Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan sebuah penyakti dengan prevalensi yang tinggi dan beban kesehatan yang besar. Hingga saat ini, penyebab SOPK masih belum jelas. Penelitian sebelumnya mengenai ekspresi reseptor vitamin D (VDR) pada pasien SOPK menunjukkan hasil yang menjanjikan namun belum terbukti secara jelas. Oleh sebab itu, diduga bahwa polimorfisme VDR berperan penting dalam kejadian dan beratnya gejala SOPK. Metode: Penelitian potong lintang dilakukan pada pasien SOPK dan wanita usia reproduktif non-SOPK sebagai kontrol pada November 2019 hingga 2021. Pasien hamil, menyusui, memiliki riwayat gangguan hormon adrenal, tiroid, maupun prolaktin, atau mengonsumsi obat hormonal dalam 6 bulan terakhir dieksklusi dari penelitian. Subjek penelitian direkrut secara konsekutif. Ekspresi VDR dinilai dari ekspresi mRNA VDR yang dinilai dengan pemeriksaan PCR. Polimorfisme VDR dinilai pada tiga titik regio penyandi gen, yakni rs7975232, rs11574113, dan rs11574114. Hasil: Sebanyak 80 pasien SOPK dan 80 pasien kontrol diikutsertakan dalam penelitian. genotip A/A pada regio rs7975232 dan genotip C/C pada regio rs11574113 lebih banyak didapatkan pada pasien dengan SOPK. Di sisi lain, genotip A/C pada regio rs7975232 dan genotip C/G pada regio rs11574114 lebih banyak didapatkan pada kelompok kontrol (p < 0,05). Tidak terdapat perbedaan ekspresi VDR pada pasien dengan polimorfisme yang berbeda (p > 0,05). Kesimpulan: Didapatkan polimorfisme gen penyandi VDR yang berbeda antara pasien SOPK dan non-SOPK. Tidak didapatkan perbedaan ekspresi VDR yang bermakna antara pasien SOPK dan non-SOPK. ......Background: Polycystic ovary syndrome (SOPK) is a disease with a high prevalence and a large health burden. Until now, the cause of SOPK is still unclear. Previous studies on vitamin D receptor (VDR) expression in PCOS patients have shown promising results but have not been clearly proven. Therefore, it is suspected that the VDR polymorphism plays an important role in the incidence and severity of PCOS symptoms. Methods: A cross-sectional study was conducted on PCOS patients and non-SOPK women of reproductive age as controls from November 2019 to 2021. Patients who were pregnant, breastfeeding, had a history of adrenal, thyroid, or prolactin hormone disorders, or had taken hormonal drugs in the last 6 months were excluded from the study. study. Research subjects were recruited consecutively. VDR expression was assessed from VDR mRNA expression assessed by PCR examination. VDR polymorphism was assessed at three points in the gene encoding region, namely rs7975232, rs11574113, and rs11574114. Results: A total of 80 PCOS patients and 80 control patients were included in the study. A/A genotypes in the rs7975232 region and C/C genotypes in the rs11574113 region were more common in patients with PCOS. On the other hand, the A/C genotype in the rs7975232 region and the C/G genotype in the rs11574114 region were more common in the control group (p < 0.05). There was no difference in VDR expression in patients with different polymorphisms (p > 0.05). Conclusions: Different polymorphisms of the VDR coding gene were found between PCOS and non-SOPK patients. There was no significant difference in VDR expression between PCOS and non-SOPK patients.

