[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-436674-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-436674-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","is-it-real-of-lower-incidence-of-vitamin-d-deficiency-in-t2dm-patients-letter-to-the-editor","Is it real of lower incidence of vitamin D deficiency in T2DM patients? - Letter to the Editor","","Letter to the editor discussing findings from a prior article on type 2 diabetes mellitus (T2DM) patients receiving dipeptidyl peptidase-4 inhibitors (DPP-4i). The authors question the extremely low recorded incidences of hypogonadism and vitamin D deficiency in the reported cohort, requesting clear definitions. They note that menopausal timing in Taiwanese women and the high prevalence of vitamin D deficiency in Asia may make the reported rates confusing. The letter emphasizes the importance of long-term safety and quality of life while supporting the original study’s potential osteoporosis-protective relevance.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/is-it-real-of-lower-incidence-of-vitamin-d-deficiency-in-t2dm-patients-letter-to-the-editor/436674/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/is-it-real-of-lower-incidence-of-vitamin-d-deficiency-in-t2dm-patients-letter-to-the-editor/436674.png","ImageObject",300,407,{"name":42,"@type":43},"Quinn Holloway","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does the letter question about the cohort study in T2DM patients?","Question",{"text":63,"@type":64},"It questions the extremely low reported incidences of hypogonadism (0 with n=1) and vitamin D deficiency (0 with n=1), asking for the authors’ definitions used in the cohort.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why are the reported incidences considered confusing?",{"text":68,"@type":64},"The letter argues that menopausal entry age in Taiwanese women is around 50 years and that more than 80% of the cohort is over 50, making hypogonadism incidence seem unusually low. It also states vitamin D deficiency is common in Asia, including Taiwan.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the letter view the value of the original publication?",{"text":72,"@type":64},"Despite the uncertainties, the letter states the questions do not reduce the study’s value and contribution, especially regarding potential anti-diabetic drug repositioning and an osteoporosis-protective relevance for T2DM therapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},436674,1790769887,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30,"preview_page_count":4},2336474466712,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","J Chin MedAssoc  \nLETTER TO THE EDITOR  \nIs it real of lower incidence of vitamin D deficiency in T2DM patients?  \nYiu-Tai Lia, Szu-Ting Yangb,c, Peng-Hui Wangb,c,d,e,*  \naDepartment of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dFemale Cancer Foundation, Taipei, Taiwan, ROC; eDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nDEAR EDITOR,  \nWe read with great interest about the article of Chang et al,1 showing that type 2 diabetes mellitus patients (T2DM) treated with oral anti-diabetic drugs as dipeptidyl peptidase-4 inhibitors (DPP-4i) had a lower risk of the development of all-cause osteoporosis than non-DPP-4i users did.1 We are also happy to learn much from the editorial comment discussing the aforementioned topic.2 We totally agree that the most important and critical issue for the treatment of the diseased patients is the long-term safety, best ratio of benefits to risks and improvement of quality of life (QoL) for the patients, as well as patients’ compliance and adherence for the treatment.2 We congratulate the success of their publication, since T2DM is a complex metabolic disease characterized by the presence of hyperglycemia and insulin resistance, leading to the development of microvascular and macrovascular complications, and exerts a major public-health toll worldwide.3 However, some of their findings may be worthy of further clarification.  \nAs shown by authors, a total of enrolled subjects were 31 695 (6339 with DPP-4i and 25 356 with non-DPP-4i) with mean age of 66 years; however, the incidence of hypogonadism was 0 (n = 1). Additionally, the incidence of vitamin D deficiency was also 0 (n = 1) in their cohort study. Could the authors kindly provide the definition of hypogonadism or vitamin D deficiency in their cohort study? To our limited knowledge, the age of Taiwanese women entering the menopause was about 50 years4 and more than 80% of enrolled cases in their cohort study were over 50 years.1 It is relatively confusing that the incidence of hypogonadism in their cohort study is so low. Although the term to describe the hypogonadism is not similar to menopause, however, menopause is the failure of female gonadal function. Is menopausal status not a reflective of hypogonadism?  \n* Address correspondence. Dr Peng-Hui Wang, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: phwang@vghtpe.gov.tw](ROC. E-mail address: phwang@vghtpe.gov.tw) (P.-H. Wang). Conflicts of interest: Dr Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2022) 85: 958.  \nReceived July 3, 2022; accepted July 5, 2022.  \ndoi: 10. 1097/JCMA.0000000000000776.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nAdditionally, vitamin D deficiency is very common in Asia population, including Taiwan.5-7 We are wondering to know why the incidence of the enrolled subjects in the current cohort study is extremely low (n = 0, and n = 1) . Although we raised the aforementioned questions, the aforementioned uncertainties did not compromise the value of the authors’ excellent work and their contribution to offering the impressive finding and useful information to consider the anti-diabetic drug reposit","cbCaiejvppzQIi95","https://ap.wps.com/l/cbCaiejvppzQIi95","pdf",284033,"English","# Letter to the Editor\n## Questioning cohort definitions and incidences\n## Context on menopause and vitamin D prevalence\n## Support for the original study’s implications\n## Acknowledgments and references","[{\"question\":\"What does the letter question about the cohort study in T2DM patients?\",\"answer\":\"It questions the extremely low reported incidences of hypogonadism (0 with n=1) and vitamin D deficiency (0 with n=1), asking for the authors’ definitions used in the cohort.\"},{\"question\":\"Why are the reported incidences considered confusing?\",\"answer\":\"The letter argues that menopausal entry age in Taiwanese women is around 50 years and that more than 80% of the cohort is over 50, making hypogonadism incidence seem unusually low. It also states vitamin D deficiency is common in Asia, including Taiwan.\"},{\"question\":\"How does the letter view the value of the original publication?\",\"answer\":\"Despite the uncertainties, the letter states the questions do not reduce the study’s value and contribution, especially regarding potential anti-diabetic drug repositioning and an osteoporosis-protective relevance for T2DM therapy.\"}]","Is it real of lower incidence of vitamin D deficiency in T2DM patients? - Letter to the Editor | PDF",1790678716]