Background and aims Serum vitamin D (sVD) deficiency may contribute to the development and progression of diabetic nephropathy (DN). Research has shown urinary vitamin D binding protein (uVDBP) excretion is increased after renal injury, and is associated with tubulointerstitial damage. Animal studies suggested that sVD deficiency may be associated with urine loss due to kidney damage. The aim was to test associations of sVD with levels of uVDBP, urinary vitamin D (uVD).
Methods 42 children aged 6–17 years with type 1 diabetes were examined: 24 nornoalbuminuric patients (1st group) and 18 microalbuminuric (2nd group). 15 healthy children were included in controls. We measured serum and urine 25(OH)D levels, uVDBP concentrations and tested their correlations.
Results sVD levels were decreased in the patients of the 1st and 2nd groups, compared with controls ((22.03 (17.23; 24.44) and 14.42 (12.02; 19.63), compared with 30.65 (28.45; 35.05) ng/ml, respectively) (p < 0.001)). uVDBP levels were elevated in the patients of the 1st and 2nd groups, compared with controls ((179.5 (174.0; 189.0) and 219.0 (216.0; 222.0), compared with 125.0 (116.5;136.0) ng/mg, respectively) (p < 0.001)). uVD levels were increased in the patients of the 1st and 2nd groups, compared with control group ((3.2 (2.9; 3.3) and 3.9 (3.7; 4.1), compared with 2.2 (2.1;2.6) ng/mg, respectively) (p < 0.001)). The correlations between the levels of sVD and uVD (r = -0.74, p < 0.01), sVD and uVDBP (r = -0,64, p < 0.01) were determined.
Conclusions These data suggest that, theoretically, one of the causes of VD deficiency in patients with DN is a urine loss.