The Anti-inflammation Effect And Mechanism Of Vitamin D On Type 2 Diabetes Mellitus

Objectice:To observe the effect of vitamin D on microalbuminuria,blood glucose,blood lipid and insulin resistance index in patients with type 2 diabetes mellitus.To investigate the effect of vitaminD on the toll like receptor 4(TLR4)inflammatory signaling pathway and oxidative stress index in peripheral blood mononuclear cells(PBMCs)in type 2 diabetic patients mellitus(T2DM).To investigate the effect of vitaminD on the function of vascular endothelial cells in patients with T2 DM.Methods: A total of 17 T2 DM patients with 25(OH)VD < 30ng/ml and microalbuminuria were enrolled from Endocrinology of Gansu Provincial Hospital between January 2016 and March 2017.These patients were randomly divided into two groups,8 cases in the control group,9 cases in the intervention group.The intervention group was given vitaminD drop(800IU/day)based on conventional hypoglycemic,the control group was given hypoglycemic therapy.All patients were followed up for 3months.The changes of 25-hydroxy-vitaminD,serum calcium,serum phosphorus,serum lipid,fasting blood glucose(FBG),fasting insulin(Fins),glycosylated hemoglobin(HbA1c),total cholesterol(TC),low density lipoprotein cholesterol(LDL),high density lipoprotein cholesterol(HDL),24 h urineprotein level were observed before and after treatment.And analyzed the expression level of PBMCs TLR4 by flowcytometry,while using echo-tracking technique(ET)to detect the changes of vascular endothelial function before and after treatment.Comparison between the two groups of the above indexes have no statistical difference before and after treatment,and observe whether the adverse reaction during the treatment.All the data were analyzed statistically by SPSS19.0 software.Results:1.The levels of urine protein,urinary albumin excretion rate,fasting blood glucose,glycosylated hemoglobin,TC,HDL-C,25-hydroxy vitaminD,serum calcium,blood phosphorus,serum uricacid,HOMA-IR and other aspects had no statistical difference(P>0.05)in two groups before treatment.Compared with before treatment,patients with FBG,HDL-C,urinary albumin excretion rate,serum uric acid,serum calcium,serum phosphorus,HOMA-IR had no statistical in two groups after 3 months treatment.The intervention group after treatment compared with before treatment,24 h urinary protein(P=0.024),25 hydroxyvitamin D(P=0.002),TC(P=0.012),HbA1c(P=0.004),the difference is statistically significant(P< 0.05).The data above detection project in control group had no statistically significant(P>0.05).While 25 hydroxyvitaminD were increased significantly after treatment in two groups.And compared with control group,the 25 hydroxyvitamin D inintervention group increased more significantly after treatment(P=0.002),the difference was statistically significant.Two groups of patients had no serious adverse reactions.2.The expression of PBMC TLR4 in the intervention group was significantly lower than that before treatment(P=0.011),the difference was statistically significant(P<0.05).Compared with before treatment,there was no significant difference in the control group(P>0.05).3.The function of vascular endothelial cells(?,Ep,AC,AI,PWV?)did not change significantly in two group before and after treatment,the difference was no statistically significant(P>0.05).Conclusions:1.VitaminD can reduce 24 h urineprotein,total cholesterol glycosylated hemoglobin levels in patients with T2 DM.2.VitaminD can reduce the expression of PBMCs TLR4 in patients with T2 DM.3.The intervention of vitamin D on T2 DM may be related to the inflammatory signaling pathway of TLR4.