Abstrak :
Polimorfisme gen VDR -1056 T/C berperan dalam metabolisme tulang dan mempengaruhi fungsi imun yang memicu terjadinya resorpsi tulang pada periodontitis. Tujuan: Untuk mengetahui perbedaan pola distribusi polimorfisme gen VDR -1056 T/C pada penyakit periodontitis dengan kelompok kontrol. Metode: Polimorfisme gen -1056 VDR dianalisis menggunakan metode PCR-RFLP dengan enzim restriksi Taq I. Hasil: Terdapat polimorfisme gen VDR -1056 T/C pada kasus dengan frekuensi genotip TC 44.5 dibandingkan dengan kelompok kontrol 55.6 . Sedangkan untuk frekuensi alel C pada kasus 44.4, dan kelompok kontrol 55.6. Kesimpulan: Distribusi polimorfisme gen VDR -1056 T/C pada penyakit periodontitis sebesar 44.5 genotip TC, 50.5 genotip TT, dan 0 genotip CC. Namun tidak terdapat perbedaan yang bermakna antara distribusi polimorfisme gen VDR -1056 T/C pada penyakit periodontitis dan kelompok kontrol p=1,0. ...... VDR 1056 T C gene polymorphism is involved in bone metabolism and affect the immune function that leads to bone resorption in periodontitis. Objective: To know the difference of distribution pattern of the gene VDR 1056 T C polymorphism in periodontitis disease with control group. Methods: The VDR 1056 T C gene polymorphism was analyzed by the PCR RFLP method with Taq I restriction enzyme digestion. Results: There are VDR 1056 T C gene polymorphism in the case with TC genotype frequency 44.55 compared with the control group 55.6 . As for the frequency of C alleles in the case 44.4 , and control group 55.6. Conclusion: The distribution of VDR 1056 T C gene polymorphism in periodontitis disease was 44.5 TC genotype, 50.5 TT genotype, and 0 CC genotype. But there was no significant difference between the distribution of VDR T C gene polymorphism in periodontitis and control group p 1.0.

Abstrak :
Latar Belakang: Vitamin D Reseptor (VDR) merupakan protein yang mengatur fungsi vitamin D biologis. Vitamin D berperan penting dalam pembentukan gigi, terutama ketika kalsifikasi email dan dentin, serta berperan dalam menjaga keseimbangan fosfat dan ion kalsium, yang merupakan faktor penting dalam perlindungan gigi. VDR. aktivitas protein dipengaruhi oleh gen VDR. Karies merupakan penyakit multifaktorial, dimana faktor Genetika juga berperan dalam mempengaruhi tingkat kerentanan seseorang terhadap karies. Adanya polimorfisme pada gen VDR diduga mempengaruhi tingkat kerentanan pejamu terhadap karies melalui perubahan yang terjadi pada metabolisme kalsium. Tujuan: Untuk mendeteksi keberadaan polimorfisme gen VDR TaqI (rs731236) di penderita karies di Indonesia. Metode: 100 bahan biologis yang disimpan dalam bentuk DNA diambil dari sampel darah, terdiri dari 50 sampel karies dan 50 sampel kontrol dianalisis menggunakan teknik PCR-RFLP. Analisis RFLP dilakukan dengan menggunakan enzim restriksi TaqI. Analisis statistik dilakukan dengan menggunakan uji eksak Fisher dan uji Koreksi kontinuitas. Hasil: Pada penelitian ini ditemukan kelompok karies bahwa tidak ada sampel yang memiliki genotipe CC, 4 sampel memiliki genotipe CT, dan 46 sampel memiliki genotipe TT. Selain itu, terdapat 4 alel C dan 96 alel T. Genotipe dan alel polimorfik lebih banyak ditemukan pada kelompok karies (100% dan ). 96%) dibandingkan dengan kelompok kontrol (88% dan 84%). Kesimpulan: Polimorfisme gen VDR TaqI (rs731236) ditemukan pada pasien karies. Ada perbedaan yang signifikan dalam distribusi genotipe dan alel dari VDR TaqI. polimorfisme gen (rs731236) antara pasien karies dan kelompok kontrol (p <0,05). ......Background: Vitamin D Receptor (VDR) is a protein that regulates the biological function of vitamin D. Vitamin D plays an important role in tooth formation, especially when calcification of enamel and dentin, and plays a role in maintaining the balance of phosphate and calcium ions, which are important factors in tooth protection. VDR. protein activity is influenced by the VDR gene. Caries is a multifactorial disease, where genetic factors also play a role in influencing a person's level of vulnerability to caries. The presence of polymorphisms in the VDR gene is thought to affect the level of host susceptibility to caries through changes that occur in calcium metabolism. Objective: To detect the presence of the VDR TaqI gene polymorphism (rs731236) in caries sufferers in Indonesia. Methods: 100 biological materials stored in the form of DNA were taken from blood samples, consisting of 50 caries samples and 50 control samples were analyzed using PCR-RFLP technique. RFLP analysis was performed using the restriction enzyme TaqI. Statistical analysis was performed using Fisher's exact test and continuity correction test. Results: In this study, the caries group found that none of the samples had the CC genotype, 4 samples had the CT genotype, and 46 samples had the TT genotype. In addition, there were 4 C alleles and 96 T alleles. Genotypes and polymorphic alleles were more commonly found in the caries group (100% and ). 96%) compared to the control group (88% and 84%). Conclusion: VDR TaqI gene polymorphism (rs731236) was found in caries patients. There were significant differences in the genotype and allele distribution of the VDR TaqI. gene polymorphism (rs731236) between caries patients and control group (p < 0.05).

