{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:13:59Z","timestamp":1787026439671,"version":"build-2736575974"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370870"],"award-info":[{"award-number":["82370870"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["202240295"],"award-info":[{"award-number":["202240295"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010108","name":"Zhongshan Hospital","doi-asserted-by":"publisher","award":["2020ZSLC19, 2020ZSLC58, 2023ZSQN03"],"award-info":[{"award-number":["2020ZSLC19, 2020ZSLC58, 2023ZSQN03"]}],"id":[{"id":"10.13039\/501100010108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["22Y31900302 , 23XD1423300"],"award-info":[{"award-number":["22Y31900302 , 23XD1423300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic peripheral neuropathy (DPN) contributes to disability and imposes heavy burdens, while subclinical DPN is lack of attention so far. We aimed to investigate the relationship between vitamin D and distinct subtypes of subclinical DPN in type 2 diabetes (T2DM) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 3629 T2DM inpatients who undertook nerve conduction study to detect subclinical DPN in Zhongshan Hospital between March 2012 and December 2019. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25(OH)D) level\u2009&amp;lt;\u200950 nmol\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1620 (44.6%) patients had subclinical DPN and they were further divided into subgroups: distal symmetric polyneuropathy (DSPN) (n=685), mononeuropathy (n=679) and radiculopathy (n=256). Compared with non-DPN, DPN group had significantly lower level of 25(OH)D (P &amp;lt; 0.05). In DPN subtypes, only DSPN patients had significantly lower levels of 25(OH)D (36.18 \u00b1 19.47 vs. 41.03 \u00b1 18.47 nmol\/L, P &amp;lt; 0.001) and higher proportion of vitamin D deficiency (78.54% vs. 72.18%, P &amp;lt; 0.001) than non-DPN. Vitamin D deficiency was associated with the increased prevalence of subclinical DPN [odds ratio (OR) 1.276, 95% confidence interval (CI) 1.086-1.501, P = 0.003] and DSPN [OR 1. 646, 95% CI 1.31-2.078, P &amp;lt; 0.001], independent of sex, age, weight, blood pressure, glycosylated hemoglobin, T2DM duration, calcium, phosphorus, parathyroid hormone, lipids and renal function. The association between vitamin D deficiency and mononeuropathy or radiculopathy was not statistically significant. A negative linear association was observed between 25(OH)D and subclinical DSPN. Vitamin D deficiency maintained its significant association with subclinical DSPN in all age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vitamin D deficiency was independently associated with subclinical DSPN, rather than other DPN subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2024.1354511","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:24:47Z","timestamp":1711326287000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Association of vitamin D deficiency and subclinical diabetic peripheral neuropathy in type 2 diabetes patients"],"prefix":"10.3389","volume":"15","author":[{"given":"Xiaoyang","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiling","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenmin","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binger","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfeng","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400697","article-title":"A multicenter study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population","volume":"36","author":"Young","year":"1993","journal-title":"Diabetologia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1038\/s41572-019-0092-1","article-title":"Diabetic neuropathy","volume":"5","author":"Feldman","year":"2019","journal-title":"Nat Rev Dis primers"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.04.031","article-title":"Humanistic and economic burden of painful diabetic peripheral neuropathy in Europe: A review of the literature","volume":"109","author":"Alleman","year":"2015","journal-title":"Diabetes Res Clin practice"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S012","article-title":"12. Retinopathy, neuropathy, and foot care: standards of medical care in diabetes-2022","volume":"45","year":"2022","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S010","article-title":"10. Microvascular complications and foot care: standards of medical care in diabetes-2018","volume":"41","year":"2018","journal-title":"Diabetes Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0850","article-title":"Subclinical neuropathy among Diabetes Control and Complications Trial participants without diagnosable neuropathy at trial completion: possible predictors of incident neuropathy","volume":"30","author":"Albers","year":"2007","journal-title":"Diabetes Care"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2114","article-title":"Neuropathy and related findings in the diabetes control and complications trial\/epidemiology of diabetes interventions and complications study","volume":"37","author":"Martin","year":"2014","journal-title":"Diabetes Care"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2011.04.012","article-title":"Novel roles of vitamin D in disease: what is new in 2011","volume":"22","author":"Makariou","year":"2011","journal-title":"Eur J Internal Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"794","DOI":"10.3390\/nu11040794","article-title":"Analysis of association between vitamin D deficiency and insulin resistance","volume":"11","author":"Szymczak-Pajor","year":"2019","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02360.x","article-title":"Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels","volume":"25","author":"Sugden","year":"2008","journal-title":"Diabetic Med J Br Diabetic Assoc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s11892-019-1201-y","article-title":"Type 2 diabetes mellitus, insulin resistance, and vitamin D","volume":"19","author":"Sacerdote","year":"2019","journal-title":"Curr Diabetes Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03379.x","article-title":"Association between vitamin D and diabetic neuropathy in a nationally representative sample: results from 2001-2004 NHANES","volume":"29","author":"Soderstrom","year":"2012","journal-title":"Diabetic Med J Br Diabetic Assoc"},{"key":"B13","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.jcte.2017.04.001","article-title":"The association between vitamin D level and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus: An update systematic review and meta-analysis","volume":"9","author":"Qu","year":"2017","journal-title":"J