The Relations Between Adipose Tissue Distribution With Vitamin D And Bone Metabolism In Different Glucose Tolerance People

Objective:To discuss the relations between adipose tissue distribution with vitamin D and bone metabolism in different glucose tolerance people.Methods:180 cases research subjects were collected in this study,they were divided into three groups according to their different glucose tolerance:Normal glucose tolerance group(NGT group),61cases;Impaired glucose tolerance group(IGT group),13cases;Type 2 diabetes mellitus group(T2DM group),106 cases.The general clinical data,the intermediate metabolites of vitamin D 25-hydroxy vitamin D(25(OH)D)and 1,25-dihydroxy vitamin D3(1,25(OH)2D3),parathyroid hormone,calcium concentration were measured.Subcutaneous adipose tissue(SAT)area and visceral adipose tissue(VAT)area were measured through dual bioelectrical impedance analysis.Bone mineral density(BMD)at lumbar spine were measured by dual energy X-ray absorptiometry,the fat%were measured by X-ray attenuation and then calculate the Fat mass index(FMI).Homeostasis model assessment-insulin resistance(HOMA-IR),homeostasis model assessment-?(HOMA-?)were computed through HOMA model,and then calculate insulin sensitive index(ISI).To discuss the relations between adipose tissue distribution with vitamin D and bone metabolism in different glucose tolerance people.Results:1?In the NGT group:? 25(OH)D showed no correlation with VAT area,SAT area,Weight,BMI,Fat%,FMI,WC,HC,Whr(P>0.05);1,25(OH)2D3 showed a negative correlation with VAT area,SAT area,Weight,BMI,Fat%,FMI(P<0.05).?The NGT group can be divided into normal VAT area group and excess VAT area group according to if the VAT area is greater than 100cm2,can be divided into Fat%more than thirty percent group and Fat%less than thirty percent group according to if the Fat%is greater than thirty percent,can be divided into normal BMI group and excess BMI group according to if the BMI is greater than 24kg/m2,1,25(OH)2D3 between the two groups had statistical significance in three cases(P<0.05),1,25(OH)2D3 significantly decreases in excess VAT area group,Fat%more than thirty percent group,excess BMI group.25(OH)D between the two groups had no statistical significance in three cases(P>0.05).?Multiple regression analysis suggested that VAT area is the major factor that influences the activated vitamin D3 level.In the T2DM group:?The 1,25(OH)2D3 in T2DM group is lower than that in IGT group.? 25(OH)D show a negative correlation with Weight,VAT area(P<0.05);1,25(OH)2D3 showed a negative correlation with VAT area,SAT area,Weight,BMI,Fat%,WC,HC,Whr(P<0.05).?The T2DM group can be divided into normal VAT area group and excess VAT area group according to if the VAT area is greater than 100cm2,can be divided into Fat%more than thirty percent group and Fat%less than thirty percent group according to if the Fat%is greater than thirty percent,can be divided into normal BMI group and excess BMI group according to if the BMI is greater than 24kg/m2,1,25(OH)2D3 between the two groups had statistical significance in three cases(P<0.05),1,25(OH)2D3 significantly decreases in excess VAT area group,Fat%more than thirty percent group,excess BMI group.25(OH)D between the two groups had no statistical significance in three cases(P>0.05).?The HOMA-IR,BMD1 and BMD2 in excess VAT area group are greater than that in nomal VAT area group;the ISI is lower than that in nomal VAT area group.?Multiple regression analysis suggested that VAT area is the major factor that influences the activated vitamin D3 level.In the NGT group:? VAT area,SAT area showed a positive correlated with BMD2,BMD(L2-L4)(P<0.05);? BMD between the normal VAT area group and excess VAT area group had no statistical significance(P>0.05).In the T2DM group:?SAT area,VAT area showed no correlation with BMD(P>0.05).?The BMD1 and BMD2 in the excess VAT area group are greater than that in the nomal VAT area group.?25(OH)D showed a positive correlation with Z3,Z4,Z(L1-L4),Z(L2-L4)(P<0.05).1,25(OH)2D3 showed a negative correlation with BMD1,BMD2,BMD3,BMD(L2-L4),T1,T2(P<0.05).4?In the NGT group:VAT area,SAT area showed a positively correlated with HOMA-IR(P<0.05),showed a negative correlated with ISI(P<0.05),showed no correlated with HOMA-p(P>0.05).In the T2DM group:VAT area showed a positively correlated with HOMA-IR(P<0.05),showed a negative correlated with ISI(P<0.05);SAT area showed no correlated with HOMA-IR,ISI(P>0.05).SAT area,VAT area showed no correlated with HOMA-p(P>0.05).5?In the NGT group:VAT area,SAT area showed no correlation with smoking,drinking(P>0.05).In the T2DM group:VAT area showed a positive correlation with smoking,drinking,drinking index(P<0.05).SAT area showed no correlation with drinking,smoking(P>0.05).Conclusions:1?Both in the NGT group and the T2DM group,reflect the content and distribution of adipose tissue indexes including BMI,Fat%,VAT,SAT were negatively correlated with 1,25(OH)2D3,but Multiple regression analysis suggested that VAT area is the major factor that influences the activated vitamin D3 level,suggesting that the visceral fat tissue plays an important role in the metalolism of activated vitamin D3.2?Both in the NGT group and the T2DM group,25(OH)D had no difference between normal VAT area people and excess VAT area people,but the excess VAT area people had low 1,25(OH)2D3 viremia,suggesting that the Visceral obesity people should pay more attention to the measurement of 1,25(OH)2D3.3?In the T2DM group,Although VAT was associated with the reduce of 1,25(OH)2D3,but the excess VAT people had a higher BMD,suggesting that visceral fat tissue may affect bone mineral density in other ways.4?In the T2DM group,VAT showed a positively correlated with insulin resistance,SAT showed no correlation with insulin resistance,suggesting that in patients with type 2 diabetes,VAT was significantly associated with insulin resistance.5?In the T2DM group,VAT showed a positively correlated with smoking and drinking,SAT showed no correlated with smoking and drinking,suggesting that Smoking,drinking may aggravate visceral obesity in patients with type 2 diabetes..