Study On Levels Of Vascular Endothelial Growth Factor And 25hydroxy Vitamin D₃ In Patients With Early Type 2 Diabetic Kidney

Objective To investigate the changes of serum 25-hydroxy vitamin D₃（25（OH）D₃）and vascular endothelial growth factor（VEGF）in type 2 diabetes mellitus patients,and to analyze their relationship with diabetes mellitus and early diabetic kidney disease.Methods The one hundred and thirteen patients with type 2 diabetes mellitus were divided into simple diabetes group including seventy-eight cases,early diabetic kidney disease group including thirty-five cases and normal control group including forty-one cases by the urinary albumin creatinine ratio（UACR）.All subjects were tested for VEGF,25（OH）D₃,glucose metabolism,and renal function.Then all subjects were divided into forty-one cases in the vitamin D adequate group,thirty-one cases in the vitamin D relatively deficient group and eighty-too cases in the vitamin D lacking group according to 25（OH）D₃ level.Pearson and Spearman analysis was used to calculate the correlation between 25（OH）D₃ and VEGF and various metabolic indexes.Independent influencing factors of early diabetic kidney disease were analyzed by binary Logistic regression.Results Firstly,serum 25（OH）D₃decreased gradually and vascular endothelial growth factor increased gradually in normal group,simple diabetes group and early diabetic kidney disease group.Secondly,compared with the vitamin D adequate group,the fasting blood glucose（FBG）,glycaemic hemoglobin（HbA1c）,urinary protein and creatinine ratio（UACR）,VEGF and hypersensitive c-reactive protein（hs-CRP）were significantly increased in the vitamin D deficiency group and the lacking group,and the estimated glomerular filtration rate（eGFR）was significantly decreased.Thirdly,25（OH）D₃ was negatively correlated with VEGF,UACR,FBG,HbA1C,Scr and hs-CRP,and positively correlated with eGFwR and blood Ca.VEGF as positively correlated with Scr,UACR,FBG,HbA1c and hs-CRP,and negatively correlated with eGFR and blood Ca.Fourthly,Logistic regression analysis showed that VEGF and hs-CRP were independent risk factors of early diabetic kidney disease,and 25（OH）D₃ was protective factors of early diabetic kidney disease.Conclusion Firstly,the deficiency and lacking of vitamin D is common in type 2 diabetes mellitus patients.With the progression of early diabetic kidney disease,The lacking of vitamin D becomes more and more serious.Secondly,VEGF level in type 2 diabetes mellitus patients is generally higher than that in normal people,and gradually increases with the progression of early diabetic kidney disease.Thirdly,VEGF level is relatively high when vitamin D lacking occur.The lacking of vitamin D and the increasing of VEGF may accelerate the development of early diabetic kidney disease.