Clin Trans endocrinology"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-014-0210-6","article-title":"Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: a systematic review and meta-analysis","volume":"38","author":"Lv","year":"2015","journal-title":"J endocrinological Invest"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03510.x","article-title":"Does Vitamin D deficiency play a role in peripheral neuropathy in Type 2 diabetes","volume":"29","author":"Shehab","year":"2012","journal-title":"Diabetic Med J Br Diabetic Assoc"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2820","article-title":"Vitamin D deficiency increases the risk of peripheral neuropathy in Chinese patients with type 2 diabetes","volume":"33","author":"He","year":"2017","journal-title":"Diabetes\/metabolism Res Rev"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-s011","article-title":"Standards of medical care in diabetes\u20132012","year":"2012","journal-title":"Diabetes Care"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000318","article-title":"Clinical and electrophysiological profiles in early recognition of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome","volume":"132","author":"Wang","year":"2019","journal-title":"Chin Med J"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Internal Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-0180","article-title":"Serum 25-hydroxyvitamin D: a predictor of macrovascular and microvascular complications in patients with type 2 diabetes","volume":"38","author":"Herrmann","year":"2015","journal-title":"Diabetes Care"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.01.022","article-title":"A systematic review on the efficacy of vitamin D supplementation on diabetic peripheral neuropathy","volume":"39","author":"Yammine","year":"2020","journal-title":"Clin Nutr (Edinburgh Scotland)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.2147\/JPR","article-title":"Does vitamin D affect diabetic neuropathic pain and balance","volume":"13","author":"Sari","year":"2020","journal-title":"J Pain Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2005.05.011","article-title":"A multicenter, double-blind, safety study of QR-333 for the treatment of symptomatic diabetic peripheral neuropathy. A preliminary report","volume":"19","author":"Valensi","year":"2005","journal-title":"J Diabetes its complications"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3679","article-title":"Vitamin D and diabetic peripheral neuropathy: A multi-center nerve conduction study among Chinese patients with type 2 diabetes","volume":"39","author":"Pang","year":"2023","journal-title":"Diabetes\/metabolism Res Rev"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2013.02.004","article-title":"Vitamin D and aging","volume":"42","author":"Gallagher","year":"2013","journal-title":"Endocrinol Metab Clinics North America"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3162","article-title":"Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle-aged patients","volume":"35","author":"Niu","year":"2019","journal-title":"Diabetes\/metabolism Res Rev"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1042\/BST20140279","article-title":"Vitamin D: a custodian of cell signaling stability in health and disease","volume":"43","author":"Berridge","year":"2015","journal-title":"Biochem Soc Trans"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2017.10","article-title":"Vitamin D administration, cognitive function, BBB permeability and neuroinflammatory factors in high-fat diet-induced obese rats","volume":"41","author":"Hajiluian","year":"2017","journal-title":"Int J Obes (2005)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1159\/000056351","article-title":"Tacalcitol, an active vitamin D3, induces nerve growth factor production in human epidermal keratinocytes","volume":"14","author":"Fukuoka","year":"2001","journal-title":"Skin Pharmacol Appl skin Physiol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/0169-328X(94)90119-8","article-title":"1,25-dihydroxyvitamin D3 regulates the synthesis of nerve growth factor in primary cultures of glial cells","volume":"24","author":"Neveu","year":"1994","journal-title":"Brain Res Mol Brain Res"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s001250051443","article-title":"A vitamin D(3) derivative (CB1093) induces nerve growth factor and prevents neurotrophic deficits in streptozotocin-diabetic rats","volume":"42","author":"Riaz","year":"1999","journal-title":"Diabetologia"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2013.05.023","article-title":"Increased vitamin D receptor expression in dorsal root ganglia neurons of diabetic rats","volume":"549","author":"Filipovi\u0107","year":"2013","journal-title":"Neurosci letters"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.12829","article-title":"Vitamin D deficiency contributes to vascular damage in sustained ischemic acute kidney injury","volume":"4","author":"de Bragan\u00e7a","year":"2016","journal-title":"Physiol Rep"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201802750RR","article-title":"Vitamin D improves endothelial barrier integrity and counteracts inflammatory effects on endothelial progenitor cells","volume":"33","author":"Schr\u00f6der-Heurich","year":"2019","journal-title":"FASEB J Off Publ Fed Am Societies Exp Biol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2518","DOI":"10.3390\/nu12092518","article-title":"High-dose vitamin D supplementation improves microcirculation and reduces inflammation in diabetic neuropathy patients","volume":"12","author":"Karonova","year":"2020","journal-title":"Nutrients"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1303","article-title":"Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments","volume":"33","author":"Tesfaye","year":"2010","journal-title":"Diabetes Care"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70065-0","article-title":"Diabetic neuropathy: clinical manifestations and current treatments","volume":"11","author":"Callaghan","year":"2012","journal-title":"Lancet Neurology"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1354511\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:24:51Z","timestamp":1711326291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1354511\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,25]]},"references-count":38,"alternative-id":["10.3389\/fendo.2024.1354511"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2024.1354511","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,25]]},"article-number":"1354511"}}