The Relationship Between Serum Vitamin D Level And Abdominal Visceral Fat, The Various Metabolic Indices In Patients With Type 2 Diabetes

Objective: The purposes of this study were to clarify the relationship between Vit D and obesity type and further discuss the relationship between Vit D and metabolic syndrome components through the analysis on correlation of serum vitamin D(Vit D) level and abdominal visceral fat in patients with type 2 diabetes.Methods: we randomly collected 213 patients with type 2 diabetes aged 26-81 in endocrinology department of the First Hospital of Qin Huangdao from November 2013 to September 2014, including 124 males and 89 females. The selected patients were divided into two groups according to Vit D median value, < 40.7 nmo/l for low concentration group(n = 108), ≥40.7nmo/l for the high concentration group(n = 105). Exclusion criteria:(1) Type l diabetes, gestational diabetes, and other special type of diabetes.(2)Autoimmune diseases, bone metabolic diseases, skin diseases, severe liver and kidney dysfunction, severe digestive system diseases, cardiovascular diseases and effects of drugs on bone metabolism.The information of all patients was collected as follows: Name, gender, age, diabetes duration, smoking history, smoking dose, smoking years, drinking history, drinking dose, drinking years, high blood pressure history, sunshine time, season in hospital, height,weight, waist circumference, hip circumference, systolic blood pressure(SBP), diastolic blood pressure(DBP), visceral fat area(VFA), body fat percentage, body fat mass, triglycerides(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL- C), high density lipoprotein cholesterol(HDL- C), glycosylated hemoglobin(Hb A1C), blood uric acid(UA), homocysteine(HCY), blood calcium(Ca), blood phosphorus(P) and parathyroid hormone(PTH), serum 25- hydroxyl vitamin D3 [25-(OH)D3].Then body mass index(BMI) and waist-to-hip ratio(WHR) were calculated.Statistical analysis was performed using SPSS17.0 software package. Normality test and homogeneity test of variances(F test) were employed before data analysis.The normal distribution data was described by Mean±SD, t-test was employed to compare difference between two groups of the normal distribution, rank sun test was employed to compare difference between two groups of the abnormal distribution, Χ2 test was employed in the comparison of rate,rectilinear correlation and multiple stepwise linear regression analysis were employed to analyze those elements. P<0.05 was considered significant for all statistical analysis.Results:1 The VFA, body fat percentage, body fat mass, BMI, DBP and TG were higher in low Vit D concentration group than that in high Vit D concentration group,the sunshine time and HDL- C were lower in low Vit D concentration group than that in high Vit D concentration group(P < 0.05).There was no statistically significant difference between the two groups in terms of drinking years,drinking dose, smoking years, smoking dose, diabetes duration, age, waist circumference, WHR, SBP, Ca, P, LDL-C, PTH, Hb A1 C, TC, HCY and UA(P > 0.05).2 The incidences of overweight and obesity, high TG,low HDL-C, high VFA were significantly higher in low Vit D concentration group than that in high Vit D concentration group(P < 0.05), There was statistically significant difference between the two groups in terms of season form rate(Χ2 = 73.404, P = 73.404). There was no statistically significant difference between the two groups in terms of smoking history, drinking history, high blood pressure history, age, gender, waist circumference, UA and HCY(P > 0.05).3 Single factor correlation analysis showed that after month in hospital and sunshine time were revised, There was statistically significant linear negative correlation between the level of serum Vit D and BMI, body fat mass, DBP,SBP, TC, the correlation coefficients respectively were-0.217(P=0.002),-0.153(P=0.026),-0.228(P=0.001),-0.141(P=0.041),-0.146(P=0.034).4 With Vit D as the dependent variable and TC(X1), DBP(X2), SBP(X3), BMI(X4), waist circumference(X5), VFA(X6), body fat percentage(X7), body fat mass(X8), month in hospital(X9), as the independent variables, The multiple stepwise linear regression analysis showed that: month in hospital(X9), BMI(X4) and DBP(X2) were introduced in the equation, Y=97.427+1.869X9-1.039X4-0.434X2,the standardized regression coefficien ts of the independent variables respectively were 0.303(X9),-0.195(X4),-0.177(X2), And the values of the P respectively were 0.000, 0.002, 0.006.Conclusions:1 There was statistically significant linear negative correlation between the level of serum Vit D and BMI,body fat mass,and there was nothing to do with abdominal visceral fat in patients hospitalized with type 2 diabetes.2 There was statistically significant linear negative correlation between the level of serum Vit D and TC,DBP,SBP in patients hospitalized with type 2 diabetes.3 Month in hospital, BMI and DBP level were the main factors affecting the level of serum Vit D in patients hospitalized with type 2 diabetes.4 While the level of serum Vit D reduced,the incidences of overweight and obesity,high VFA,high TG and low HDL-C increased.