Correlation Between Serum 25 Hydroxyvitamin D Level And Left Ventricular Hypertrophy In Patients With Type 2 Diabetes

Objective:In this study,we observed the correlation between serum 25 hydroxyvitamin D[25(OH)D]level and left ventricular mass index(LVMI)in patients with type 2diabetes mellitus(T2DM),to explore the relationship between vitamin D and left ventricular hypertrophy(LVH)in patients with type 2 diabetes mellitus and the related factors affecting left ventricular hypertrophy,so as to provide theoretical basis for the early diagnosis and treatment of complications in patients with type 2 diabetes mellitus in the future.Method:A total of 349 T2DM patients hospitalized in the Department of Endocrinology,the First Affiliated Hospital of Nanchang University from June 2020 to November 2020 were collected according to the inclusion criteria and exclusion criteria.The basic information of the patients and the test results of venous blood in the morning of the second day after admission were collected,including gender,age,height,weight,body mass index(BMI),history of hypertension,systolic blood pressure,diastolic blood pressure,course of diabetes,fast blood glucose(FBG),2-hour post prandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1C),serum creatinine(Scr),blood urea nitrogen(BUN),serum uric acid(SUA),homocysteine(Hcy),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),calcium(Ca),phosphorus(P),25 hydroxyvitamin D,parathyroid hormone(PTH).Right ventricular outflow tract(RVOT),right ventricular diameter(RVd),left atrial diameter(LAd),aortic diameter(AOd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),Left ventricular end diastolic diameter(LVEDd)and left ventricular ejection fraction(LVEF)were measured by echocardiography,and calculate the LVMI.According to the serum 25 hydroxyvitamin D levels,the patients were divided into vitamin D deficiency group(< 20 ng / ml),vitamin D deficiency group(20-30 ng / ml)and vitamin D sufficient group(≥ 30 ng / ml).The differences of each index among the three groups were compared,and the effects of different levels of vitamin D on LVH were analyzed by multivariate logistic regression.Result:1.Among the three groups,there were statistically significant differences in FBG,TG,HDL-C,PTH,RVOT,RVD,LAd,IVST,LVPWT,LVEDd,LVEF and LVMI(P < 0.05).The incidence of LVH in vitamin D deficiency group was significantly higher than that in vitamin D sufficient group(P < 0.05).2.Spearman correlation analysis showed that 25(OH)D was negatively correlated with TC,TG,P,FBG,PTH and LVMI,and positively correlated with HDL-C and Ca(P < 0.05).3.Univariate analysis showed that age,duration of diabetes,systolic blood pressure,Scr,estimated glomerular filtration rate(eGFR),SUA,TC,HDL-C,PTH and 25(OH)D levels were associated with LVMI(P < 0.05).4.With T2DM combined with LVH as the dependent variable,age,diabetes course,history of hypertension,gender,BMI,eGFR,SUA,TC,HDL-C,PTH,25(OH)D level as independent variables,multivariate logistic regression analysis showed that vitamin D deficiency,the course of diabetes,and female were risk factors for LVH in T2DM,while HDL-C is a protective factor.Conclusion:1.The lower the serum 25(OH)D level,the larger the RVOT,RVd,LAd,IVST,LVPWT,and LVEDd of T2DM patients,and the lower the LVEF,suggesting that vitamin D deficiency may be a risk factor affecting the structure and function of the heart.2.Serum 25(OH)D level is negatively correlated with LVMI in T2DM patients.Vitamin D deficiency may be an independent risk factor for LVH in patients with T2DM.