{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:41:59Z","timestamp":1787870519073,"version":"build-2784847793"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>Cardiovascular autonomic neuropathy (CAN) may be associated with other diabetes mellitus-related complications. In addition, lower vitamin D (VD) levels have been associated with diabetic kidney disease (DKD) and diabetic neuropathy. We evaluated the relationship between serum VD and CAN in patients with type 2 Diabetes Mellitus (T2DM) in early and advanced stages of DKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-six T2DM patients, 28 in early DKD stage (urine albumin to creatinine ratio (UACR)): 30 to 299 mg\/g - group 1), and 48 in advanced DKD stage (UACR \u2265300 mg\/g - group 2), participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In group 1, prevalence of CAN was 46% versus 75% in group 2 (p=0.01). 25(OH)D was lower in group 2 (26.3\u00a0\u00b1\u00a09.8 vs 30.0\u00a0\u00b1\u00a08.0; p&amp;lt;0.05) and, in this group, those with CAN vs without CAN showed lower 25(OH)D (27.8\u00a0\u00b1\u00a08.3 vs 32\u00a0\u00b1\u00a06.3; p&amp;lt;0.05). Only in group 2, patients with VD deficiency (&amp;lt;no&amp;gt;&amp;lt;20&amp;lt;\/no&amp;gt; ng\/ml) vs normal, showed worse CAN parameters, particularly VLF (65.5 (46-104) vs 309 (106.5-682.5), p&amp;lt;0.01), SDNN (10.5 (8-17.5) vs 28.5 (13-48), p&amp;lt;0.05) and Valsalva Maneuver (1.12\u00a0\u00b1\u00a00.04 vs 1.30\u00a0\u00b1\u00a00.21, p&amp;lt;0.05). We have found a correlation between VD concentration and CAN prevalence (r = -0.3, p&amp;lt;0.05). Logistic regression showed that VD concentration &amp;lt;no&amp;gt;&amp;lt;20&amp;lt;\/no&amp;gt; ng\/ml increased 24 times the chance of abnormal VLF (R\u00b2: 0.38; OR: 24.1; 95% (CI: 2.6\u2013222); p&amp;lt;0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To our knowledge, this is the first study to demonstrate an association between lower VD and CAN in T2DM and advanced DKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1810159","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:37:06Z","timestamp":1776227826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Vitamin D and cardiovascular autonomic neuropathy in type 2 diabetes mellitus according to diabetic kidney disease 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