Study On The Relationship Among Serum Apn,25 (OH) D With Lower Limb Vascular Disease In Type 2 Diabetes Mellitus And Type 2 Diabetes Mellitus

Objective: To explore the possible relationship between APN,25(OH)D and the severity of T2 DM lower extremity angiopathy and provide a new view of diagnosis and treatment for T2 DM lower limb angiopathy by observing the serum adiponectin(adiponectin,APN),25 hydroxy-vitamin D(25-hydroxy vitamin D,25(OH)D)and related metabolic indexes in normal population,type 2 diabetes mellitus(T2DM)patients and patients with T2 DM complicated with lower limb angiopathy.Methods:A total of 100 T2 DM patients were selected as observation group and divided into two groups according to ankle-brachial index(ABI): 1)T2DM complicated with lower limb angiopathy(PAD group,50 cases.2)Simple T2 DM group(NPAD group,50 cases).Healthy population were selected as normal control group(NC group,50 cases).All subjects were determined sex,age,course,height,body weight,calculated body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),ABI,triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C),hemoglobin(HbA1c),fasting plasma glucose(FPG),two-hour postprandial plasma glucose(2hPG),APN,25(OH)D,fasting insulin(FINS),and calculated homeostasis model of assessment for insulin resistance index(HOMA-IR).Statistical analysis was carried out using SPSS18.0 software,and the measurement data were expressed in``X±s,T test was used to compare groups,Pearson test was used to analyze the correlation between variables,and Multiple linear regression analysis was used to analyze the relationship between ABI and indexes.The difference was statistically significant(P<0.05).Results: Compared with NC group,the levels of APN and 25(OH)D in T2 DM gr oup were significantly lower,while the levels of TC,TG,LDL-C were significantly higher(P<0.05),but there was no significant difference in HDL-C level(P>0.05).T2 DM group was divided into two groups according to ABI: simple T2 DM group(NPAD group)and T2 DM complicated with lower limb angiopathy group(PAD gro up),compared with NPAD group,the levels of APN and 25(OH)D in PAD group de creased significantly while the levels of TC,TG,LDL-C increased significantly(P<0.05),but there was no significant difference in the level of HDL-C(P>0.05).Pearson correlation analysis showed that there was a negative correlation between serum A PN level and BMI,FPG,HbA1 c,2hPG,TG,TC,LDL-C(P<0.05)),and there was a positi ve correlation between serum APN level and ABI,25(OH)D(P<0.05),there was no significant correlation between serum APN level and age,course,FINS,HOMA-IR,HDL-C,SBP,DBP(P>0.05).ABI was regarded as dependent variables,and age,sex,course,BMI,FPG,2hPG,HbA1 c,FINS,HOMA-IR,TC,TG,HDL-C,LDL-C,SBP,DBP,25(OH)D and APN were regarded as independent variables,multivariate linear regressi on analysis was performed,the results showed that 25(OH)D and APN were positiv ely correlated with ABI(P<0.05).Conclusion: The levels of serum APN,25(OH)D are correlated with the severity of T2 DM lower limb angiopathy.Early monitoring of serum APN,25(OH)D level may play a role in predicting the severity of T2 DM lower extremity angiopathy.