A Study On The Correlation Between Vitamin D,RAAS And Insulin Resistance In Type 2 Diabetes

Objective:This study was conducted to investigate the interaction between vitamin D,the renin-angiotensin-aldosterone system and insulin resistance index and the extent of their effects.The aim is to analyze whether vitamin D can influence insulin resistance levels by affecting the renin-angiotensin-aldosterone system,with the aim of providing a new approach for the prevention and treatment of diabetes.Methods:This study selected 98 patients with type 2 diabetes mellitus aged 18-70 years admitted to a tertiary care hospital affiliated to Shanxi Medical University in the last 6years.We collected gender,age,height,weight,25(OH)VD3,biochemical indexes,fasting insulin,fasting glucose,renin,angiotensin II,and aldosterone of the patients.Based on 25(OH)VD3 levels,we divided these 98 T2 DM patients into four groups:adequate group(≥30ng/m L),deficient group(20-30ng/m L),deficient group(<20ng/m L)and severely deficient group(<10ng/m L).Differences in insulin resistance levels and renin-angiotensin-aldosterone system results were compared between the groups.The degree of insulin resistance was assessed using HOMA-IR(insulin resistance index),where HOMA-IR = FPG(fasting glucose)× FINS(fasting insulin)/ 22.5.Levels of the renin-angiotensin-aldosterone system were assessed by renin,angiotensin II,and aldosterone indicators,and the relationship between them was analyzed.Data analysis was performed using SPSS 20.0 statistical software,and each baseline characteristic was determined by chi-square test,and whether the data conformed to normal distribution characteristics was determined by normality test analysis.For non-normally distributed data,we used the median(interquartile spacing)[M(P25～P75)] to represent the median.One-sample Wilcoxon rank sum test was used for comparison between groups;count data were expressed as percentages(%)and compared using the χ2 test;for analysis of group differences and correlation analysis,we used the Spearman correlation test,with P<0.05 indicating statistically significant differences.Results:A total of 98 cases were screened according to the general data of patients who met the inclusion criteria.The patients were divided into four groups according to their25(OH)VD3 levels: 0 in the adequate group(≥ 30 ng/m L),5 in the deficient group(20-30 ng/m L),53 in the deficient group(<20 ng/m L),and 40 in the severely deficient group(<10 ng/ml).The chi-square test showed no significant differences between these three data groups for each baseline characteristic.In the correlation analysis,we explored the relationship between renin,angiotensin II,aldosterone,25-hydroxyvitamin D,disease duration,and insulin resistance index using the Spearman correlation test.The results showed that there were statistically significant differences between 25-hydroxyvitamin D and insulin resistance index and renin-angiotensin-aldosterone system levels.25-hydroxyvitamin D showed significant negative correlation(p<0.05)and a significant positive correlation with renin(r=0.397,p<0.05).There was a significant positive correlation between disease duration and insulin resistance index(r=0.911,p<0.05).In the subgroup variability analysis,there were significant differences in renin,angiotensin II,aldosterone and insulin resistance indices among the 25-hydroxyvitamin D level subgroups(p<0.05).As 25-hydroxyvitamin D levels decreased,the degree of insulin resistance increased,while renin,angiotensin II and aldosterone levels increased.In the normality test,BMI,systolic blood pressure,diastolic blood pressure,renin,angiotensin II,aldosterone,25-hydroxyvitamin D,and insulin resistance index did not conform to the normal distribution characteristics.The above 10 indices were analyzed using the one-sample Wilcoxon rank sum test,and the p-values were significantly less than 0.05,with statistically significant differences.Conclusion:There is a relationship between low 25-hydroxyvitamin D levels and the insulin resistance index and the renin-angiotensin-aldosterone system.This implies that low25-hydroxyvitamin D levels may increase the index of insulin resistance and increase the activity of the renin-angiotensin-aldosterone system in diabetic patients.25-hydroxyvitamin D may influence the development and progression of diabetes and its associated complications by regulating the metabolism and utilization of the renin-angiotensin-aldosterone system.Therefore,25-hydroxyvitamin D and the renin-angiotensin-aldosterone system may be potential targets for the treatment of diabetes mellitus.