Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes

Lyu Qiuju; Yang Qin; Li Hui

doi:doi:10.11648/j.sd.20251306.20

Research Article |

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Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes

Lyu Qiuju^*, Yang Qin, Li Hui

Published in Science Discovery (Volume 13, Issue 6)

Received: 9 December 2025 Accepted: 17 December 2025 Published: 29 December 2025

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Abstract

Objective: To investigate the effects of normalizing vitamin D levels (≥20 ng/ml) on renal function indicators in patients with type 2 diabetes. Methods: Sixty-six patients with type 2 diabetes were enrolled. After vitamin D supplementation, vitamin D levels, urinary microalbumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were measured. Based on post-supplementation vitamin D levels, patients were divided into normal vitamin D level group (≥20 ng/ml) and vitamin D deficiency group (<20 ng/ml). Differences in UACR and eGFR between the two groups were compared. Results: The eGFR in the normal vitamin D level group was significantly higher than that in the vitamin D deficiency group, while the UACR in the normal vitamin D level group was significantly lower than that in the vitamin D deficiency group (P < 0.05). Conclusions: Normalization of vitamin D levels (≥20 ng/mL) in patients with type 2 diabetes may be associated with improved renal function indicators.

Published in	Science Discovery (Volume 13, Issue 6)
DOI	10.11648/j.sd.20251306.20
Page(s)	166-169
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Vitamin D, Type 2 Diabetes, Glomerular Filtration Rate, Urinary Microalbumin-to-creatinine Ratio

1．引言

糖尿病肾病（Diabetic kidney disease, DKD）是指由糖尿病引起的肾脏结构损伤和功能障碍，是糖尿病患者常见且严重的慢性并发症之一。我国约 20%~40%的糖尿病患者合并糖尿病肾病，现已成为慢性肾脏疾病（Chronic kidney disease, CKD）和终末期肾功能不全(end stage renal disease, ESRD)的主要原因

[1]

，造成极大医疗经济负担。近年来，多项研究发现糖尿病肾病患者血中25-羟基维生素D水平较糖尿病不伴肾病组明显降低

[2, 3]

，提示２型糖尿病患者维生素Ｄ缺乏与糖尿病肾病具有相关性。研究表明现维生素D水平与肾功能指标如肾小球滤过率、血肌酐、血尿酸、尿素氮及尿微量白蛋白/肌酐比值等成相关性，维生素D缺乏可增加糖尿病患者的肾功能恶化风险，相反维生素D补充可降低糖尿病肾病患者尿白蛋白、血肌酐水平

[4-7]

，表明维生素D可能具有改善肾功能指标作用。目前较少报道关注2型糖尿病患者补充维生素D后维生素D水平正常化对肾功能指标影响，因此本回顾性观察研究旨在探索2型糖尿病患者维生素D水平正常化后对改善其肾功能指标肾小球滤过率及尿微量白蛋白/肌酐比值的影响。

2．资料与方法

2.1．一般资料与分组

纳入2021年1月-2025年7月于乐山市人民医院就诊的2型糖尿病并补充维生素D制剂的病例，维生素D补充至少3月后测定血清25-羟基维生素D水平，根据2023年《维生素D营养状况评价及改善专家共识》建议将 25-羟基维生素D≥20 ng/mL认为是维生素D正常水平

[8]

，因此本研究将补充维生素D2或D3后血清25-羟基维生素D水平的病例分为维生素D水平正常组（血清25-羟基维生素D≥20 ng/mL）和维生素D水平缺乏组（血清25-羟基维生素D<20 ng/mL）。

2.2．纳入标准

年龄≥18岁，符合WHO 1999年2型糖尿病诊断标准。

2.3．排除标准

1型糖尿病、特殊类型糖尿病、妊娠糖尿病、分型不明的糖尿病患者、糖尿病急性并发症、重症感染、血液系统疾病、严重心脏疾病患者。

2.4．观察指标

2.4.1．基线资料

年龄，性别。

2.4.2．评价指标

肾小球滤过率（CKD-EPI公式）、尿微量白蛋白/尿肌酐比值（尿微量白蛋白浓度/尿肌酐浓度）。

2.5．统计方法

采用SPSS 19.0软件对数据进行分析。计量资料满足正态性，则结果以

±SD表示，否则以四分位数Q₅₀(Q₂₅, Q₇₅)表示；两组数据如符合正态性，则采用参数检验t检验，否则选用非参数检验Mann-Whitney 检验；分类资料采用卡方（χ²）检验。P<0.05为差异有统计学意义。

