| Objective To investigate the the correlation between 1,25-dihydroxy-vitamin D3 and the inflammation in the patients with diabetic nephropathy.Methods Thirty patients with type 2 diabetes mellitus with normal renal function in our hospitals from January 2015 to September 2016 were selected as group A(Albumin-to-Creatinine Ratio(ACR)<30mg/g and Glomerular-Filtration-Rate(GFR)≥90 ml/min/1.73m^2).Another 90 patients with diabetic nephropathy were randomly divided into 3 groups according to Albumin-to-Creatinine-Ratio(ACR)and Glomerular-Filtration-Rate(GFR)early diabetic nephropathy group with ACR 30~299mg/g and GFR≥90 ml/min/1.73m^2(group B,n=30),clinical diabetic nephropathy group with ACR>300mg/g and GFR≥60ml/min/1.73m^2(group C,n=30),renal failure group with GFR<60ml/min/1.73m^2 and GFR≥15ml/min/1.73m^2(group D,n=30).Another 30 healthy people were selected as group E.The group C were randomly divided into the treatment group(C2,n=20)receiving therapy of calcitriol soft gelatin capsules(0.25 μg qd)and control group(C1,n=10)receiving routine therapy for 8 weeks.Also,the group D were randomly divided into the treatment group(D2,n=20)receiving therapy of calcitriol soft gelatin capsules(0.25 μg qd)and control group(D1,n=10)receiving routine therapy for 8 weeks.All patients were observed for 8 weeks to compare the changes of 1,25-dihydroxy-vitamin D3,serum Ca,P,Cr,CRP,IL-6,IL-1β,TNF-α and 24 hour urine micro albumin(24h UMA),Albumin-to-Creatinine Ratio(ACR)before and after therapy.The levels of serum 1,25-dihydroxy-vitamin D3,Ca,P,Cr,CRP,IL-6,IL-1β,TNF-α,Albumin-to-Creatinine Ratio(ACR)were all detected in treatment group and control group.Results(1)There were no significant differences of age,weight,sex ratio among the 5 groups(P>0.05).The values of FPG,2h PG and HbA1 c were similar among A,B,C,D groups(P>0.05).(2)Compared with group A,the levels of serum 1,25-dihydroxy-vitamin D3 were significantly decreased,and the levels of serum TNF-α,IL-6,IL-1β,ACR were all significantly increased in group B,C,D(P<0.05).Compared with group B,the levels of serum 1,25-dihydroxy-vitamin D3 were significantly decreased,and the levels of serum TNF-α,IL-6,IL-1β,ACR were all significantly increased in group C(P<0.05).Compared with group C,the levels of serum 1,25-dihydroxy-vitamin D3 were significantly decreased,and the levels of serum TNF-α,IL-6,IL-1β,CRP were all significantly increased in group D(P<0.05).levels of serum P were greatly higher in group D when compared to group A,while levels serum Ca were significantly lower.(3)The levels of serum 1,25-dihydroxy-vitamin D3 increased significantly and serum Cr,CRP,IL-6,IL-1β,TNF-α,ACR greatly decreased after 8 weeks of calcitriol therapy in the treament group(C2,n=20).However,the levels of serum 1,25-dihydroxy-vitamin D3,Ca,P,Serum creatinine,CRP,IL-6,IL-1β,TNF-α,ACR show no significant differences in the control group(C1,n=10)(P>0.05).(4)The levels of serum 1,25-dihydroxy-vitamin D3 and Ca both increased significantly and serum Cr,P,CRP,ESR,IL-6,IL-1β,TNF-α,ACR greatly decreased after 8 weeks of calcitriol therapy in the treament group(D2,n=20).However,the levels of serum Ca,P,Serum creatinine,CRP,IL-6,IL-1β,TNF-α,1,25-dihydroxy-vitamin D3,ACR,show no significant differences in the control group(D1,n=10)(P>0.05).(5)Among C,D groups,the levels of CRP,ESR,IL-6,IL-1β,TNF-α,ACR were significantly lower in treatment group than those in the control group after treatment,however,the levels of 1,25-dihydroxy-vitamin D3 were greatly higher in treantment group.(5)The level of 1,25-dihydroxy-vitamin D3 in patients was negatively correlated with the levels of TNF-α,IL-6,IL-1β,CRP,ESR(r=-0.7242,-0.6291,-0.7185,-0.6124,-0.6971,P<0.05).Conclusion The level of serum 1,25-dihydroxy-vitamin D3 were decreased in diabetic nephropathy patients,which was related to the inflammation.Serum 1,25-dihydroxy-vitamin D3 may play an important role in the inhibition of diabetic nephropathy progression by its anti-inflammatory effect. |
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