PMID- 35596636
OWN - NLM
STAT- MEDLINE
DCOM- 20220524
LR  - 20221207
IS  - 0042-8833 (Print)
IS  - 0042-8833 (Linking)
VI  - 91
IP  - 2
DP  - 2022
TI  - [Vitamin supply of patients with type 2 diabetes mellitus complicated by 
      nephropathy].
PG  - 58-71
LID - 10.33029/0042-8833-2022-91-2-58-71 [doi]
AB  - Insufficient vitamin content in the diet is a risk factor for the development of 
      various diseases and their progression, and drug therapy can also contribute to 
      the development of a deficiency of these micronutrients. Data on vitamin 
      sufficiency of patients with type 2 diabetes mellitus (T2DM) and diabetic 
      nephropathy (DN) are needed to develop measures to improve it. The aim of the 
      research was to compare vitamin status of patients with T2DM without DN and those 
      with T2DM complicated by nephropathy by assessing vitamin blood level and urinary 
      excretion. Material and methods. In a single-stage research, 57 patients with 
      T2DM and concomitant obesity (14 men, 43 women aged 42-75 years) have been 
      examined. The 1st group included 26 patients with T2DM (7 men and 19 women, BMI 
      41.5+/-1.7 kg/m(2)) with glycated hemoglobin (HbA1c) - 8.0+/-1.4%, blood serum 
      glucose level 8.1+/-0.6 mmol/l, glomerular filtration rate (GFR) - 86.7+/-3.0 ml/min 
      per 1.73 m(2), microalbuminuria - 18.0+/-2.0 mg/day. The 2nd group included 31 
      patients with T2DM complicated by DN (7 men and 24 women, BMI 42.5+/-1.3 kg/m(2)), 
      with an HbA1c level of 6.4+/-0.2%, blood serum glucose level 6.8+/-0.3 mmol/l, GFR - 
      62.8+/-2.7 ml/min per 1.73 m(2), microalbuminuria - 59.5+/-22.5 mg/day. The 
      determination of vitamins capital ES, Cyrillic (ascorbic acid), A (retinol), E (alpha- and 
      gamma-tocopherols), D [25(OH)D], B(2) (riboflavin) and beta-carotene in blood serum and 
      vitamins C (ascorbic acid), B(1) (thiamine), B(2) (riboflavin) and B(6) 
      (4-pyridoxic acid) in the morning portion of urine collected on an empty stomach 
      within 40-120 min was carried out. The vitamin status was assessed based on the 
      concentration of vitamins in blood serum and urinary excretion relative to the 
      lower limit of the norm, as well as using the criteria for the optimal supply and 
      2 molar ratios. Results. Compared to patients with T2DM without nephropathy, 
      patients with DN were better provided with vitamins B(2), A and beta-carotene: 
      vitamin B(2) deficiency was found 3.2 fold less often (in 9.7%), beta-carotene - 1.8 
      fold less often (in 35.5%), nonoptimal retinol level occurred twice less often 
      (in 41.9%). At the same time, serum alpha-tocopherol level below the optimal level 
      was found in 67.7% of individuals versus 50% among patients with T2DM without 
      nephropathy, with a significantly reduced urinary excretion of vitamins B(1) and 
      B(2). With the exception of one man, the rest of the DN patients had a deficiency 
      or lack of vitamin D. The characteristic features of the vitamin status of 
      patients in both groups were the complete absence of individuals who were 
      simultaneously optimally provided with all the studied vitamins and beta-carotene 
      (when assessing the vitamin status using both the absolute serum vitamer levels 
      and 2 additional molar ratios), and a high frequency of detection of several 
      simultaneously non-optimal vitamin status indicators. A negative correlation was 
      found between blood serum level of beta-carotene and glycemia (rho=-0.359, p=0.006), 
      as well as GFR (rho=-0.289, small er, Cyrillic=0.029) and positive with high-density lipoprotein 
      cholesterol (rho=0.423, small er, Cyrillic=0.001), that indicated the need to increase this 
      antioxidant blood level in patients with T2DM. The presence of a negative 
      correlation between the concentration ratio of vitamins C and E and glucosuria 
      (rho=-0.288, p=0.033) and postprandial glycemia (rho=-0.313, p=0.031) indicated the 
      need to maintain it at an optimal level. Conclusion. For patients with T2DM and 
      concomitant obesity, vitamin D and beta-carotene turned out to be the most 
      problematic, since their reduced levels are detected more often than other 
      vitamins. In addition to the optimal blood level of vitamins C and E, it is 
      extremely important for them to maintain the blood molar ratio of ascorbic acid 
      and alpha-tocopherol at an optimal level. The purposefully development of specialized 
      vitamin complexes containing effective doses is necessary for patients with DN.
