Changes Of Serum 25(OH)D And Abdominal Visceral Fat Area In Patients With Type 2 Diabetes Mellitus Under Different Bone Mass

Objective: By determination of serum 25-hydroxyvitamin D levels and abdominal visceral fat area in patients with type 2 diabetes mellitus under different bone masses and observation of their changes.The aim of this study is to explore the correlation between25(OH)D ? VFA and blood lipids,bone metabolism and abdominal obesity indicators,aiming to provide new targets for clinical prevention and treatment of T2 DM and osteoporosis.Methods: 101 patients with T2 DM hospitalized in the endocrinology department of our hospital were randomly selected.The bone mineral density of all subjects was determined and divided into 3 groups according to the results:(1)T2DM normal bone group(32 cases in DMNB group);(2)T2DM bone mass reduction group(34 cases in DMLB group);(3)T2DM osteoporosis group(35 cases in DMOP group).In the same period,23 patients with gender,age and normal bone mass in our physical examination center were selected as the control group(23 in the NC group).The general basic data of all subjects were collected,and all subjects were tested for serum fasting plasma glucose,glycosylated hemoglobin,fasting plasma insulin,total cholesterol,triglyeride high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,serum calcium,serum phosphorus,alkaline phosphatase,serum 25(OH)D,parathyroid hormone,Beta-Crosslaps,procollagen I N-Terminal propeptide content.Compare the general data of each group,relevant clinical biochemical indicators,serum 25(OH)D levels and body fat distribution;Correlation between serum 25(OH)D and VFA and various indicators in Pearson correlation analysis;Partial correlation analysis of the correlation between different parts of BMD and various indicators;multi-factor Logistic analysis of the impact of different indicators on T2 DM combined with OP.Results: 1.(1)Compared with NC group,the levels of HbA1 c,FPG,In(HOMA-IR),LDL-C,?-CTX and PINP in DMNB group,DMLB group and DMOP group weresignificantly increased,HDL-C and QUICK levels were significantly reduced,DMLB The waist circumference,WHR and PTH levels in the DMOP group were significantly increased,and the TC levels in the DMOP group were significantly increased(P<0.05).(2)Compared with the DMNB group,the age,waist circumference,WHR,HbA1 c,In(HOMA-IR),PTH,?-CTX,and PINP levels in the DMLB group and the DMOP group were significantly increased,and the levels of QUICK and HDL-C were significantly decreased,and the levels of TC and LDL-C in DMOP group were significantly increased,and the difference was statistically significant(P<0.05).(3)Compared with the DMLB group,the age,HbA1 c,In(HOMA-IR),TC,LDL-C,?-CTX,and PINP levels in the DMOP group were significantly increased,and the QUICK level was significantly lower.The difference was statistically significant(P<0.05).2.(1)Compared with the two groups,serum25(OH)D showed a gradual decrease trend,that is NC group>DMNB group>DMLB group>DMOP group,and the difference was statistically significant(P<0.05).(2)The VFA and VFA/SFA of DMLB group and DMOP group were significantly higher than those of NC group and DMNB group.The BMD of SFA and four sites of bone density were significantly lower than that of NC group and DNNB group,the difference was statistically significant(P<0.05).(3)LS-BMD and FN-BMD in the DMOP group were significantly lower than those in the DMLB group,and the difference was statistically significant(P<0.05).3.Pearson correlation analysis showed that serum 25(OH)D was positively correlated with HDL-C and negatively correlated with BMI,VFA,HbA1 c,TC,?-CTX and PINP(P<0.05);VFA was positively correlated with WHR,BMI,HbA1 c,TC,In(HOMA-IR)and ?-CTX,and negatively correlated with serum 25(OH)D,HDL-C and PINP(P<0.05).Partial correlation regression analysis showed that:(1)LS-BMD was positively correlated with BMI,VFA,25(OH)D and HDL-C,and negatively correlated with In(HOMA-IR),?-CTX and PINP(P<0.05);(2)FN-BMD was positively correlated with BMI,25(OH)D,HDL-C,and negatively correlated with VFA,LDL-C,?-CTX,and PINP(P<0.05);(3)WT-BMD was positively correlated with BMI,negatively correlated with ?-CTX and PINP(P<0.05);(4)TH-BMD was positively correlated with BMI and25(OH)D,and In(HOMA-IR),?-CTX,PINP was negatively correlated(P<0.05).4.Multivariate logistic regression analysis showed that HbA1 c and VFA are independent risk factors for T2 DM combined with OP.Serum 25(OH)D and HDL-C are independent protective factors for T2 DM combined with OP.Conclusion: The lack of vitamin D and the excessive accumulation of visceral fat may be related to T2 DM and bone loss.