To Investigate The Relationship Between Peripheral Neuropathy And Serum 25-hydroxyvitamin D3 Levels In Patients With Type 2 Diabetes Mellitus

OBJECTIVE:Diabetic peripheral neuropathy(DPN)is one of the most common and complicated chronic complications of type 2 diabetes(T2DM).Its pathogenesis and diagnosis and treatment are still a major problem faced by medical workers.This study retrospectively analyzed the relationship between peripheral neuropathy and serum 25-hydroxyvitamin D3 in type 2 diabetic patients,hoping to provide new ideas and approaches for the prevention and treatment of DPN.METHODS: A total of 202 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology and Geriatric Endocrinology and Metabolism,First Affiliated Hospital of Guangxi Medical University from January 2016 to October 2018 were enrolled.According to whether there were peripheral neuropathy,94 patients with type 2 diabetes and peripheral neuropathy(DPN)group,and 108 patients with simple type 2 diabetes mellitus(SDM)group.Record general information about all subjects,including age,gender,duration,height,weight,blood pressure,smoking history,and calculate body mass index(BMI);collect relevant glucose metabolism indicators and isletfunction indicators,including fasting insulin(FINS),Fasting blood glucose(FPG),fasting C-peptide(FCP),postprandial 2-hour blood glucose(2h PPG),glycosylated hemoglobin(HBA1c),and calculation of insulin resistance index according to the steady-state model(HOMA)method [(Homa-IR)=FINSxFPG/22.5] and islet ?-cell function index [(Homa-?)=(20xFINS)/(FPG-3.5)];recording serum 25-hydroxyvitamin D3[25-(OH)D3],parathyroid hormone(PTH)And related biochemical indicators,including serum albumin(ALB),serum creatinine(Scr),serum uric acid(SUA),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),blood calcium(Ca),blood phosphorus(P),and the like.The single factor comparison of all normal distribution indicators between the two groups was performed by two independent sample t test,and the skewed distribution data were compared using nonparametric rank sum test;the comparison of multiple groups was performed by chi-square(X2)test.then DPN was used as the dependent variable,serum 25-hydroxyvitamin D3,FPG,HBA1 c,FCP,BMI,ALB was used for multivariate logistic regression analysis of independent variables;Pearson analysis was used to analyze the correlation between serum25-hydroxyvitamin D3 and other biochemical indicators.RESULTS: According to the statistical analysis,the serum 25-hydroxyvitamin D3 level was lower in the study group than in the control group.The serum [25-(OH)D3] level of the study group was(53.16±14.25nnmol/l)lower than that of the control group(63.3± 16.12nmol/l),the difference between the two groups was statistically significant(P=0.00<0.05).The proportion of serum [25-(OH)D3] in the study group(44.7%)was significantly higher than that in the control group(19.4%)(P<0.05).Multivariate logistic regression analysis found that serum [25-(OH)D3] was one of the protective factors of DNP(OR=0.959 95% CI 0.940-0.979,P<0.05).Pearson product moment analysisshowed that serum [25-(OH)D3] was negatively correlated with glycosylated hemoglobin(HbA1c)in diabetic patients(P=0.009<0.05).Conclusion: 1.The level of serum 25-hydroxyvitamin D3 in type 2diabetes mellitus with peripheral neuropathy was lower than that in type 2diabetes,and the proportion of serum 25-hydroxyvitamin D3 deficiency was higher than that in type 2 diabetes.2.Serum 25-hydroxyvitamin D3 is an independent risk factor for peripheral neuropathy in type 2 diabetes.3.There is a negative correlation between serum 25-hydroxyvitamin D3 and glycosylated hemoglobin.