3．结果

3.1．基线资料

本研究共纳入66例2型糖尿病患者，补充维生素D后根据血清25-羟基维生素D水平分为维生素D水平正常和维生素D水平缺乏两组，分别有42例与24例。2型糖尿病患者维生素D水平正常组血清25-羟基维生素D水平明显高于维生素D水平缺乏组（P<0.05，表1）。维生素D水平正常组与维生素D水平缺乏组的年龄、性别无统计学差异（P>0.05，表1）。

表1 维生素D水平正常组与维生素D水平缺乏组基线资料比较。

组别	维生素D水平正常组	维生素D水平缺乏组	统计值
血清25-羟基维生素D（ng/mL）	28.61[24.16,33.43]	16.39[12.72,18.14]	t= -6.7 P<0.001
年龄（岁）	57.60±11.63	58.00±12.80	t=0.3，P=0.90
性别（男/女，例）	24/18	8/16	χ2=3.47，P=0.06

3.2．维生素D水平正常化对肾小球滤过率与尿微量白蛋白/肌酐比值的影响

2型糖尿病患者维生素D水平正常组肾小球滤过率明显高于维生素D水平缺乏组，但维生素D水平正常组尿微量白蛋白/肌酐比值明显低于维生素D水平缺乏组（P<0.05，表2），提示维生素D水平正常化可能与改善2型糖尿病患者的肾功能指标相关。

表2 维生素D水平正常组与维生素D水平缺乏组肾小球滤过率与尿微量白蛋白/肌酐比值比较。

组别	维生素D水平正常组	维生素D水平缺乏组	统计值
肾小球滤过率（ml·min-11.73m-2)	82.19±14.37	68.96±25.61	t= -2.3，P=0.03
尿微量白蛋白/肌酐比值（mg/g）	2.13[0.76,4.77]	5.10[1.45,24.00]	t= -2.35，P=0.02

4．讨论

维生素D是一种维持人体健康所必须的有机化合物，在调节钙、磷代谢及骨代谢方面具有重要作用。维生素D缺乏在全球人群中相当普遍，其缺乏或不足与CKD高发病率相关。中国南方人群中CKD合并维生素D不足患病率，1~2 期CKD患者发生率 92.3%

[9]

，3~5期CKD患者发生率96.7%

[10]

。许多研究表明维生素 D 在蛋白尿和肾小球硬化的消退中起关键作用。研究发现足细胞表达维生素D受体（vitamin D receptor，VDR），且维生素D/维生素D受体（vitamin D/vitamin D receptor，VD/VDR）信号通路对糖尿病肾病具有强大的肾脏保护活性

[11]

。动物和细胞实验的证据也显示维生素D能通过多种途径减轻肾细胞的损伤和过度增殖，从而改善糖尿病肾病预后。缺乏维生素 D 的糖尿病大鼠的肾小球簇、系膜和间质相对面积以及肾功能损害增加

[12]

。补充维生素D则可以降低炎症标志物如肿瘤坏死因子α（Tumor Necrosis Factor-alpha，TNF-α）和白介素6（Interleukin-6，IL-6）来延缓糖尿病肾病的进展

[13]

。

本研究发现2型糖尿病患者维生素D水平正常化可能显著改善患者肾功能指标如肾小球滤过率与尿微量白蛋白/肌酐比值。上述研究结果证实25羟基维生素D水平与糖尿病患者肾功能恶化相关性结果，例如李丹丹等发现25羟基维生素D3与血肌酐、尿素氮、β2-微球蛋白与血尿酸指标均呈负相关关系；程昌琴等亦发现与维生素D3正常组相比较，维生素D3缺乏组及不足组血肌酐水平明显增高，且25-羟维生素D3水平与血清血肌酐水平呈负相关；马世凤等报道25-羟维生素D与尿微量白蛋白/肌酐比值呈负相关；25-羟维生素D与肾小球滤过率呈正相关

