The Association Between Vitamin D Receptor Gene Polymorphism And Osteoporosis Patients With Type 2 Diabetes Mellitus Of The Han Nationality In Kunming Region

Parti:The association between vitamin D receptor gene polymorphism and type 2 diabetes mellitus of the Han nationality in Kunming region.Objective:The prevalence of diabetes mellitus, especially type 2 diabetes mellitus (T2DM), is rising alarmingly in the Chinese population. This study was conducted to assess the association between vitamin D receptor (VDR) gene polymorphism and type 2 diabetes mellitus(T2DM) of the Han nationality in Kunming region.Methods:One-hundred-twenty-six Kunming individuals (90 T2DMs and 36 controls) were enrolled in this randomized controlled trial. rs7975232 single nucleotide polymorphism (SNPs) of the VDR was genotyped by using the Polymerase chain reaction of restriction fragment length polymorphism (PCR-RFLP) method. Height, weight, Body mass index (BMI), waist circumference, hip circumference, waist hip rate (WHR)were measured.High density lipoprotein (HDL-C), low density lipoprotein (LDL-C), fasting plasma glucose (FPG), postprandial blood glucose (PBG), total cholesterol (TC), triglyceride (TG), blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA), HbAlc,25-hydroxy-vitamin D3 (250HD3), fructosamine (FA), c-peptide of fasting, postprandial in 30 minutes and 120minutes were examined and compared between two groups.Result:1.There were significant different frequencies of 3 SNPs of VDR-Apal polymorphism between two groups (P<0.001). The C/A genotype was more common in T2DM patients than controls (62.2% vs 38.9%). However, there was no significantly difference between C and A allele in two groups.2. Frequency of C/A genotype of VDR Apal was higher than that in the control group[odds ratio (OR)= 1.36, 95% confidence interval (CI)=0.54-1.71]. Furthermore, T2DM patients was older than that of control group [odds ratio (OR) were 1.09 respectively,95% confidence interval (CI) were 1.03-1.18].25OHD3 in T2DM group was lower than that of control group [odds ratio (OR)=0.84,% confidence interval (CI)=0.73-0.93], suggesting that age and C/A genotype are risk factors of T2DM. Meanwhile 25OHD3 may be a protective factor of T2DM.Conclusion:1. There is a significantly association between C/A genotype of rs7875232 and the prevalence of T2DM of the Han nationality in Kunming region.2. Low level of serum 25OHD3 is significantly associated with T2DM. 95% confidence interval (CI)=0.54-1.71]. Furthermore, T2DM patients was older than that of control group [odds ratio (OR) were 1.09 respectively,95% confidence interval (CI) were 1.03-1.18].25OHD3 in T2DM group was lower than that of control group [odds ratio (OR)=0.84,% confidence interval (CI)=0.73-0.93], suggesting that age and C/A genotype are risk factors of T2DM. Meanwhile 25OHD3 may be a protective factor of T2DM.Conclusion:1. There is a significantly association between C/A genotype of rs7875232 and the prevalence of T2DM of the Han nationality in Kunming region.2. Low level of serum 25OHD3 is significantly associated with T2DM.Part 2:The association between vitamin D receptor gene polymorphism and diabetic osteoporosis of the Han nationality in Kunming region.Objective:Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing osteoporosis. A possible association between vitamin D receptor (VDR) gene polymorphism and diabetic osteoporosis (DP) has been described in some populations. We genotyped the VDR gene polymorphism in a healthy Kunming adult population, a group of patients with T2DM free of DP and in a group of diabetes patients with osteoporosis, to assess the correlations among vitamin D receptor(VDR) gene polymorphism,T2DM and DP of the Han nationality in Kunming region.Methods:One-hundred-twenty-six Kunming individuals (50 T2DMs,40DPs and 36 controls) were enrolled in this study.Apal of the VDRwas genotyped by using Polymerase chain reaction of restriction fragment length polymorphism (PCR-RFLP) methods. Height, weight, Body mass index (BMI), Bone mineral density (BMD), waist circumference, hip circumference, waist hip rate (WHR) were measured. Serum calcium (Ca), serum phosphorus (P), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), fasting plasma glucose (FPG), postprandial blood glucose (PBG), total cholesterol (TC), triglyceride (TG), blood urea nitrogen (BUN), serum creatinine (Cr),uric acid(UA), HbAlc were examined. Serum level of bone gamma-carboxyglutamic-acid-containing proteins (BGP), bone alkaline phosphatase (BALP), calcitonin (CT),25-hydroxy-vitamin D3 (250HD3), parathyroid hormone (PTH), carboxy terminal propeptide of type I procollagen (PICP), tartrate-resistant acid phosphatase (TRAP) were measured by Enzyme-Linked Immusorbent Assay (ELISA).Results:The A/A genotype in DP patients were more common than other two groups (66.7% vs 33.3% vs 0.0%, P=0.005). However, there was no significantly difference between C and A allele in three groups, C allele has a dominant prevalence in all groups. Serum level of Cr, CT in A/A carriers were significantly higher than that of other groups (P<0.05, but BMI,HDL-C and 250HVD were significantly lower than that of other two groups (P<0.05). Age, duration of disease and HbAlc in DP patients were higher than that of DM patients (P< 0.05). The fasting c-peptide of DP patients is lower than that in DM groups (P=0.021). The serum level of BGP in control group was the highest in all groups (P=0.001). The serum level of TRAP in control group was much lower than other two groups (P=0.014). Logistic regression analysis shows that age, HbAlc, A/A genotype in DP patients were more higher than that of other groups [odds ratio (OR) were 1.09,1.18,1.73 respectively,95% confidence interval (CI) were 1.16-1.04,1.36-1.03,3.27-0.92 respectively]. BMI, BGP,250HD3 in DM and control groups are more higher than that of DP group [odds ratio (OR) were 0.80, 0.21,0.25 respectively,95% confidence interval (CI) were 0.96-0.67,0.62-0.07, 0.94-0.06 respectively], suggesting that old age, higher HbAlc, A/A genotype are the risk factors of DP, meanwhile, the appropriate BMI, BGP, higher level of 25OHD3 may be the protective factor of osteoporosis.Conclusion:There is an association between the A/A genotype of VDR and osteoporosis in the type 2 diabetes mellitus of Kunming region.For type 2 diabetes patients, old age, higher HbAlc, A/A genotype are the risk factors of osteoporosis, meanwhile, the appropriate BMI, BGP, higher level of 250HD3 may be the protective factors of osteoporosis.