Reversal Of Kidney Disease Vitamin D₃ Supplementation In Patients With Early Type 2 Diabetic Kidney Disease And Its Relationship With VEGF

Objective:To study the patients with Type 2 diabetes mellitus（T2DM）whose serum 25-（OH）VD（25-hydroxyvitamin D）level is lower than the normal value,and the patients with early diabetic nephropathy（EDKD）were supplemented with D₃（vitamin D₃,Vit D₃）24 for 24weeks.To observe changes in glucose metabolism,renal function,the glomerular filtration rate（e GFR）,vascular endothelial growth factor（VEGF）and other relevant indicators,And analyze its influence on renal function,so as to provide clinical basis for the treatment of early diabetic kidney disease.Methods:From October 2020 to June 2021,76 patients with type 2 diabetes were diagnosed in the Department of Endocrinology of XXX Hospital.They were complicated with early diabetic kidney disease and 25-OH-VD<30ng/ml.Record the patient’s name,sex,age,course of disease,medical history,body mass index（BMI）,Detection of 25-OH-VD（25-hydroxy vitamin D,25-hydroxyvitamin D）level,urinary albumin creatinine ration,UACR),glycosylated hemoglobin（Hb A1c）,fasting blood glucose（FPG）,serum creatinine（Scr）,blood uric acid（UA）,urea nitrogen（BUN）,VEGF,triglyceride（TG）,total cholesterol（TC）,high-density lipoprotein cholesterol（HDL-C）and low-density lipoprotein cholesterol（LDL-C）,serum calcium（Ca）,serum phosphorus（P）,serum magnesium（Mg）,.They were randomly divided into vitamin D3 treatment group of 37 cases and control group of 39 cases.Both the treatment group and the control group took vitamin D₃by guiding diet and lifestyle on the basis of routine hypoglycemic and antihypertensive treatment.On this basis,the treatment group took vitamin D₃1000IU orally every day,Telephone follow-up was conducted once every two weeks for the first four weeks,and then once every four weeks.After 24 weeks the two groups were tested again to compare the changes in the indicators before and after treatment with Vit D₃and to analyse statistically the effect onearly diabetic kidney disease.SPSS25.0 and Graph Pad 8.0 were used to analyse.Results:1.After 24 weeks,the serum 25-OH-VD level in the treatment group was significantly higher than the baseline level（P<0.05）.No significant change in serum25-OH-VD levels in the control group compared to baseline（P>0.05）.The level of serum25-OH-VD in treatment group was higher than that in control group（P<0.05）.2.After 24 weeks,the levels of serum FBG and Hb A1c in treatment group and control group were lower than those at baseline（P<0.05）.However,there was no significant difference between FBG and Hb A1c between the treatment group and the control group（P>0.05）.3.After 24 weeks,the levels of serum VEGF and UACR in the treatment group decreased significantly（P<0.05）.Serum VEGF and UACR levels in the control group had no significant changes（P>0.05）.Serum VEGF and UACR levels in the treatment group were lower than those in the control group（P<0.05）.4.At baseline,there was no significant difference in general conditions and indexes between the two groups（P>0.05）.After 24 weeks of treatment,DBP,SBP,eGFR,Scr,UA,BUN,TG,TC,HDL-C,LDL-C,Ca,P and Mg in the treatment group and the control group had no obvious changes（P>0.05）.5.The level of 25-OH-VD is negatively correlated with VEGF and UACR,while VEGF is positively correlated with UACR.Other test items are irrelevant.Conclusion:1.On the basis of sunshine and taking vitamin D from diet,taking vitamin D₃1000 IU daily for 24 weeks can obviously increase the level of 25-OH-VD.However,only sunshine and diet intervention did not significantly improve the 25-OH-VD level of Baotou population.2.Vitamin D₃ supplementation can reduce the levels of UACR and VEGF in patients with EDKD,but has no effect on renal function and eGFR.3.Vitamin D is negatively correlated with VEGF and UACR,VEGF is positively correlated with UACR.4.Close telephone follow-up can benefit the blood sugar of patients with type 2 diabetes,but no additional benefit of vitamin D₃ on sugar metabolism is found.