PREDICTIVE FACTORS OF MACROANGIOPATHY IN HYPERTENSIVE DIABETIC PATIENTS WITH VITAMIN D DEFICIENCY

Abstract

Objective: Several studies have shown an association between low levels of 25-hydroxyvitamin D and an increased risk of cardiovascular disease. Cardiovascular complications are the most prevalent cause of mortality in patients with type 2 diabetes mellitus and hypertension. The aim of our study was to determine the risk factors related to macroangiopathy among hypertensive diabetic patients with vitamin D deficiency. Design and method: Retrospective study, conducted on 1756 type 2 diabetics with hypertension in whom a vitamin D assay was done in the internal medicine department in the area of Blida during the period from April 2020 to November 2022. Results: 63.1% of patients had high blood pressure at the first examination. In addition, hyperuricemia was present in 39.8% patients, NASH (non-alcoholic fatty liver disease) was also present in 34.6% patients, hypertriglyceridemia in 48.3% patients, hypercholesterolemia in 60.2% patients and mixed dyslipidemia in 46.7% patients. Microalbuminuria, as a cardiovascular risk factor was positive in 39.2% patients. 61 % patients had at least one macrovascular complication. The univariate analysis showed a significant association between macroangiopathy and male gender (p = 0.029), HbA1c > 9.5% (p = 0.008), the cumulative number of cardiovascular risk factors > 5 (p 24 pg / mL (p = 0.007). Multivariate regression analysis showed that cumulative cardiovascular risk factors > 5 (OR = 13.9 [95% CI: 1.4 -137.6], p = 0.024), presence of microangiopathy (OR = 22 [95% CI: 2.2 - 215.4], p = 0.008) and HbA1c > 9.5% (OR = 36.6 [95% CI: 2.6 - 505]; p = 0.007) were predictor factors of macroangiopathy among patients with type 2 diabetes mellitus and Vitamine D deficiency. Conclusions: In hypertensive diabetic patients, cardiovascular diseases were the consequence of the additive effects of traditional risk factors with the participation of vitamin D deficiency.