Correlation Analysis Of Serum Vitamin D And Trace Element Zinc Levels With TyG Index In The Elderly With Type 2 Diabetes Mellitus

Objective:Insulin resistance(IR)is the core link that causes a variety of metabolic diseases,including type 2 diabetes mellitus(T2DM).IR is more common and complex in the elderly with T2DM.Several studies showed that the triglyceride glucose index(TyG index)could be used as a metabolic indicator to evaluate IR.The purpose of this study was to investigate the relationship between serum vitamin D and trace element zinc levels and TyG index in elderly patients with T2DM.Serum vitamin D and trace element levels in elderly patients with T2DM were detected,demographic data and clinical laboratory indicators were collected,and the differences of laboratory indicators in elderly patients with T2DM were analyzed stratified according to gender,glycosylated hemoglobin level and vitamin D level,and then related factors affecting TyG index were analyzed to establish a multiple linear regression model.To provide a theoretical basis for accurate therapy in elderly patients with T2DM.Methods:In this study,201 elderly patients with T2DM admitted to a Department of Geriatrics,the First Bethune Hospital of Jilin University from July 2021 to November 2022 were collected as research objects,and basic information was collected by self-made Questionnaire for Elderly inpatients with Basic Information.Fasting serum trace elements zinc,copper(Zn,Cu),peripheral blood fasting blood glucose(FPG),glycated hemoglobin(HbA1c),25-hydroxyvitamin D[25(OH)D],serum calcium ion(Ca2+),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol were determined(HDL-C),serum creatinine(Scr),serum uric acid(UA),serum albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),cholinesterase(CHE)and other related biochemical indexes.According to HBA1c7.0%,they were divided into good blood glucose control group and poor blood glucose control group.According to serum 25(OH)D level,they were divided into vitamin D non-deficiency group and vitamin D deficiency group with 20 ng/mL.Demographic data and laboratory indicators were compared,respectively.The correlation between vitamin D,trace element Zn and TyG index in elderly patients with type 2 diabetes mellitus was analyzed,as well as the possible factors affecting vitamin D and TyG index in elderly patients with T2DM.Then,variables related to TyG index were screened,and heat maps and linear correlation maps were drawn by GraphPad Prism9.Multiple independent variables were selected according to correlation results and clinical experience,and TyG index was used as dependent variable to conduct multiple linear regression analysis.Results:1.Serum 25(OH)D in male patients was higher than that in female patients,while serum trace elements Cu,TC and HDL-C were lower than that in female patients,the difference was statistically significant(P<0.01).Serum ALB in male patients was higher than that in female patients,and the difference was statistically significant(P<0.05).2.Taking HbA1c as the basis of grouping,we found that serum 25(OH)D level in well-controlled group(HbAlc≤7.0%)was higher than that in poorly controlled group(HbA1c>7.0%),and the difference was statistically significant(P<0.05).Compared with the poorly controlled group,the serum trace elements Cu,AST,ALT and TyG indexes in the well controlled group were lower,and the difference was statistically significant(P<0.05).3.Serum 25(OH)D was used as the basis of grouping.Compared with the vitamin D non-deficiency group[25(OH)D≥20 ng/mL],the index of HbAlc,trace elements Cu and TyG in the vitamin D deficiency group[25(OH)D<20 ng/mL]were higher,and the difference was statistically significant(P<0.05).Trace elements Zn,ALB and eGFR in vitamin D deficiency group were lower than those in vitamin D non-deficiency group,and the difference was also statistically significant(P<0.01).4.Bivariate correlation analysis showed that serum 25(OH)D and HbAlc,trace elements Zn and Cu,AST,ALB,eGFR,HDL-C and TyG index were correlated(P<0.05).HbAlc,serum 25(OH)D,Ca2+,AST,CHE,ALB,TC and HDL-C were correlated with TyG index(P<0.05).5.The results of multiple linear regression model showed that 25(OH)D was an influencing factor for TyG index in total patients and female patients,but not in male patients.There was no significant correlation between Zn and TyG index in total patients,male patients and female patients.Conclusions:1.In the elderly with T2DM,serum vitamin D level in women is lower than that in men.2.In the elderly with T2DM,serum vitamin D level was negatively correlated with HbAlc and TyG index,and positively correlated with trace elements Zn and ALB.3.The results of multiple linear regression model showed that vitamin D deficiency was associated with high TyG level in elderly women with T2DM,but was not significant in elderly men with T2DM.There was no significant correlation between Zn level and TyG index in elderly patients with T2DM.4.According to the results of this study,it is suggested that elderly patients with T2DM can be appropriately supplemented with vitamin D to help alleviate IR,especially in women.