| Objective:To investigate the relationship between serum vitamin D[25(OH)D]levels and skeletal muscle mass in patients with type 2 diabetes mellitus(T2DM).Methods:1172 patients with T2DM(801 males and 371 postmenopausal females)hospitalized in the Department of Endocrinology of the First Hospital of Lanzhou University from 2021.07-2022.09 were included.Bone Mineral Densitometry(BMD)and whole-body skeletal muscle mass were measured by dual-energy X-ray bone densitometry;Skeletal muscle mass index(SMI)and Appendicular skeletal muscle mass index(ASMI)were calculated using the formula,respectively.Men were grouped according to SMI and ASMI quintile levels(S1-S5;A1-A5),and women were grouped according to SMI and ASMI quartile levels(S1-S3;A1-A3);the differences in serum25(OH)D levels and prevalence of vitamin D deficiency were compared among different SMI and ASMI groups.The correlation between serum 25(OH)D levels and SMI and ASMI in T2DM patients of different genders was analyzed by univariate correlation and multiple linear regression analysis.Results:(1)The SMI level of vitamin D deficiency group(14.86±2.98kg/m~2)decreased compared with those in the insufficiency and adequate group(16.63±2.65kg/m~2 and16.63±3.21kg/m~2,all p<0.05).The 25(OH)D levels in the S5 group(19.58±7.37ng/m L)were higher than those in the S1(12.71±6.73ng/m L),S2(14.85±6.52ng/m L),S3(14.75±6.69ng/m L),and S4(16.69±7.52ng/m L)groups in male patients(all p<0.05),and the 25(OH)D level in the group S4 was higher than that in the group S1.The prevalence of vitamin D deficiency in the S5 group(53.5%)was lower than those in the S1,S2 and S3 groups(90.1%,75%and 81.9%,all p<0.05),the prevalence of vitamin D deficiency in the S4 group(67.6%)was lower than those in the S1 and S3groups(all p<0.05),and the prevalence of vitamin D deficiency in the S2 group was lower than that of S1 group(p<0.05);SMI level was significantly and positively correlated with 25(OH)D(r=0.31,p<0.05);multiple linear regression analysis showed that 25(OH)D was independently and positively correlated with SMI level[β=0.172,95%CI(0.034,0.108),p<0.001].(2)The ASMI level(7.64±0.69kg/m~2)in the vitamin D deficiency group decreased compared with those in the insufficiency and adequate group(8.01±0.71kg/m~2 and 7.91±0.65kg/m~2,all p<0.05).The median levels of 25(OH)D in male patients in groups A3,A4,and A5(17.80 ng/m L,17.85 ng/m L,and 19.00 ng/m L)were higher than those in groups A1 and A2(12.80 ng/m L and 13.10 ng/m L,all p<0.05);the prevalence of vitamin D deficiency in groups A4 and A5(59.4%and 51.9%)were lower than those in groups A1,A2,and A3(82%,77.5%,and 70%,all p<0.05),and the prevalence of vitamin D deficiency in group A3 was lower than that in group A1(p<0.05);ASMI levels were significantly and positively correlated with 25(OH)D(r=0.307,p<0.05);multiple linear regression analysis showed that 25(OH)D and ASMI levels were independently positively correlated(β=0.266,95%CI(-0.04,-0.001),p<0.05).(3)The levels of SMI in the groups of vitamin D deficiency,insufficiency and adequacy(17.86±3.54kg/m~2,18.20±3.48kg/m~2 and 19.31±2.93kg/m~2)gradually increased,and the difference were not statistically significant(all p>0.05).The median level of 25(OH)D in female patients was higher in the S3 group(20.50 ng/m L)than those in the S1 and S2 groups(14.30 ng/m L and 17.25 ng/m L,both p<0.05);the prevalence of vitamin D deficiency in the S3 group was lower(47.4%)than that in the S2(73.2%)group(p<0.05);the level of SMI and 25(OH)D was significantly and positively correlated(r=0.272,p<0.05);multiple linear regression analysis showed that25(OH)D was independently and positively correlated with SMI level(β=0.147,95%CI(0.016,0.122),p<0.05).(4)The levels of ASMI in the groups of vitamin D deficiency,insufficiency and adequacy(8.15±1.00kg/m~2,8.35±0.88kg/m~2 and 8.38±1.03kg/m~2)gradually increased,and the difference were not statistically significant(all p>0.05).The median level of25(OH)D was lower in the A1 group(15.11±7.83 ng/m L)than those in the A2 and A3groups(19.15±7.19 ng/m L and 20.33±7.65 ng/m L,both p<0.05)in female patients;the prevalence of vitamin D deficiency were lower in the A2 and A3 groups(52.8%and54.1%)than that in the A1(71%)group(both p<0.05);ASMI level was significantly and positively correlated with 25(OH)D(r=0.234,p<0.05);multiple linear regression analysis showed that 25(OH)D was independently and positively correlated with ASMI level(β=0.191,95%CI(0.012,0.035),p<0.05).Conclusion:Serum vitamin D levels in men and postmenopausal women with type 2 diabetes mellitus are closely related to skeletal muscle mass index,and with the decrease of25(OH)D levels,skeletal muscle mass index decreases in men and postmenopausal women with type 2 diabetes,and vitamin D deficiency is a risk factor for skeletal muscle mass decline in men and postmenopausal women with type 2 diabetes. |
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