Correlation Between Serum Vitamin D Levels And Peripheral Neuropathy In Patients With Type 2 Diabetes

Objective: Diabetes is a metabolic disease characterized by hyperglycemia.Diabetic peripheral neuropathy(DPN)is the most common chronic complication.Studies have shown that serum 25-hydroxy vitamin D(25(OH)D)can improve insulin resistance,but whether it is related to the occurrence of DPN is not clear.This study aimed to investigate the risk factors associated with DPN and to explore the correlation between serum 25(OH)D levels and DPN.Methods: 231 patients with type 2 diabetes mellitus admitted to the Department of Endocrinology,Hebei General Hospital from January 2018 to January 2019 were enrolled.According to the consensus of the diagnosis and treatment of diabetic peripheral neuropathy in the Chinese Medical Association Neurology Branch in 2013,they were divided into diabetic peripheral neuropathy group(DPN)and no-diabetic peripheral neuropathy group(NDPN).General data of each patient was recorded and blood sample was collected to measure blood lipids,serum albumin,uric acid,glycated hemoglobin and serum 25(OH)D levels.To analyze the risk factors associated with DPN in patients with type 2 diabetes,and to explore the role of serum 25(OH)D levels in DPN in patients with type 2 diabetes.Result:1.Comparison of basic clinical data between DPN and NDPN groupsOf the 231 patients with type 2 diabetes,155 were in the DPN group and 76 in the NDPN group.The prevalence of DPN was 67.1% in this group of hospitalized patients.There were 153 cases of vitamin D insufficiency and deficiency in the DPN group,accounting for 98.7%.The age of DPN group was higher than that of NDPN group,the course of disease was longer than that of NDPN group,and the serum vitamin D level was lower than that of NDPN group,the difference was statistically significant(P<0.05).In this study,glycosylated hemoglobin,fasting blood glucose,homocysteine,uric acid,triglyceride,body mass index,serum albumin,total cholesterol,Low density lipoprotein-cholesterol and other indicators were also compared,but the difference was not statistically significant(P >0.05).2.Correlation between different serum 25(OH)D levels and the incidence of DPNAccording to the serum 25(OH)D quartile,the subjects were divided into four groups according to the 25(OH)D level from low to high.From Q1 group to Q4 group,the incidence of DPN was 77.6%,75.9%,65.5% and 49.1% respectively.Compared with the Q1 group,the incidence of diabetic neuropathy in the Q2,Q3,and Q4 groups decreased in turn,but the difference between the Q4 group and the Q1 group was statistically significant(P<0.05).3.Analysis of the influencing factors of peripheral neuropathyLogistic regression analysis showed that age,the course of disease,and serum vitamin D were risk factors for peripheral neuropathy in type 2 diabetes.Conclusion:1.In patients with type 2 diabetes,the prevalence of DPN increases with the decrease of serum 25(OH)D level.There is a clear correlation between the serum vitamin D level and DPN.2.Age,the course of disease,and serum 25(OH)D level are risk factors for DPN in patients with type 2 diabetes.Whether vitamin D supplementation can prevent or delay the development of DPN in patients with type 2 diabetes remains to be further studied.