applied Statistical Methods: Vol. 10: Iss. 1, Article 10. (2011). Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://digitalcommons.wayne.edu/jmasm/vol10/iss1/10\u003c/span\u003e\u003cspan address=\"http://digitalcommons.wayne.edu/jmasm/vol10/iss1/10\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUmar, M., Sastry, K. S. \u0026amp; Chouchane, A. I. Role of vitamin D beyond the skeletal function: a review of the molecular and clinical studies. \u003cem\u003eInt. J. Mol. Sci.\u003c/em\u003e \u003cb\u003e19\u003c/b\u003e (6), 1618 (2018).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHayes, C. E., Nashold, F. E., Spach, K. M. \u0026amp; Pedersen, L. 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Lower vitamin D intake is associated with low HDL cholesterol and vitamin D insufficiency/deficiency in Brazilian children. \u003cem\u003ePublic Health. Nutr.\u003c/em\u003e \u003cb\u003e21\u003c/b\u003e (11), 2004\u0026ndash;2012 (2018).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Diabetic Nephropathy, Type 2 Diabetes Mellitus, Vitamin D, HbA1c, Lipid Profile","lastPublishedDoi":"10.21203/rs.3.rs-7684637/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7684637/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eVitamin D deficiency is known as an important factor involved in pathogenesis and progression of type 2 diabetes mellitus to complications of diabetes. The study is aimed to assess level and severity of vitamin D deficiency and its association with clinico -demographic and glucose and lipid profile parameters among diabetic and diabetic nephropathy patients. The study was conducted with 252 study subjects divided in three groups: Individuals with Type 2 Diabetes Mellitus, those with Diabetic Nephropathy and Healthy controls. Sociodemographic factors, clinical profile, serum 25 \u0026ndash; hydroxy vitamin D, glucose and lipid profile were assessed across the three groups. Vitamin D deficiency was observed in 67.9% of controls, 81% of patients with diabetes mellitus and 88.1% of patients with diabetic nephropathy (p\u0026thinsp;=\u0026thinsp;0.004). Vitamin D levels showed significant negative association with HbA1c and positively with HDL levels. No significant statistical associations were found for vitamin D with gender or geographical area. Vitamin D deficiency was significantly associated with poor glycemic control with HbA1c more than 8% and 87.7% had vitamin D levels\u0026thinsp;\u0026lt;\u0026thinsp;20ng/ml (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042). More than two third of the diabetics and nephropathy patients had vitamin D deficiency and it was associated with poor glycemic control and altered lipid parameters. Screening and supplementation of Vitamin D may have beneficial role in the management of diabetes mellitus and also prevention of complications.\u003c/p\u003e","manuscriptTitle":"Prevalence of Vitamin D Deficiency and it’s Correlation with HbA1c in Type 2 Diabetes Mellitus","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-10 05:18:23","doi":"10.21203/rs.3.rs-7684637/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"63947861297909273745074780363420228026","date":"2025-11-03T22:33:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"94953310324126988405065832908006966992","date":"2025-10-30T11:14:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-28T01:39:20+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-28T01:36:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-06T13:41:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-03T12:16:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-10-03T12:13:36+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3a6de831-8ebe-441d-bef3-c236df0e017a","owner":[],"postedDate":"November 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":57373088,"name":"Health sciences/Diseases"},{"id":57373089,"name":"Health sciences/Endocrinology"},{"id":57373090,"name":"Health sciences/Medical research"},{"id":57373091,"name":"Health sciences/Nephrology"}],"tags":[],"updatedAt":"2025-11-10T05:18:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-10 05:18:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7684637","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7684637","identity":"rs-7684637","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}