| Objective:There was a high prevalence of Vitamin D insufficiency in Chinese population,and there is a lot of evidence showed a strong association between Vitamin D insufficiency with increased risk with Coronary Heart Disease(CHD).Lipoprotein-associated phospholipase A2(Lp-PLA2)is a new inflammatory maker associated with increased risk of cardiovascular disease.The aim of this study was to evaluate the relationship of25-hydroxyvitamin D[25(OH)D] and Lp-PLA2 in T2 DM with CHD.Methods:The fasting serum 25(OH)D values of 127 Type 2 Diabetes Mellitus Patients(T2DM)were detected by enzyme-linked immunosorbent assay,and the Lp-PLA2 values were detected by double-antibody sandwich enzyme-linked immunosorbent assay,and calcium(Ca),phosphorus(P),glycated hemoglobin(Hb A1c),fasting plasma glucose(FPG),blood lipids and other clinical data were detected.All patients’ age,sex,duration of diabetes,history of dyslipidemia and CHD,usage of statins,smoking status,blood pressure and history of hypertension were recorded.Results:(1)In this study,we enrolled 127 T2 DM patients,who were divided into groups,including 64 simple T2 DM patients and 63 simple T2 DM patients with CHD.Comparing the difference of calcium,phosphorus,25(OH)D,Lp-PLA2 and other indexes between the two groups,it was found that the average level of 25(OH)D in the T2 DM group and T2 DM with CHD group was(34.5±9.0)ng/ml and(30.1±6.9)ng/ml,respectively.The level of 25(OH)D was significantly lower in T2 DM subjects with CHD than those without CHD(P=0.003).On the contrary,the average level of Lp-PLA2 between the two groups were(111.6±41.5)ng/ml and(133.8±58.9)ng/ml,respectively,and the level of Lp-PLA2 was significantly higher in T2 DM subjects with CHD than those without CHD(P=0.025).The usage of Statins rates between the two groups were 15.6% and 79.4%,respectively,and the usage of Statins rates was significantly higher in T2 DM subjects with CHD than those without CHD(P=0.000).(2)Linear regression analysis found that there was a significant negative correlation between 25(OH)D values and Lp-PLA2 values in all the patients(r=-0.505,P=0.000),and this negative association persisted in Diabetes Mellitus patients with different age,genders,history of CHD,duration of diabetes,Hb A1 c,blood pressure and 25(OH)D insufficiency group.(3)According to the 25(OH)D levels,127 T2 DM patients were divided into 25(OH)D sufficiency group(72 cases)and 25(OH)D insufficiency group(55 cases),and each clinical index between the two groups was analyzed and compared,it was found that the incidence of CHD in the 25(OH)D sufficiency group and 25(OH)D insufficiency group was 37.5% and 65.5%,respectively,and the incidence of CHD was significantly increased in the 25(OH)D insufficiency group compared to the 25(OH)D sufficiency group(P=0.002).The incidence of Hypertension between the two groups were 51.4%and 70.9%,respectively,and the incidence of Hypertension was significantly increased in the 25(OH)D insufficiency group compared to the 25(OH)D sufficiency group(P=0.026).The usage of Statins rates between the two groups were 16.7% and 87.3%,respectively,and the usage of Statins rates was significantly increased in the 25(OH)D insufficiency group compared to the 25(OH)D sufficiency group(P=0.000).The average level of Lp-PLA2 between the two groups were(102.7±41.7)ng/ml and(144.3±50.7)ng/ml,respectively,and the Lp-PLA2 level was significantly increased in the 25(OH)D insufficiency group compared to the 25(OH)D sufficiency group.(4)Logistic regression analysis showed that the 25(OH)D levels insufficiency was associated with approximately 3-fold higher risk of CHD after adjustment for Lp-PLA2,calcium,phosphorus,age,gender,blood lipids and blood pressure(OR = 3.022,P =0.027).Conclusion:1.The 25(OH)D and Lp-PLA2 levels were significant differences in T2 DM patients with CHD and those without CHD.T2 DM patients with CHD showed lower 25(OH)D level and higher Lp-PLA2 level.2.There was a negative association between 25(OH)D and Lp-PLA2 in all T2 DM patients and among age,genders,history of CHD,duration of diabetes,Hb A1 c,blood pressure and 25(OH)D insufficiency group.3.The prevalence of CHD and hypertension,usage of Statins rates and Lp-PLA2 level in the 25(OH)D insufficiency group was higher than that in 25(OH)D sufficiency group.4.25(OH)D insufficiency could increase the prevalence of CHD in diabetes and vitamin D supplementation might be favorable to protect CHD in this population. |
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