Correlation of vitamin D and diabetic peripheral neuropathic pain: A cross-sectional study

ObjectiveAlthough ample evidence exists on the association between vitamin D deficiency and diabetic peripheral neuropathy, only a few studies have distinguished between painful and painless forms. This study compared serum vitamin D levels in type 2 diabetes patients with and without painful neuropathy.MethodsWe enrolled 46 patients with diabetes (painless diabetic peripheral neuropathy, n = 15; painful diabetic peripheral neuropathy, n = 16; non-neuropathy, n = 15) and 15 healthy controls. Assessments included neurologic exams, Michigan Neuropathy Screening Instrument, electrophysiology, skin biopsy, and serum 25(OH)D measurements.ResultsThe level of 25(OH)D was significantly lower in painful diabetic peripheral neuropathy (23.00 ± 7.97) patients versus controls (44.48 ± 6.77), non- diabetic peripheral neuropathy (31.22 ± 6.14) patients, and painless diabetic peripheral neuropathy patients (36.91 ± 6.22; P < 0.01). Multivariate analysis identified vitamin D as an independent factor for painful diabetic peripheral neuropathy (P = 0.007). The 25(OH)D level was significantly correlated with sural amplitude (r = 0.377), peroneal amplitude (r = 0.434), vibration threshold (r = -0.393), and Michigan Neuropathy Screening Instrument score (r = -0.456).ConclusionsSerum 25(OH)D levels were significantly lower in painful diabetic peripheral neuropathy, suggesting the potential role of vitamin D deficiency in the pathogenesis of diabetic peripheral neuropathy.