The Expression Level Of 25 - Hydroxyl Vitamin D And The Correlation With Islet Autoantibodies In Patients With Type 2 Diabetes

Objective:To investigate the distribution of islet autoantibodies in patients with type 2diabetes mellitus（T2DM） with different serum levels of 25 hydroxyvitamin D（25（OH）D 3） and to analyze the relationship between them.It provides a reference for further revealing the pathogenesis of T2DM and its early prevention and treatment.Method:1.From October 2016 to October 2017,T2DM patients admitted to the Endocrinology Department of our hospital were selected as subjects.According to the level of 25（OH） D3,the patients with T2DM were divided into three groups:high level（group A）,middle level（group B） and low level（group C）.2.The age,sex,course of disease and body mass index（Body Mass index,BMI） of the subjects were measured and recorded.Determination of fasting blood glucose,（FPG）,total bilirubin,（STB）,total bile acid,（TBA）,creatinine,（Cr）,blood by biochemical analysis Serum（TC）,triglyceride,（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C） and glycosylated hemoglobin（HbA1c） were determined by high performance liquid chromatography（HPLC）.The level of fasting insulin（FINS）,fasting C peptide（FCP）,25（OH）D₃ was measured by electrochemiluminescence immunoassay（ELEIA）.Urinary microalbumin（mAlb）;was measured by rate scatter turbidimetry.Immunoblotting assay of glutamic acid decarboxylase antibody（GADA）,islet cell antibody（ICA）,insulin autoantibody（IAA）,Zn Transporter 8 antibody（ZnT8） and protein tyrosine phosphatase antibody（IA-2A）.3.SPSS17.0 statistical software was used for statistical analysis.Results:1.According to the level of 25（OH） D₃,patients with T2DM were divided into high level（group A,n=80,≥40.6nmol/l）,middle level（group B,n=81,<40.6 nmol/L,≥26.2nmol/l） and low level（group C,n=79,P<0.05）.<26.2nmol/l).There was no significant difference in age,sex,course of disease and BMI between groups A,B and C（P>0.05）.2.Compared with group A（18.59±10.99）,mAlb in group B（30.35±27.20） was higher（P<0.05）.The level of mAlb in group C（110.46±256.13）was significantly higher than that in group B（30.35±27.20）（P<0.01）,and the level of mAlb in group C（110.46±256.13） was higher than that in group B（30.35±27.20）（P<0.05）.There was no significant difference in ALT,AST,r-GT,STB,TBA,Cr,GLU,HbA1c,TG,TC,LDL-C,HDL-C,2hPBG and other biochemical indexes among the three groups（P>0.05）.3.Compared with groups A and B,The level of FCP in group C was decreased[0.51（0.30,0.83）;0.54（0.29,0.72）;0.38（0.23,0.51）]（P<0.01）,but there was no significant difference between group A and group B（P>0.05）.There was no significant difference in Fins,ISI,HOMA-IR,HOMA-βand other indexes among the three groups（P>0.05）.4.The correlation between the level of 25（OH）D₃ and mAlb and FCP was analyzed.The level of 25（OH）D₃ was negatively correlated with the level of mAlb（r=-0.287;p=0.000） and positively correlated with the level of FCP（r=0.197;p=0.002）.5.The multivariate linear stepwise regression analysis using FCP as a dependent variable showed that 25（OH）D₃ was a factor affecting the expression of FCP.6.Multiple linear stepwise regression analysis using mAlb as a dependent variable showed that the course of disease（B=3.152;P=0.016） and 25（OH）D₃（B=-1.940;P=0.001）,Cr（B=1.240;P=0.005）,ALT（B=1.519;P=0.026） were the factors affecting the expression of mAlb.7.There was no significant difference in the positive rate of total GADAb,ICA,IAA,IA2A,ZnT8A,antibody between group A,group B and group C（P>0.05）.8.Whether or not the total antibody of GADAb,ICA,IAA,IA2A,ZnT8A,was positive as the dependent variable,according to age,course of disease,sex,and BMI,GLU,HbA1c,TG,TC,LDL-.C,HDL C,2 h PBG,Fins,FCP,25（OH）D₃,IRI,ISI,Homa B as independent variables,the regression equation was established.Logisitic regression analysis showed that age was the factor influencing the positive rate of GADAb in T2DM patients（OR=0.961;P=0.031）.The positive rate of GADAb was higher in the younger age group,IR was the factor influencing the positive rate of total antibody and ICA in T2DM patients[（OR=1.472;P=0.028）,（OR=1.217;P=0.031）],The detection rate of total antibody and ICA was higher in patients with high IR level.and 2hPBG was the factor influencing the positive rate of IA2A in T2DM patients（OR=1.144;P=0.035）,and the positive rate of IA2A in patients with high 2hPBG level was higher.25（OH）D₃ failed to enter all Logisitic regression equations as an independent variable.Conclusion:1.There was no difference in the distribution of islet autoantibody in T2DM patients with different serum 25（OH）D₃ levels.The level of 25（OH）D₃ in T2DM patients may not affect the positive rate of islet autoantibodies such as GADAb,IC-A,IAA,IA2A,ZnT8A.2.The level of 25（OH）D3 may have Influence effect on the decrease of mAlb level and islet cell function in patients with T2DM.3.Age is a factor affecting the positive rate of GADAb in patients with T2DM,HOMA-IR is the factor affecting the positive rate of ICA and total antibody in patients with T2DM.,and 2hPB is a factor affecting the positive rate of IA2A in patients with T2DM.