| OBJECTIVE: To investigate the relationship between serum 25-hydroxyvitamin D concentration and urinary albumin/creatinine ratio and the clinical significance of combined detection in diabetic nephropathy.METHODS: Retrospective analysis of clinical data of 816 patients with type 2diabetes(T2DM)admitted to the Department of Endocrinology,Provincial Hospital of Anhui Medical University from January 2017 to December 2018,including gender,age,duration of diabetes,weight,height,and admission Systolic blood pressure,diastolic blood pressure,smoking history,and fasting morning venous blood test serum 25-vitamin D concentration(25-OHVD),glycosylated hemoglobin,blood lipids and other biochemical indicators and morning urine test urinary albumin /creatinine ratio(UACR).According to the difference of UACR values,it was divided into normal proteinuria group(UACR<30ug/mg Cr),micro-proteinuria group(30ug/mg Cr≤UACR<300ug/mg Cr)and large amount of proteinuria group(UACR≥300ug/mg Cr).According to the serum 25-hydroxyvitamin D concentration,it was divided into normal group(25-OHVD≥20ng/m L),insufficient group(12 ng/m L≤25-OHVD<20 ng/m L),and lacked group(25-OHVD<12 ng)./m L).Each group was compared and analyzed using statistical methods.RESULTS:1.A total of 816 patients with type 2 diabetes mellitus were included in the study,including 494 patients with normal proteinuria,213 patients with microalbuminuria and 109 patients with large proteinuria.The abnormal rate of UACR(≥30ug/mg Cr) was 39.5%.The proteinuria group accounted for 26.1%,and the large proteinuria group accounted for 13.4%;(1)The levels of SBP,Cr,UA and BUN increased with the increase of UACR value,and the levels of e GFR and 25-hydroxyvitamin D decreased with the increase of UACR value.The differences between the groups were statistically significant.(P<0.05);there was no significant difference between the groups(P>0.05)for DBP,HDL,LDL,smoking history and other comparisons.(2)Compared with the normal proteinuria group,the differences in gender,age,duration of disease,BMI and ABI abnormalities were statistically significant(P<0.05).There was no significant difference in Hb A1 C,TC and TG.>0.05).(3)Compared with the normal proteinuria group,the abnormalities of age,course of disease,BMI,Hb A1 C,TC and ABI in the large proteinuria group were statistically significant(P<0.05).There was no significant difference in gender and TG(P<0.05).(4)Compared with the microalbuminuria group,the differences of gender,TC and TG in the large amount of proteinuria were statistically significant(P<0.05).There was no significant difference in the abnormalities of age,disease duration,BMI,Hb A1 C and ABI.>0.05).2.Correlation analysis of UACR anomalies shows:(1)UACR was positively correlated with disease course,SBP,DBP,Hb A1 c,TC,LDL,BUN,Cr,UA,ABI(P<0.01),and positively correlated with age and BMI(P<0.05).(2)UACR was significantly negatively correlated with e GFR and 25-hydroxyvitamin D levels(P<0.01).(3)There was no correlation with gender,TG,HDL,smoking history and other indicators(P>0.05);3.In this study,816 patients with type 2 diabetes mellitus had a normal serum concentration of 25-hydroxyvitamin D in 222 patients,336 patients in the inadequate group,and 258 patients in the lack group.The abnormal rate of serum25-hydroxyvitamin D was 72.8%.41.2%,the lack of group accounted for 31.6%.(1)The proportion of sex females and UACR increased with the decrease of25-hydroxyvitamin D concentration in the three groups.The difference between the groups was statistically significant(P<0.05),but for the disease course,DBP,Hb A1 C,TC,There were no statistical differences between the groups(P>0.05).(2)Compared with the normal group,the difference of SBP and HDL in the insufficient group was statistically significant(P<0.05),but there was no significant difference in age,BMI,e GFR,BUN,Cr,ABI and smoking history(P>0.05)..(3)Compared with the normal group,the differences in age,BMI,SBP,e GFR,Cr,ABI,and smoking history were statistically significant(P<0.05).There was no significant difference in HDL and BUN(P>0.05).(4)Compared with the deficiency group,the differences in age,BMI,e GFR,HDL,BUN,Cr,ABI,and smoking history were statistically significant(P<0.05),and there was no significant difference in SBP(P>0.05).4.Correlation analysis between 25-hydroxyvitamin D concentration and renal function indexes(e GFR,Cr,BUN,UACR): serum 25-hydroxyvitamin D concentration was positively correlated with e GFR(P<0.01),and was associated with blood Cr and UACR.There was a significant negative correlation(P<0.01),and there was no significant correlation with blood BUN(P>0.05).5.Logistic regression analysis: elevated duration of diabetes,BMI,SBP,Hb A1 c,TC,Cr,UA and decreased concentrations of DBP,LDL,and 25-hydroxyvitamin D may be independent risk factors for diabetic nephropathy.(P < 0.05;OR values ??were1.040,1.073,1.043,1.121,1.366,1.017,1.002,0.972,0.655,0.957).CONCLUSION:1.There is a significant correlation between UACR value and 25-hydroxyvitamin D concentration.The decrease of 25-hydroxyvitamin D concentration and the increase of UACR value are synchronous in the early and middle stages of diabetic nephropathy.UACR combined with 25-hydroxyvitamin D concentration detection 2Early diagnosis of type 2 diabetic nephropathy and assessment of the severity of renal disease have certain clinical value;2.The occurrence and development of type 2 diabetic nephropathy may be related to the course of diabetes,BMI,blood pressure,blood lipids,25-hydroxyvitamin D concentration,etc.,based on the control of blood pressure,blood sugar,blood lipids and other indicators,through early screening of serum 25-hydroxy Vitamin D concentration and timely supplementation of vitamin D may have certain clinical significance in delaying the development of diabetic nephropathy.3.In women with type 2 diabetes,the deficiency of 25-hydroxyvitamin D is more serious,and it is necessary to pay attention to screening and timely replenishment during the diagnosis and treatment of diseases. |
PDF Full Text Request