| Background:With the rapid development of the global economy,the severe trend of aging,changes in production and lifestyle,and the reduction of physical labor and activities,diabetes mellitus(diabetes mellitus,DM)has become a common disease.It is estimated that there will be 642 million diabetic patients worldwide in 2040.Epidemiological studies show that the prevalence of diabetes in China has increased nearly four times from 3.2% in 1996 to 11.6% in 2010.In 2045,there will be 120 million diabetic patients in China,with the largest number of diabetic patients in the world.The terrible thing about diabetes is that it causes damage to the heart,eyes,kidneys and other organs,which can kill and maim,and seriously threaten human health.With the progress of the course of disease,more than half of patients with type 2 diabetes mellitus(T2DM)will suffer from retinopathy,all type 1 diabetes mellitus(T1DM)will eventually suffer from retinopathy,86% of T1 DM will eventually bec ome blind,and nearly 1/3 of T2 DM patients will become blind due to diabetic retinopathy(DR).The rapid increase in the number of diabetic retinopathy has become a worldwide concern.Early intervention and diagnosis can help delay the progress of the disease,and the search for new treatments may prevent its prevalence.Scholars from various countries have conducted a large number of animal experiments and clinical studies on the occurrence of DR from various perspectives and levels.Some foreign scholars have found that vitamin D is closely related to DR.Vitamin D can protect ganglion cells and blood-retinal barrier,reduce the toxicity of high sugar.Vitamin D deficiency may increase the incidence of DR,while domestic clinical studies on this aspect are few.Objective:To explore the relationship between 25-hydroxyvitamin D3 and retinopathy in patients with type 2 diabetes mellitus,and to provide clinical evidence for early prevention and control of DR.Methods:A total of 399 patients with type 2 diabetes mellitus hospitalized in Endocrinology Department from January 2017 to January 2018 were collected,including 223 males(55.9%)and 176 females(44.1%).All the selected patients underwent mydriasis-free fundus photography and fundus angiography when necessary.According to the examination results and staging criteria,the selected patients were divided into non-diabetic retinopathy group(199 cases in NDR group),non-proliferative diabetic retinopathy group(150 cases in NPDR group)and proliferative diabetic retinopathy group(50 cases in PDR group).The general conditions of patients were analyzed,including gender,age,course of diabetes,height,weight,and body mass index(BMI);fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),serum uric acid,serum calcium,lipid,fasting C-peptide(FCP),25-hydroxyvitamin D3 [25-(OH)D3] and other biochemical indicators were collected and recorded.SPSS 22.0 statistical software was used to analyze the data,mean ±standard deviation or median(quartile distance)was used to describe the measurement data,and percentage description was used to describe the counting data.Single factor analysis of variance,rank sum test,chi-square test,Spearman correlation analysis and Logistic regression analysis were used to process the data.The difference was statistically significant(P <0.05).Results:1.A total of 399 patients with T2 DM were divided into three groups according to retinal stage and fundus examination results: NDR group(n = 199),NPDR group(n = 150),PDR group(n = 50).The prevalence of DR in patients with type 2 diabetes mellitus was 50.1%.2.There was no significant difference in FBG,blood calcium,TG,TC,LDL,HDL and serum uric acid among NDR,NPDR and PDR groups(P >0.05).There were significant differences in sex,course of disease,age,BMI,glycosylated hemoglobin,fasting c-peptide and 25-hydroxyvitamin D3 among the three groups(P <0.05).BMI,25-hydroxyvitamin D3 and fasting C-peptide levels in NDR,NPDR and PDR groups gradually decreased,while glycosylated hemoglobin levels gradually increased.The age of NPDR group and PDR group was higher than that of NDR group.in PDR group,the course of disease was more than 10 years and the probability of female was higher.3.There was significant difference in the level of 25-hydroxyvitamin D3 between male and female(P < 0.05).The level of 25-hydroxyvitamin D 3 in male [22.3(18.4 25.3)] was higher than that in female [19.89(17.6 22.3)].The longer the course of diabetes,the lower the level of 25-hydroxyvitamin D3,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that 25-hydroxyvitamin D3 was negatively correlated with glycosylated hemoglobinandage,and positively correlated with fasting C-peptide and blood calcium(P <0.05).4.Logistic regression analysis showed that the course of diabetes was a risk factor for DR,and 25-hydroxyvitamin D3 and fasting C-peptide were significantly correlated with DR,which were protective factors.Conclusion:25-hydroxyvitamin D3 is closely related to DR and is the protective factor of DR.The 25-hydroxyvitamin D3 levels in this study population were related to age,gender,duration of diabetes,and fasting C-peptide,glycosylated hemoglobin,and serum calcium levels. |
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