| Objective This study aims to evaluate the correlation between serum 25 hydroxyvitamin D level [25(OH)D] and cardiac autonomic neuropathy(CAN)in patients with type 2 diabetes(T2DM).Methods From June 2021 to June 2022,227 patients with T2 DM who met the admission standard were chosen as the subjects of this study,Collect general clinical data(age,gender,diabetes course,height,weight,and calculate body mass index)and Serological parameters(including blood glucose,lipids,25 hydroxyvitamin D,etc.).According to Ewing test results,all patients were divided into diabetes cardiac autonomic neuropathy group(DCAN)and non diabetes cardiac autonomic neuropathy group(NDCAN).The criteria for categorizing 25 hydroxyvitamin d into 3groups in this study were as follows: the vitamin D normal group defined as greater than or equal to 30 ng / ml(n = 50 patients),the vitamin D insufficient group defined as greater than or equal to 20 to less than 30 ng / ml as inter dimensional(n = 121patients),and the vitamin D deficient group defined as less than 20 ng / ml(n = 56patients).The prevalence of DCAN was statistically analyzed.The basic clinical data of DCAN patients,NDCAN patients and patients with different vitamin D groups were compared.The binary logistic regression analysis was used to explore the influencing factors of T2 DM patients with DCAN.Results(1)Nutritional status of vitamin D in type 2 diabetes patients: Among 227T2 DM patients who met the criteria,24.67%(56 cases)were vitamin D deficient,53.30%(121 cases)were vitamin D deficient,and only 22.02%(50 cases)were vitamin D sufficient.Among DCAN patients,33.58%(45 cases)were vitamin D deficient,52.23%(70 cases)were vitamin D deficient,and 14.18%(19 cases)were vitamin D sufficient;In NDCAN group,vitamin D deficiency accounted for 11.83%(11 cases),vitamin D deficiency accounted for 54.84%(51 cases),and vitamin D adequacy accounted for 33.33%(31 cases).There was statistically significant difference in vitamin D deficiency rate between DCAN group and NDCAN group(P<0.05).(2)Comparison of clinical data between DCAN and NDCAN: 227 T2 DM patients in the included group were divided into two groups according to whether they were complicated with diabetes and cardiac autonomic neuropathy: DCAN group and non DCAN group.The age,course of diabetes,TG and UACR in DCAN group were significantly higher than those in NDCAN group(P<0.005);SBP was smaller than NDCAN group,the difference was statistically significant(P<0.005);Male proportion,DBP,BMI,FPG,Hb A1 c,TCH,HDL-C,LDL-C,UA,CREA,FC-P,HOMA-β、There was no statistical difference between HOMA-IR groups(P>0.05);The serum25-hydroxyvitamin D level in DCAN group was significantly lower than that in NDCAN group [23.50(17.00,29.00)vs 29.00(24.00,34.00)ng/ml,P<0.01].(3)Comparison of clinical data and DCAN detection rate of T2 DM patients in different subgroups of vitamin D: The difference of DCAN detection rate and ACR in each group was statistically significant(P<0.01).Course of diabetes,BMI,SBP,DBP,FPG,Hb A1 c,TCH,TG,HDL-C,LDL-C,UA,CREA,FC-P,HOMA in each group-β 、 Compared with HOMA-IR,the difference was not statistically significant(P>0.05).(4)Logistic regression analysis of influencing factors of DCAN in T2 DM patients:With the presence of DCAN as the grouping dependent variable(assigned DCAN:Yes=l,No=0),the influencing factors of P<0.2 in the above univariate analysis(including serum 25(OH)D level,diabetes course,age,UACR,TG,SBP)were included in the logistic regression model as independent variables.The results showed that low serum 25-hydroxyvitamin D level,low systolic blood pressure and high triglyceride were the risk factors for DCAN in T2 DM patients(P<0.01).Conclusions The vitamin D levels in patients with T2 DM combined with DCAN were significantly lower than those in patients with NDCAN;Vitamin D deficiency is an independent risk factor for T2 DM patients with DCAN,which can be used to screen and prevent diseases,and remind clinicians to pay attention to and prevent the occurrence of early DCAN. |
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