Abstrak :
Kejadian stunting pada masa anak-anak masih menjadi masalah kesehatan masyarakat, khususnya di negara berkembang seperti Indonesia. Berdasarkan data Riset Kesehatan Dasar (Riskesdas, 2013) prevalensi stunting pada anak usia 5-12 di Indonesia sebesar 30,7%. Faktor nutrisi telah diketahui sebagai penyebab kejadian stunting. Namun, beberapa penelitian menemukan adanya kontribusi genetik terhadap penyerapan kalsium yang akan mempengaruhi pertumbuhan, yaitu gen vitamin D receptor (VDR). Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara faktor genetik dan nutrisi terhadap height-for-age Z-core (HAZ) pada anak sekolah dasar di kabupaten Malang, Jawa Timur. Penelitian ini menggunakan desain studi potong lintang dan dilakukan pada tahun 2018. Penelitian ini melibatkan 142 anak sekolah dasar berusia 8-10 tahun. Pengukuran tinggi badan dilakukan untuk menghitung HAZ pada anak-anak. Asupan energi, protein, kalsium dan vitamin D diperoleh dengan 24-hour dietary recall selama 4 hari. Dua SNP yang terletak pada daerah promoter dari gen VDR dipilih (rs11568820 dan rs4516035); dan distribusi genotipnya dianalisis menggunakan Real Time PCR. Faktor lain seperti karakteristik sosiodemografi, riwayat penyakit menular dan skor paparan sinar matahari diperoleh dengan kuesioner terstruktur, dan kuesioner paparan sinar matahari. Hasil penelitian menunjukkan bahwa prevalensi stunting sebesar 21,8%. Asupan makan sebagian besar kurang terpenuhi, khususnya asupan kalsium dan vitamin D. Distribusi genotip rs11568820 adalah TT (19%), CT (43,7%) dan CC (37,3%). Sedangkan distribusi genotip rs4516035 adalah TT (90,8%) dan CT (9,2%). Analisis bivariat menunjukkan adanya korelasi yang signifikan antara asupan energi dan protein terhadap HAZ (p=0,030 dan p=0,016), tetapi tidak pada asupan kalsium dan vitamin D. Selain itu, tidak ditemukan hubungan yang signifikan antara polimorfisme kedua SNP gen VDR dengan HAZ (p>0,05). Setelah disesuaikan dengan faktor-faktor lainnya, asupan protein secara signifikan berkolerasi dengan HAZ (β=0,034, 95% CI 0,016 – 0,053, p<0,001, adj. R2=0,077). Efek dari aktivitas gen VDR kemungkinan tidak terlihat karena rendahnya asupan vitamin D yang diperlukan untuk meningkatkan penyerapan kalsium yang kemudian akan mempengaruhi HAZ. ......Childhood stunting remains as a major public health problem, especially in developing countries such as Indonesia. According to Indonesia Basic Health Research (Riskesdas, 2013) the prevalence of stunting among children aged 5-12 years old in Indonesia was 30.7%. Nutrition factors has been known as a predominant factors associated with stunting. However, some studies discovered a genetic contribution in calcium absorption that will affect growth of the children, known as vitamin D receptor (VDR) gene. The aim of this present study was to assess the association between genetic and nutritional factors related to height-forage Z-score (HAZ) of elementary school children in Malang District, East Java. The study design was a cross-sectional study which began on 2018. In this study, 142 children aged 8-10 years old were included. Height measurement was obtained to calculate HAZ of the children. Dietary intake consist of energy, protein, calcium and vitamin D intake were obtained using 4 days 24-hour dietary recall. Two SNPs located in the promoter region of VDR gene were selected (rs11568820 and rs4516035); its genotype distribution were analyzed using Real Time PCR system. Other factors such as sociodemographic characteristics, history of infectious diseases and sun exposure score were assessed using structured questionnaire and sun exposure questionnaire. The result showed that the prevalence of stunting was 21.8%. Dietary intake were mostly inadequate, especially for calcium and vitamin D intake. Genotype distribution of rs11568820 was TT (19%), CT (43.7%), and CC (37.3). While for rs4516035 the distribution was TT (90.8%) and CT (9.2%). Bivariate analysis showed a significant correlation between energy and protein intake with HAZ of the children (p=0.030 and p=0.016, respectively), but not with calcium and vitamin D intakes. There were no significant association between VDR gene polymorphism for both SNPs and HAZ of the children (p>0.05). Adjusted by other factors, protein intake was significantly correlated with HAZ (β=0.034, 95% CI 0.016 – 0.053, p<0.001, adj. R2=0.077). The effect of VDR gene promoter activity might not revealed due to very low vitamin D intake to stimulates intestinal calcium absorption which in turn affect HAZ.

