| ObjectiveWith the increasing incidence of diabetes and diabetic nephropathy year by year,diabetes and diabetic nephropathy have become a global health problem,and the early prevention and treatment of diabetic nephropathy has become particularly important.To observe the Serum levels and deficiency of 25 hydroxyvitamin D3 in patients with type 2 diabetes mellitus and diabetic nephropathy.To explore the correlation between vitamin D and type 2 diabetic nephropathy.MethodsA total of 205 male patients with type 2 diabetes who were admitted to the department of endocrinology of our hospital from January 2018 to May 2019 were selected.Height,weight,age,serum 25-hydroxyvitamin D3(25(OH)D3),urine microalbumin excretion rate(UAER),estimate glomerular filtration rate(eGFR),blood urea nitrogen(BUN),blood creatinine(SCr)and other indicators of all subjects were collected.According to the UAER detection value,the subjects were divided into the non-diabetic nephropathy group(NDN,UAER<20ug/min,n=117)and the diabetic nephropathy group(DN,UAER?20ug/min,n=88).General clinical data and laboratory indicators were compared between the two groups.According to UAER(UAER<20 ug/min in the non-diabetic nephropathy group,20 ug/min?UAER?200 ug/min in the microalbuminuria group,UAER>200ug/min in the macroalbuminuria group)and eGFR(CKD1-5 stage),the incidence of vitamin D deficiency and the level of 25(OH)D3 between the groups were further stratified and compared.Pearson correlation analysis was used to investigate the correlation between serum 25(OH)D3 level and 24h urinary albumin and eGFR.ResultsThe blood level of 25(OH)D3 in the DN group was significantly lower than that in the NDN group(DN50.96±15.15,NDN60.68±16.64,P<0.001).The levels of systolic blood pressure,urea nitrogen,creatinine and 24h urinary albumin were higher than those of the NDN group,and the differences were statistically significant.The incidence of coronary heart disease,hypertension,diabetic peripheral neuropathy,and diabetic retinopathy in the DN group was higher than that in the NDN group,and the difference was statistically significant.The incidence of vitamin D deficiency was successively increased in the non-diabetic nephropathy group,microalbuminuria group and large albuminuria group,and the average 25(OH)D3 level was successively decreased,with statistically significant difference.However,there was no significant difference in the vitamin D deficiency rate among diabetic nephropathy patients with different CKD stages,and there was a significant difference in the overall level of 25(OH)D3 between the groups.Pairwise comparison showed that only significant decrease in the level of 25(OH)D3 occurred at stage 4-5 of CKD.Pearson correlation analysis showed that 25(OH)D3 was negatively correlated with the 24h urine trace albumin quantitative determination(r=-0.361 p<0.001).After excluding the interference of age,disease course,body mass index,blood pressure,and other confounding factors,the level of 25(OH)D3 was still correlated with the 24h urine trace albumin quantitative determination(r=-0.328 p<0.001),but there was no significant correlation between 25(OH)D3 and glomerular filtration rate(p>0.05).ConclusionThere was a correlation between vitamin D deficiency and diabetic nephropathy in patients with type 2 diabetes,and there was a negative correlation between 25 hydroxy-vitamin D3 level and urinary albumin quantification in patients with type 2 diabetes,but no correlation was found between vitamin D level and glomerular filtration rate. |
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