Study On The Relationship Between Serum 25(OH)D Level And Carotid Atherosclerotic Plaque In Patients With Type 2 Diabetic Kidney Disease

Objective : To investigate the serum 25-hydroxy vitamin D[25-hydroxy vitamin D[25-hydroxy vitamin] when type 2 diabetes mellitus(T2DM)and diabetic kidney disease(DKD)complicated with carotid atherosclerotic plaque(CASP)D,25(OH)D] level,further analyze the relationship between serum 25(OH)D level and T2 DM and DKD combined with CASP,and provide clinical evidence for CASP in the prevention and treatment of T2 DM diabetic kidney disease.Methods: 1.Retrospectively analyze the medical history data of T2 DM patients hospitalized in the Endocrinology Department of the Affiliated Hospital of Youjiang Medical University for Nationalities and other non-diabetic kidney disease patients hospitalized in the Nephrology Department from January 2020 to August 2020.2.Grouping: T2 DM patients are group A;T2DM patients without kidney disease(WKD)are group B;T2DM patients with DKD are group C;patients with non-diabetic kidney disease(NDKD)For group D.3.Record and collect general clinical data and laboratory examination indicators of the above patients who meet the standards;including gender,age,diabetes course,smoking history,drinking history,height,weight,body mass index BMI),blood pressure(BP): systolic blood pressure(SBP)/diastolic blood pressure(DBP),fasting plasma glucose(FPG),2-hour postprandial blood glucose(2h PPG),glycated hemoglobin(Hemoglobin a1 c,Hb A1c),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),Urinary albumin /creatinine ratio(UACR)and other biochemical indicators,using enzyme-linked immunosorbent assay(ELISA)to detect serum 25(OH)D levels.4.The data uses SPSS22.0software for data statistical analysis.Multi-group comparison of count data adopts chi-square test;multi-group measurement data adopts analysis of variance;Spearman method is used to analyze the correlation between 25(OH)D and each variable;analysis of influencing factors adopts multiple linear stepwise regression analysis or Logistic regression Analysis;P<0.05 as the difference is statistically significant.Results:(1)A total of 504 patients with T2 DM met the inclusion criteria of this study.Among them,333 cases were male,the average serum 25(OH)D level was(19.56±7.42)ng/mL,and 299 cases(89.79%)lacked serum 25(OH)D;171 cases were female,the average serum 25(OH)D level was It was(18.45±7.33)ng/mL,and 163 cases(95.32%)lacked serum25(OH)D.There were 209 elderly(age ≥ 65 years)patients,the average serum 25(OH)D level was(19.34±7.32)ng/mL,and 191 cases of serum 25(OH)D deficiency and deficiency(accounting for 91.39%);middle-aged and young people(age<65)There were 295 patients with an average serum 25(OH)D level of(19.07±7.46)ng/mL,and 271 cases of serum25(OH)D deficiency and deficiency(accounting for 91.86%).There is no statistically significant difference in serum 25(OH)D level and its deficiency and deficiency rate in comparison of gender and age(P>0.05).(2)Comparison of general clinical data between groups: Among the 4 groups of T2 DM,WKD,DKD,and NDKD,the prevalence of young and middle-aged patients was higher than that of elderly patients: group A(58.53% VS41.47%),group B(57.94% VS 42.06)%),group C(59.56% VS 40.44%),group D(62.80%VS 37.20%),and the difference was statistically significant(P<0.001).(3)Comparison of the composition ratio of different serum 25(OH)D levels in each group: The 25(OH)D insufficiency and deficiency rate of group B is 92.83%,which is higher than that of group A(91.67%),group C(89.62%),Group D(84.30%).And after comparison,the difference was statistically significant(P<0.05).(4)Comparison of the number and composition ratio of carotid artery intimal changes in T2 DM patients: The incidence of CASP in each group was81.55% in group A,84.11% in group B,77.05% in group C,and 78.51% in group D.Namely:Group C is lower than Group A,Group B and Group D.And after comparison,the difference was statistically significant(P<0.05).(5)Comparison of clinical data and biochemical indicators among the 4 groups of patients: BMI,DM course,SBP,DBP in general data and FPG,2h PPG,HBA1 c,TG,serum 25(OH)D levels and other indicators in biochemical indicators In comparison,the difference was statistically significant(P<0.05);while the difference between TC and LDL-C groups was not statistically significant(P>0.05).(6)Spearman correlation analysis found that the course of DKD patients with serum 25(OH)D and T2DM(r=-0.433,P<0.001),HBA1c(r=-0.374,P<0.001),LDL-C(r=-0.351,P<0.001),UACR(r=-0.51,P<0.001)are correlated;but there is no correlation with age,SBP,DBP,BMI,FBG,2h PPG,TG,TC(P>0.05).(7)Logistic regression analysis found that 25(OH)D is an independent protective factor for DKD patients with T2 DM complicated by CASP(OR value is 0.940)(P<0.001);while the course of DM,HBA1 c,LDL-C are formed by CASP Risk factors(OR values were 1.652,1.533,1.477)(P<0.001).Conclusion:(1)Patients with T2 DM,especially DKD,are generally inadequate and lack of 25(OH)D;(2)Insufficiency and lack of 25(OH)D may be one of the risk factors that promote DKD and CASP.Clinically,attention should be paid to the role of vitamin D in the diagnosis and treatment of DKD and its possible positive effects.