Abstrak :
Ketimpangan antara kadar vitamin D25(OH) rendah dan keadaan resistensi insulin pada penderita SOPK dengan anovulasi kronik menarik untuk digali lebih jauh. Anovulasi kronik pada SOPK diyakini disebabkan terhentinya pertumbuhan folikel di ovarium. Pada resistensi insulin, vitamin D diperkirakan berperan di sel sasaran dengan menambah substrat reseptor insulin. Perlu diungkap pengaruh vitamin D terhadap pertumbuhan folikel ovarium dengan mengukur kadar AMH, kemudian diperbandingkan antara penderita S-OPK-RI dan SOPK-nir-RI berdasarkan perubahan kadar reseptor insulin darah. Penelitian ini bertujuan menentukan pengaruh pemberian vitamin D3 terhadap pertum-buhan folikel ovarium dan penurunan kadar AMH melalui jalur reseptor insulin dan resep-tor vitamin D darah. Penelitian dua tahap dilakukan dari 14 Agustus 2018 hingga 25 Fe-bruari 2019 terhadap 35 subjek SOPK-RI dan 35 subjek SOPK-nir-RI di Poliklinik Infer-tilitas dan Endokrinologi Departemen Obstetri dan Ginekologi RSPAD Gatot Soebroto (RSGS), Jakarta. Tahap pertama adalah iris-silang antara SOPK-RI dan nir-RI untuk mem-bandingkan kadar vitamin D25(OH), AMH, reseptor insulin dan reseptor vitamin D darah. Tahap kedua adalah uji kuasi-eksprimental untuk mengetahui pengaruh pemberian vitamin D3 12.000 IU per minggu selama tiga bulan terhadap pertumbuhan folikel dengan peman-tauan USG-transvaginal atau transrektal sebulan sekali dan kadar AMH pada SOPK-RI dan nir-RI. Kadar glukosa puasa, insulin puasa, vitamin D25(OH), AMH diukur dari darah. Reseptor vitamin D darah dan reseptor insulin darah diperiksa dari sel mononukleus darah tepi (SMDT). Hasil penelitian memperlihatkan bahwa: (1) prapemberian vitamin D3 nilai yang berbeda bermakna antara SOPK-RI dan SOPK-nir-RI adalah kadar glukosa puasa (84 vs. 78 mg/dL; p = 0,016), insulin puasa (20,3 vs. 7,49 μIU/mL; p < 0,001) (2) pascapemberian vitamin D3 yang berbeda bermakna adalah kadar glukosa puasa (82 vs. 79 mg/dL; p = 0,049), insulin puasa (23,19 vs. 10,54; p < 0,001), reseptor insulin lebih tinggi pada SOPK-RI diban-dingkan SOPK-nir-RI (18,80 vs. 14,78 ng/mL; p = 0,020), reseptor vitamin D pada SOPK-nir-RI menurun bermakna (63,29%); (3) pascapemberian vitamin D3 ditemukan: (a) delta perubahan kadar vitamin D25(OH) pasca (8,38 ng/mL (63,4%) [SD 4,06] SOPK-RI vs. 12,31 ng/mL (10,29%) SOPK-nir-RI, p < 0,001); (b) delta perubahan penurunan kadar AMH pasca SOPK RI 10,29 vs. SOPK-nir-RI 14,61%; p = 0,492); (c) delta peningkatan diameter folikel antara dua kelompok SPOK meningkat pada bulan pertama (14,3% vs. 50%), kedua (33,3% vs. 66,7%), dan ketiga (50% vs. 66,7%), tetapi yang berbeda bermak-na (p < 0,05) hanya pada bulan pertama, yaitu lebih besar pada SOPK-nir-RI. Disimpulkan bahwa vitamin D3 menurunkan kadar AMH pada SOPK-RI dan SOPK-nir-RI, serta meningkatkan pertumbuhan folikel pada kededua kelompok SOPK, pada bulan pertama perubahan diameter folikel lebih besar pada SOPK nir-RI. Prapemberian vitamin D3 tidak ditemukan perbedaan kadar reseptor insulin dan reseptor vitamin D pada kededua kelompok SOPK, sedangkan pascapemberian vitamin D3 terdapat penurunan kadar reseptor vitamin D pada SOPK-nir-RI. ......Discrepancy between low-level vitamin 25(OH)D and insulin resistance in PCOS patients with chronic anovulation required to be further explored. Chronic anovulation in PCOS is believed to be caused by the follicular arrest in the ovary. In insulin resistance the