| Objective Sudomotor function(SF)detection is a simple,reliable and objective method for the early screening of diabetic neuropathy(DPN).In recent years,studies indicated that vitamin D deficiency was closely related to chronic complications of diabetes mellitus such as DPN.However,no clinical studies on the correlation between vitamin D and perspiration function have been reported.The study’s main purpose was to explore the relationship of serum 25‐hydroxyvitamin D3[25-(OH)D3]level and sudomotor function of sweat glands in patients with type 2 diabetes mellitus(T2DM).Methods 1042 patients with T2 DM who were hospitalized in the department of Endocrinology,Eastern Theater Command Hospital from January 2017 to August2020 were selected.We collected the clinical and serum biochemical data of these patients.According to the serum 25-(OH)D3 level,we divided them into three groups,deficient group(Group A)referred to patients with25-(OH)D3<20ng/m L,insufficient group(Group B)referred to patients with20ng/m L≤25-(OH)D3<30ng/m L and sufficient group(Group C)referred to patients with 25-(OH)D3≥30ng/m L.We used the output of Sudoscan to detect the sudomotor function of patients.Sudoscan parameters included hands electrochemical skin conductance(HESC),feet electrochemical skin conductance(FESC),hands asymmetry ratio(HASYM)and feet asymmetry ratio(FASYM).We compared the sudoscan parameters and clinical biochemical indexes among three groups.We used spearman correlation analysis and multiple stepwise linear regression to analyze the correlation between 25-(OH)D3 level and sudomotor function.Binary logistic regression was used to analyze the risk factors of sweating dysfunction.Results(1)Compared with Group A,24-hour urinary protein quantitation(24-h UPQ)was lower in Group B,body mass index was higher,triglyceride(TG)and 24-h UPQ were lower in Group C.Compared with Group B,TG and 24-h UPQ were lower in Group C(P<0.05).Compared with group A,HESC and FESC were higher in Group B and Group C,while HASYM and FASYM were lower.The difference between them was statistically significant(P<0.05).However,there was no significant difference between Group B and Group C(P>0.05).(2)Among all the patients,the rate of25-(OH)D3 insufficiency was 55.09%,the rate of 25-(OH)D3 deficiency was 19.38%and the rate of 25-(OH)D3 sufficiency was 25.53%.The patients with abnormal sudomotor function accounted for 39.83% and those with normal sudomotor function accounted for 60.17%.Serum 25-(OH)D3 level was significantly lower in patients with abnormal sudomotor function compared with that in patients with normal sudomotor function(t=5.000,P<0.001)and the rate of vitamin D deficiency was higher in patients with abnormal sudomotor function compared with that in patients with normal sudomotor function.Serum 25-(OH)D3 level was significantly higher in male than that in female(t=3.179,P=0.002)and the rate of vitamin D deficiency was lower in male than that in female.(3)Spearman correlation analysis showed that serum 25-(OH)D3 level was positively related to HESC and FESC(r=0.143,0.150),and negatively related to HASYM and FASYM(r=-0.091,-0.064).HESC and FESC were positively related to low density lipoprotein cholesterol(LDL-C),and negatively related to diabetes duration,serum creatinine(Scr)and 24-h UPQ(P<0.05).(4)Multiple stepwise linear regression analysis showed that serum 25-(OH)D3level,age,diabetes duration,LDL-C,serum uric acid and Scr were connected with sudomotor function.(5)Bariate logistic regression analysis indicated that diabetes duration(OR=1.036),age(OR=1.021),Scr(OR=1.007)and 25-(OH)D3(OR=0.956)were independent risk factors of sweating dysfunction.Conclusion Serum 25-(OH)D3 level in patients with T2 DM is positively correlated with sudomotor function.Low serum 25-(OH)D3 level is also an independent risk factor of sweating dysfunction. |
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