[5-7, 14]

。糖尿病患者补充维生素D可升高肾小球滤过率并降低血肌酐、蛋白尿水平，亦佐证维生素D补充维生素可改善肾功能指标

[15, 16]

。此外，随机双盲安慰剂对照临床试验证实，连续6个月的50000 U维生素D给药后（每月一次），维生素D降低糖尿病肾病患者血肌酐、尿白蛋白等肾功能恶化指标

[4]

。

综上所述，本研究发现2型糖尿病患者维生素D水平正常化（≥20 ng/mL）可能与改善其肾功能指标相关，支持补充维生素D可用于管理糖尿病的建议。但本研究存在单中心研究、纳入样本量较少、随访时间较短、非随机研究等缺陷，为更准确的评估补充维生素D对2型糖尿病患者肾功能指标的影响，未来需要大规模、随访周期足够的随机对照研究。

基金项目

四川省医学科研课题计划（项目编号：S21108）。

利益冲突

本研究无任何利益冲突。

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APA Style

Qiuju, L., Qin, Y., Hui, L. (2025). Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Science Discovery, 13(6), 166-169. https://doi.org/10.11648/j.sd.20251306.20

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ACS Style

Qiuju, L.; Qin, Y.; Hui, L. Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Sci. Discov. 2025, 13(6), 166-169. doi: 10.11648/j.sd.20251306.20

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AMA Style

Qiuju L, Qin Y, Hui L. Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Sci Discov. 2025;13(6):166-169. doi: 10.11648/j.sd.20251306.20

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@article{10.11648/j.sd.20251306.20,
  author = {Lyu Qiuju and Yang Qin and Li Hui},
  title = {Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes
},
  journal = {Science Discovery},
  volume = {13},
  number = {6},
  pages = {166-169},
  doi = {10.11648/j.sd.20251306.20},
  url = {https://doi.org/10.11648/j.sd.20251306.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sd.20251306.20},
  abstract = {Objective: To investigate the effects of normalizing vitamin D levels (≥20 ng/ml) on renal function indicators in patients with type 2 diabetes. Methods: Sixty-six patients with type 2 diabetes were enrolled. After vitamin D supplementation, vitamin D levels, urinary microalbumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were measured. Based on post-supplementation vitamin D levels, patients were divided into normal vitamin D level group (≥20 ng/ml) and vitamin D deficiency group (<20 ng/ml). Differences in UACR and eGFR between the two groups were compared. Results: The eGFR in the normal vitamin D level group was significantly higher than that in the vitamin D deficiency group, while the UACR in the normal vitamin D level group was significantly lower than that in the vitamin D deficiency group (P < 0.05). Conclusions: Normalization of vitamin D levels (≥20 ng/mL) in patients with type 2 diabetes may be associated with improved renal function indicators.},
 year = {2025}
}

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TY  - JOUR
T1  - Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes

AU  - Lyu Qiuju
AU  - Yang Qin
AU  - Li Hui
Y1  - 2025/12/29
PY  - 2025
N1  - https://doi.org/10.11648/j.sd.20251306.20
DO  - 10.11648/j.sd.20251306.20
T2  - Science Discovery
JF  - Science Discovery
JO  - Science Discovery
SP  - 166
EP  - 169
PB  - Science Publishing Group
SN  - 2331-0650
UR  - https://doi.org/10.11648/j.sd.20251306.20
AB  - Objective: To investigate the effects of normalizing vitamin D levels (≥20 ng/ml) on renal function indicators in patients with type 2 diabetes. Methods: Sixty-six patients with type 2 diabetes were enrolled. After vitamin D supplementation, vitamin D levels, urinary microalbumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were measured. Based on post-supplementation vitamin D levels, patients were divided into normal vitamin D level group (≥20 ng/ml) and vitamin D deficiency group (<20 ng/ml). Differences in UACR and eGFR between the two groups were compared. Results: The eGFR in the normal vitamin D level group was significantly higher than that in the vitamin D deficiency group, while the UACR in the normal vitamin D level group was significantly lower than that in the vitamin D deficiency group (P < 0.05). Conclusions: Normalization of vitamin D levels (≥20 ng/mL) in patients with type 2 diabetes may be associated with improved renal function indicators.
VL  - 13
IS  - 6
ER  -