vitamin D is thought to play a role in target cell by adding the insulin receptor substrate. It is nec-essary to elucidate the effect of vitamin D on the ovarian folliculogenesis by measuring the AMH levels, which are then compared between patients with IR-PCOS and non-IR-PCOS based on the changes in blood insulin receptor levels. The aim of this study is to determine the effect of vitamin D3 administration on ovarian follicular growth and reduction of AMH through insulin receptor and blood vitamin D re-ceptor pathways. The two stages study was carried out from 14th August 2018 to 25th February 2019 on 35 IR-PCOS and 35 non-IR-PCOS subjects at the Infertility and Endo-crinology Out-patient Clinic, Department of Obstetrics and Gynecology, Gatot Soebroto Central Army Hospital (RSGS), Jakarta. The first stage was a cross-section study between IR-PCOS and non-IR-PCOS to compare levels of vitamin 25(OH)D, AMH, blood insulin receptors and vitamin D receptors; the second is a quasi-experimental test to determine the effect of 12,000 IU vitamin D3 administration per week for 3 months on follicular growth with transvaginal or transrectal ultrasound monthly and AMH levels on IR-PCOS-and non-IR-PCOS. Fasting glucose, fasting insulin, vitamin D25(OH), AMH levels are measured from the blood. Blood vitamin D receptor and insulin receptor were measured from the peripheral blood mononuclear cells (PBMC). The results of the study demonstrated that: (1) before administration of vitamin D3, there were differences in fasting glucose (84 vs. 78 mg/dL; p = 0.016) and fasting insulin (20.3 vs. 7.49 μIU/mL; p < 0.001) between the two groups; (2) after vitamin D3 administration, significant differences were found between the two groups for the levels of fasting glucose (82 vs. 79 mg / dL; p = 0.049), fasting insulin (23.19 vs. 10.54; p < 0.001); higher insulin receptors was found in IR-PCOS compared to non-IR-PCOS (18.80 vs. 14.78 ng / mL; p = 0.020), the vitamin D receptors in non-IR-PCOS decreased significantly (63.29%); (3) vitamin 25(OH)D levels before vitamin D3 administration were not significantly different in the two groups (13.84 vs. 10.97 ng/mL; p = 0.327), while after vitamin D3 administration the levels increased significantly (8.38 ng/mL (63.4%) [SD 4.06] in IR-PCOS vs. 12.31 ng/mL (10.29%) in non-IR-PCOS, p < 0.001); (4) AMH levels decreased in the both groups after vitamin D3 admin-istration but the ratio of the decrease was not significantly different (10.29 vs. 14.61%; p = 0.492); (5) follicular diameter between the two groups increased in the first month (14.3% vs. 50%), the second month (33.3% vs. 66.7%), and the third month (50% vs. 66.7% ) after vitamin D3 administration, but the significant difference (< 0.05) was demonstrated only in the first month, which was greater in non-IR-PCOS than that in the IR-PCOS. It is concluded that vitamin D3 decreases AMH levels in both IR-PCOS and non-IR-PCOS. It increases folliculogenesis in both PCOS groups; in the first month, the changes in follic-ular diameter are greater in non-IR-PCOS. Before vitamin D3 administration, there is no difference in the levels of insulin receptors and vitamin D receptors between the two groups, whereas after vitamin D3 administration there is a decrease in the levels of vitamin D re-ceptors in non-IR-PCOS. Keywords: AMH, IR-PCOS, non-IR-PCOS, PBMC, vitamin D receptor, insulin receptor, vitamin D25(OH).

