Relationship Between Vitamin D,PTH And Atherosclerotic Plaque In Early-onset Type 2 Diabetes Mellitus

Objective:In this study,we compared the prevalence of carotid atherosclerotic plaque between early-onset type 2 diabetes mellitus and late-onset type 2 diabetes mellitus.The relationship between serum vitamin D level,PTHand carotid atherosclerosis in patients with type 2 diabetes mellitus was discussed in order to provide a new theoretical direction for early prevention and treatment of cardiovascular and cerebrovascular diseases in patients with type 2 diabetesmellitus.Methods:A total of 633 patients with type 2 diabetes mellitus were collected and divided into early-onset type 2 diabetes mellitus(diagnostic age≤40 years old)and late-onset type 2diabetes mellitus(diagnosis age>40 years old)according to the age of diabetes diagnosis.The differences in vitamin D,PTH,carotid atherosclerotic plaque,and other indicators were compared between the two groups.At the same time,we analyzed the sex,age,BMI,duration of diabetes,vitamin D,PTH,serum calcium,serum phosphorus,alkaline phosphatase UA,blood lipids,Hcy,Hb A1 c,HOMA-IR,carotid atherosclerotic plaque and other indicators among groups under different levels of vitamin D and whether or not it combined with carotid atherosclerotic plaque formation.And we will screen for the protection of carotid atherosclerotic plaque formation and risk factors.Results:1.In this study,a total of 633 patients with type 2 diabetes mellitus were included,including 215 patients with early-onset type 2 diabetes mellitus and 418 patients with late-onset type 2 diabetes mellitus.About 90.70% of the patients with early-onset type 2diabetes mellitus had vitamin D deficiency(the serum vitamin D level was lower than 20ng/ml),and about 89.47% of the patients with late-onset type 2 diabetes mellitus had vitamin D deficiency.Comparativedifferences in vitamin D levels between the two groups were statistically significant(P<0.05).About 44.65% of early-onset type 2diabetes mellitus complicated with carotid atherosclerotic plaque,about 43.78% of late-onset type 2 diabetes mellitus with carotid atherosclerotic plaque.However,comparativedifferences in carotid atherosclerotic plaque formation between the two groups were not statistically significant(P>0.05).2.According to serum vitamin D levels,they were divided into Q1 group: 264 cases of severe vitamin D deficiency group(<10 ng/ml),Q2 group: 305 cases of vitamin D deficiency group(10-20 ng/ml),Q3 group: 64 cases of normal and insufficient vitamin D group(≥20 ng/m1).There was no statistically significant difference in FPG,2h PG,FINS,FC-P,HOMA-IR and Hb A1 c between groups(P>0.05).There was statisticallysignificant difference in PTH,carotid atherosclerotic plaque between groups(P<0.01).After adjusting for age,BMI,duration of diabetes,Hb A1 c,serum vitamin D was positively correlated with HOMA-IR(r=0.090,P<0.05);serum vitamin D was negatively correlated with PTH(r=-0.174,P<0.01)and carotid atherosclerotic plaque(r=-0.179,P<0.01).3.According to whether or not combining with the carotid atherosclerotic plaques,they were divided into 2 groups.There was statisticallysignificant difference in age,course of diabetes,systolic blood pressure,smoking history,history of hypertension,Hcy,Ca,vitamin D and PTH between groups.(P<0.05).And these indexes were used as independent variables,whether or not combining with the carotid atherosclerotic plaque formation as the two categories of dependent variables;Stepwise Logistic regression analysis was carried out.Finally,it was concluded that the age(OR: 1.065,P <0.01),diabetes course(OR:1.124,P<0.01),the smoking(OR: 2.705,P<0.01),Hcy(OR: 1.036,P<0.05),PTH(OR: 1.022,P<0.01)were the risk factors for carotid atherosclerotic plaque formation,and the serum vitamin D(OR:0.926,P < 0.01)was the protective factor of carotid atherosclerotic plaque formation.Conclusion:1.The rate of serum vitamin D deficiency in patients with early-onset type 2diabetes mellitusmay be higher than that in patients with late-onset type 2diabetesmellitus.2.The prevalence of early-onset type 2 diabetes mellitus with carotid atherosclerotic plaque may not be lower than that of late-onset type 2 diabetes mellitus.3.Serum vitamin D is negatively correlatewith PTH.4.Age,course of diabetes,smoking,Hcy,PTH were risk factors for carotid atherosclerotic plaque formation in patients with type 2 diabetes mellitus;Serum vitamin D was the protective factor of carotid atherosclerotic plaque formation in type 2 diabetes mellitus.