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Author Information

Lyu Qiuju

Department of Endocrinology, Leshan People's Hospital, Leshan, China

Contact Email
Yang Qin

Department of Endocrinology, Leshan People's Hospital, Leshan, China
Li Hui

Department of Endocrinology, Leshan People's Hospital, Leshan, China

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Table 1

表1 维生素D水平正常组与维生素D水平缺乏组基线资料比较。
Table 2

表2 维生素D水平正常组与维生素D水平缺乏组肾小球滤过率与尿微量白蛋白/肌酐比值比较。

Plain Text BibTeX RIS

APA Style

Qiuju, L., Qin, Y., Hui, L. (2025). Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Science Discovery, 13(6), 166-169. https://doi.org/10.11648/j.sd.20251306.20

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ACS Style

Qiuju, L.; Qin, Y.; Hui, L. Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Sci. Discov. 2025, 13(6), 166-169. doi: 10.11648/j.sd.20251306.20

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AMA Style

Qiuju L, Qin Y, Hui L. Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes. Sci Discov. 2025;13(6):166-169. doi: 10.11648/j.sd.20251306.20

Copy | Download

@article{10.11648/j.sd.20251306.20,
  author = {Lyu Qiuju and Yang Qin and Li Hui},
  title = {Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes
},
  journal = {Science Discovery},
  volume = {13},
  number = {6},
  pages = {166-169},
  doi = {10.11648/j.sd.20251306.20},
  url = {https://doi.org/10.11648/j.sd.20251306.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sd.20251306.20},
  abstract = {Objective: To investigate the effects of normalizing vitamin D levels (≥20 ng/ml) on renal function indicators in patients with type 2 diabetes. Methods: Sixty-six patients with type 2 diabetes were enrolled. After vitamin D supplementation, vitamin D levels, urinary microalbumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were measured. Based on post-supplementation vitamin D levels, patients were divided into normal vitamin D level group (≥20 ng/ml) and vitamin D deficiency group (<20 ng/ml). Differences in UACR and eGFR between the two groups were compared. Results: The eGFR in the normal vitamin D level group was significantly higher than that in the vitamin D deficiency group, while the UACR in the normal vitamin D level group was significantly lower than that in the vitamin D deficiency group (P < 0.05). Conclusions: Normalization of vitamin D levels (≥20 ng/mL) in patients with type 2 diabetes may be associated with improved renal function indicators.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Effects of Normalizing Vitamin D Levels on Glomerular Filtration Rate and Urinary Microalbumin-to-Creatinine Ratio in Patients with Type 2 Diabetes

AU  - Lyu Qiuju
AU  - Yang Qin
AU  - Li Hui
Y1  - 2025/12/29
PY  - 2025
N1  - https://doi.org/10.11648/j.sd.20251306.20
DO  - 10.11648/j.sd.20251306.20
T2  - Science Discovery
JF  - Science Discovery
JO  - Science Discovery
SP  - 166
EP  - 169
PB  - Science Publishing Group
SN  - 2331-0650
UR  - https://doi.org/10.11648/j.sd.20251306.20
AB  - Objective: To investigate the effects of normalizing vitamin D levels (≥20 ng/ml) on renal function indicators in patients with type 2 diabetes. Methods: Sixty-six patients with type 2 diabetes were enrolled. After vitamin D supplementation, vitamin D levels, urinary microalbumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were measured. Based on post-supplementation vitamin D levels, patients were divided into normal vitamin D level group (≥20 ng/ml) and vitamin D deficiency group (<20 ng/ml). Differences in UACR and eGFR between the two groups were compared. Results: The eGFR in the normal vitamin D level group was significantly higher than that in the vitamin D deficiency group, while the UACR in the normal vitamin D level group was significantly lower than that in the vitamin D deficiency group (P < 0.05). Conclusions: Normalization of vitamin D levels (≥20 ng/mL) in patients with type 2 diabetes may be associated with improved renal function indicators.
VL  - 13
IS  - 6
ER  -

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