Serum 25-hydroxyvitamin D Concentration And BaPWV Among Type 2 Diabetes

Objective:The purpose of this study is to evaluate the correlation bet ween serum 25-hydroxyvitamin D [25(OH)D] and ba PWV in patients with Type 2 diabetes.In order to provide the early diagnosis and treatment of macrovascular complications in patients with type 2 diabetes mellitus.Methods:This study was a retrospective cohort study,where 189 adult patient with type 2 diabetes diagnosed in the first affiliated Hospital of Guangxi Medical University from July 2017 to July 2019 were collected.The general data of the patients included in this study were collected and venous blood samples were taken from all patients the second day after admission: sex,age,height,weight,smoking and drinking history,admission heart rate,admission systolic blood pressure,admission diastolic blood pressure,blood uric acid,fasting and postprandial blood glucose,glycosylated hemoglobin,blood lipids,25(OH)D.At the same time,the results of brachial and ankle pulse wave velocity(ba PWV)were also collected.According to the level of 25(OH)D,all patients were equally divided into four groups(Q1: 9.14-33.00nmol/L;Q2:33.10 to 44.30 nmol/L;Q3:44.40 to 52.40 nmol/L;Q4:52.50 to 89.30 nmol/L).Different indexes and the ba PWV of defferent serum 25(OH)D levels in type 2diabetes would be compared among the four groups,and to explore the independent influencing factors of type 2 diabetes arteriosclerosis.In this study,SPSS 22.0 software was used for statistical analysis.Continuous variables conforming to normal distribution were expressed as mean±standard deviation(SD),nonnormal distribution data were expressed as percentage,and analysis of variance was used for comparison between groups.Single-factor analysis was used to compare the correlation between all variables and ba PWV,and Pearson correlation analysis was used to investigate the correlation between 25(OH)D level and ba PWV.The influential factors were determined by adjusting the confounding factors screened by multi-factor logstic regression analysis,and P< 0.05 was considered statistically significant.Results:Among the four groups of type 2 diabetes patients with different25(OH)D,the mean ba PWV levels of the four groups were(1856.12±583.16)nmol/L,(1699.99±343.13)nmol/L,(1619.85±305.43)nmol/L,(1596.4±205.95)nmol/L,respectively,with significant differences(P<0.05)(trend P=0.005).Univariate analysis showed that age,systolic blood pressure,diastolic blood pressure,diabetic nephropathy,diabetic retinopathy,25(OH)D were correlated with ba PWV in patients with type 2 diabetes(P<0.05).After adjusting for the screened confounding factors by multi-factor logstic regression,the results showed that the duration of diabetes,age,and systolic blood pressure were independently correlated with ba PWV,and the OR values were(1.008;1.095;1.038;P<0.05).25(OH)ba PWV in group Q4 was significantly lower than that in group Q1,showing a negative correlation(Q4 vs.Q1: OR=0.313;95% CI0.098 to 0.995;Trend P<0.05),there was no significant difference between ba PWV of group Q2 and group Q3 and that of group Q1(P > 0.05).Pearson correlation analysis showed that there was a negative correlation between25(OH)D and ba PWV(correlation coefficient r=-0.2457),that is,with the increase of 25(OH)D,ba PWV showed a decreasing trend.Conclusions:1.The proportion of 25(OH)D deficiency in T2 DM patients was as high as59.8%,and only 2.1% of T2 DM patients had adequ-ate vitamin D,indicating that vitamin D deficiency was common in T2 DM patients.2.Diabetes course,age and systolic blood pressure were independent risk factors for systemic atherosclerosis in T2 DM patients.The longer the diabetes course,the older the diabetes,and the higher the systolic blood pressure,the greater the risk of atherosclerosis in T2 DM patients.3.The serum 25(OH)D level was closely related to the occurrence of T2 DM atherosclerosis,and the negative correlation between 25 hydroxyvitamin D and ba PWV in T2 DM patients was found.With the increase of 25 hydroxyvitamin D,ba PWV showed a decreasing trend.It is suggested that serum 25(OH)D is a protective factor for arteriosclerosis in type 2 diabetes mellitus.