Abstrak :
Sindrom ovarium polikistik (SOPK) merupakan kelainan yang ditandai oleh hiperandrogenemia, ovarium disfungsi, dan polikistik ovarium yang dapat menyebabkan infertilitas. Meski etiologi pastinya belum diketahui, obesitas merupakan ciri khas umum pada SOPK di mana sekitar 40--80% wanita SOPK meningkatkan obesitas. Kej Vitamin D Receptor (VDR) terkait dengan SOPK melalui peradangan kronik tingkat rendah. Tujuan penelitian adalah mempelajari ekspresi mRNA gen VDR pada wanita obesitas dan non-obesitas dengan SOPK dan normal. Sampel darah dari 120 subjek dibagi menjadi empat kelompok, yaitu 30 normal non-obesitas (BMI <25), 30 normal non-obesitas (BMI> 25), SOPK non-obesitas (BMI <35), dan 30 SOPK obesitas (BMI> 25) kemudian dianalisis menggunakan kuantitatif Real-Time PCR (qPCR) dengan metode kurva standar. Hasil penelitian menunjukkan bukti mRNA gen VDR pada subjek obesitas dan SOPK secara signifikan lebih tinggi dibandingkan kedua kontrol. Hasil ini menunjukkan bahwa gen VDR terkait dengan obesitas dan SOPK.

---

Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenemia, ovarian dysfunction, and polycystic ovaries that can cause infertility. Although the exact etiology is unknown, obesity is a hallmark common in PCOS where about 40-80% of PCOS increase obesity. Vitamin D Receptor (VDR) is associated with PCOS through low-level chronic inflammation. The aim of the study was to study the expression of VDR gene mRNA on obese and non-obese women with PCOS and normal. Blood samples from 120 subjects were divided into four groups, namely 30 normal non-obese (BMI <25), 30 normal non-obese (BMI> 25), non-obese PCOS (BMI <35), and 30 obese PCOS (BMI> 25) was then analyzed using quantitative Real-Time PCR (qPCR) with the standard curve method. The results showed evidence of VDR gene mRNA in obese and PCOS subjects was significantly higher than the two controls. These results indicate that the VDR gene is associated with obesity and PCOS.

Abstrak :
Background: Diabetic kidney disease (DKD), as a common cause of end-stage renal disease (ESRD), is a chronic complication of diabetes mellitus (DM). It has been established that vitamin D deficiency is one of DKD risk factors, which may be related to vitamin D receptor (VDR) polymorphisms. This study aimed to analyze the association between VDR polymorphisms and DKD in Indonesian population, also risk factors that influence it. Methods: a cross-sectional study was conducted in Type 2 DM patients who visited internal medicine outpatient clinic at Dr. Cipto Mangunkusumo Hospital, Jakarta, from November 2014 until March 2015. Data collection includes characteristics of subjects and laboratory examination, including BsmI polymorphisms in the vitamin D receptor gene. Patients with acute and severe disease were excluded from the study. Bivariate and multivariate analyses were done. Results: of 93 DM subjects, 42 (45.2%) subjects were without DKD and 51 (54.8%) subjects had DKD. Most of the subjects had the Bb genotype (89.2%), with no subject having the BB genotype. The proportions of the B and b alleles were 44.6% and 55.4%, respectively. There is no association between BsmI polymorphisms in the vitamin D receptor gene and DKD (OR = 1.243; CI 95% 0.334-4.621; p value = 0.751). Conclusion: the profile of BsmI polymorphisms in the vitamin D receptor gene in the Indonesian population were genotypes Bb (89.2%) and bb (10.8%). There was no association between BsmI polymorphisms in the vitamin D receptor gene and DKD. Duration of DM more than five years influenced the association between those variables.