CI  - Copyright(c) GEOTAR-Media Publishing Group.
FAU - Vrzhesinskaya, O A
AU  - Vrzhesinskaya OA
AUID- ORCID: 0000-0002-8973-8153
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Leonenko, S N
AU  - Leonenko SN
AUID- ORCID: 0000-0003-0048-4220
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Kodentsova, V M
AU  - Kodentsova VM
AUID- ORCID: 0000-0002-5288-1132
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Beketova, N A
AU  - Beketova NA
AUID- ORCID: 0000-0003-2810-2351
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Kosheleva, O V
AU  - Kosheleva OV
AUID- ORCID: 0000-0003-2391-9880
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Pilipenko, V V
AU  - Pilipenko VV
AUID- ORCID: 0000-0002-0628-0854
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Plotnikova, O A
AU  - Plotnikova OA
AUID- ORCID: 0000-0001-8232-8437
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Alekseeva, R I
AU  - Alekseeva RI
AUID- ORCID: 0000-0003-4129-6971
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
FAU - Sharafetdinov, Kh Kh
AU  - Sharafetdinov KK
AUID- ORCID: 0000-0001-6061-0095
AD  - Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, 
      Moscow, Russian Federation.
LA  - rus
PT  - Journal Article
DEP - 20220314
PL  - Russia (Federation)
TA  - Vopr Pitan
JT  - Voprosy pitaniia
JID - 2984870R
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Vitamins)
RN  - 01YAE03M7J (beta Carotene)
RN  - 11103-57-4 (Vitamin A)
RN  - 1406-16-2 (Vitamin D)
RN  - H4N855PNZ1 (alpha-Tocopherol)
RN  - PQ6CK8PD0R (Ascorbic Acid)
RN  - TLM2976OFR (Riboflavin)
RN  - X66NSO3N35 (Thiamine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ascorbic Acid
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 2/complications
MH  - *Diabetic Nephropathies/complications
MH  - Female
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity
MH  - Riboflavin
MH  - Thiamine
MH  - Vitamin A
MH  - Vitamin D
MH  - *Vitamins
MH  - alpha-Tocopherol
MH  - beta Carotene
OTO - NOTNLM
OT  - blood serum
OT  - diabetic nephropathy
OT  - polyhypovitaminosis
OT  - type 2 diabetes mellitus
OT  - vitamin deficiency
OT  - vitamins
COIS- The authors declare no overt and potential conflict of interest related to the 
      publication of this article.
EDAT- 2022/05/22 06:00
MHDA- 2022/05/25 06:00
CRDT- 2022/05/21 05:02
PHST- 2022/01/24 00:00 [received]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/05/21 05:02 [entrez]
PHST- 2022/05/22 06:00 [pubmed]
PHST- 2022/05/25 06:00 [medline]
AID - 10.33029/0042-8833-2022-91-2-58-71 [doi]
PST - ppublish
SO  - Vopr Pitan. 2022;91(2):58-71. doi: 10.33029/0042-8833-2022-91-2-58-71. Epub 2022 
      Mar 14.