Correlation Between Vitamin D, Alkaline Phosphatase, and Lipid Profile in Type 2 Diabetes

Abstract

Background: Vitamin D is essential for immune system control, glucose metabolism, and musculoskeletal development. Conflicting findings have implicated vitamin D in dyslipidemia, and its deficiency has been associated with several clinical diseases.

Objective: This research sought to explore the connection between vitamin D level, alkaline phosphatase, and lipid profile in individuals with type 2 diabetes in contrast to those without diabetes.

Methods: The study was conducted as a case-control study in Mosul City/Iraq, from October 2024 to January 2025. Involved a total of 160 participants within the age range of 35 to 60 years old. The participants were divided into two categories: one group consisted of type 2 diabetics (referred to as cases, including 80 individuals), while the other group consisted of individuals (referred to as controls consisting of 80 individuals. The subjects' lipid profiles, glycemic control (hemoglobin A1c, fasting plasma glucose), alkaline phosphatase activity, and vitamin D levels were examined.

Results: The diabetes mellitus group (cases) showed significantly lower vitamin D (6.86 ± 2.3 ng/mL vs. 32.3 ± 12.14 ng/mL) and HDL-C levels (26.66± 9.85 mg/dL vs. 48.56± 9.66 mg/dL) and higher alkaline phosphatase activity(151.91± 22.47U/L vs. 61.18± 12.69 U/L), total cholesterol (213.43± 30.47 mg/dL vs.155.52± 13.7 mg/dL), LDL(137.2±, 31.06mg/dL, vs.81.85± 16.46mg/dL), VLDL (59.57±10.85mg/dL vs. 25.1±5.34mg/dL). Triglycerides (247.86± 54.27 mg/dL vs. 125.53± 26.73 mg/dL), and atherogenic index (10.24± 3.32 vs.5.33 ± 2.37) compared to the control. A positive relation was found between alkaline phosphatase and HbA1c (r = 0.860, p < 0.001), alkaline phosphatase and fasting plasma glucose (r = 0.787, p < 0.001) among cases. Lipid profile components, including total cholesterol correlated positively with HbA1c (r = 0.876, p < 0.001) and fasting plasma glucose (r =0.836, p < 0.001), LDL correlated positively with HbA1c (r =,0.742 p < 0.001) and fasting plasma glucose (r = 0.752 p < 0.001) while vitamin D levels were negatively related to total cholesterol(r =-0.609, p < 0.001), LDL(r =-0.497, p < 0.001), VLDL(r =-0.333, p =0.00251), and triglycerides(r =-0.333, p =0.00251).

Conclusion: Diabetic patients showed lower vitamin D levels, remarkably higher lipid profiles and higher alkaline phosphatase compared to the control group. Strong correlations were observed between alkaline phosphatase, HbA1c, and fasting plasma glucose, indicating a potential link to glycemic control. Additionally, vitamin D levels showed negative correlations with total cholesterol, LDL, VLDL, and triglycerides in diabetic patients.