The Study Of Correlation Between Vitamin D Deficiency And Type2Diabetic Patients With Peripheral Neuropathy

ObjectiveThe incidence of type2diabetes continues to rise, which has become a seriouschronic noncommunicable diseases endangering health of people all over the world.Diabetic peripheral neuropathy is a common complication of diabetes which can causediabetic patients’ disability and reduce the quality of life, but its pathogenesis has not beenfully elucidated. Early animal experiments confirmed that the vitamin D receptor (VDR)existed in the pancreas, leading attention to type2diabetes and vitamin D. There wereepidemiological evidence which showed that vitamin D deficiency could increase the riskof type2diabetes mellitus. Vitamin D receptor (VDR) is widely distributed in the retina,kidneys, nerves and other organs, so vitamin D deficiency will aggravate the progress ofdiabetes complications. At present the study of the relationship between type2diabetesvascular lesions and vitamin D is relatively mature, but the study about vitamin D anddiabetic peripheral neuropathy is relatively small. In order to further clarify therelationship between vitamin D and type2diabetes peripheral neuropathy, this researchthrough the measurement and comparison of serum vitamin D levels and other relevantclinical indicators among type2diabetes patients with peripheral neuropathy, type2diabetes patients without peripheral neuropathy and normal control group to discuss thecorrelation between Vitamin D deficiency and type2diabetic peripheral neuropathy.Methods1Study objects1.1type2diabetes groupSelect146cases of patients with type2diabetes from October2011to October2012in endocrinology department of Jinan Central Hospital (According to1999WHO diabetesdiagnosis and classification standards, and with reference to the latest diabetes diagnosisguidelines of the2010ADA), by electromyogram examination, according to nerve conduction velocity (NCV) normal or not to group:76cases of type2diabetes withperipheral neuropathy group,70cases of type2diabetes without peripheral neuropathygroup. The age, gender and duration of the two groups were matched. All patients weregiven oral medications, diet control and (or) insulin therapy.1.2normal control group50cases of normal people at the same time from the medical center in jin JinanCentral Hospital with no family history of diabetes, and the age and gender matched withthe type2diabetes group.2research methods2.1electromyography examinationDetermination of left or right motor nerve conduction velocity (MNCV) and sensorynerve conduction velocity (SNCV) respectively (choose according to clinical symptoms),normal value reverence with Jinan Central Hospital electromyography room standard (setup in different age group), less than x-2S diagnosed with peripheral neuropathy.2.2the determination of clinical biochemical indexes and serum vitamin DAll subjects were accepted venous blood3ml after fasting for12-14hours at8o’clock next morning, determination of the clinical biochemical indexes includingglycosylated hemoglobin (HbA1c), aspertate aminotransferase (AST), alanineaminotransferase (ALT), alkaline phosphatase (ALP), total cholesterol (TCH), triglyceride(TG), high-density lipoprotein (HDL), low density lipoprotein (LDL), apolipoprotein A(Apo-A), apolipoprotein B (Apo-B), and serum vitamin D (25(OH) D).Results1The various clinical indicators which included age, gender, duration, BMI, AST,ALT, ALP, TCH, TG, HDL, LDL, Apo-A and Apo-B between Type2diabetes withperipheral neuropathy group and Type2diabetes without peripheral neuropathy group. Thedifference of these indicators between the two groups had no statistical significance (P>0.05).2The serum vitamin D levels of Type2diabetes with peripheral neuropathy group(30.55±8.95nmol/L) were significantly lower than that in group without peripheralneuropathy (58.86±15.79nmol/L)(P<0.01) and normal control group (60.10±6.63nmol/L)(P<0.01); no Statistical difference of serum vitamin D level was found between thediabetic patients without peripheral neuropathy and the healthy controls (P>0.05); theHbA1c levels of Type2diabetes with peripheral neuropathy group were significantlyhigher than that in group without peripheral neuropathy (P <0.01). 3Glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol(ldl-c) was negatively correlated with serum vitamin D level(P <0.05);4Binary logistic regression analysis showed that vitamin D deficiency wassignificantly associated with DPN (OR=1.212, P=0.000).ConclusionsThe serum vitamin D levels of Type2diabetes with peripheral neuropathy group weresignificantly lower than that in group without peripheral neuropathy and normal controlgroup; vitamin D deficiency is an independent risk factor of diabetes peripheral neuropathy,further research is needed to confirm whether vitamin D supplements can prevent or delaythe onset of this lesion.