25?OH?D₃ Level And Coronary Artery Disease In Type 2 Diabetes Mellitus Relevance Study

Objective:It aims to study the correlation between 25-hydroxyvitamin D₃[25?OH?D₃]and insulin resistance?coronary artery lesion in type 2 diabetes mellitus?T2DM?,and to explore the effect of 25?OH?D₃ on the occurrence and development of T2DM and CHD.Methods:From December 2017 to February 2019,469 patients who underwent CAG surgery in the Departments of Endocrinology and Cardiology of the First Affiliated Hospital of Xi'an Medical College were collected,including 105 patients in the group of T2DM+CHD,164 patients in the group of CHD,92 patients in the group of T2DM alone,108 healthy patients in the group of neither T2DM nor CHD.Serum 25?OH?D₃levels were detected by ELISA and graded,?comparing the 25?OH?D₃ levels of subjects in the four groups;?having the correlation between 25?OH?D₃ levels and glucose or lipid metabolism indicators;?having the correlation between 25?OH?D₃ levels and coronary artery lesions;?doing the multiple linear regression analysis of 25?OH?D₃ levels with demographic characteristics,biochemical indicators,Gensini scores and other indicators;?doing the Logistic regression analysis of influencing factors about coronary heart disease.Results:1?General data showed that?1?Serum 25?OH?D₃ level was significantly lower in T2DM+CHD group,pure CHD group and pure T2DM group than in healthy group?P<0.05?,but there was no significant difference between T2DM+CHD group and pure CHD group?P>0.05?.?Gensini score in the T2DM+CHD group and the pure CHD group was higher than that in the healthy group?P<0.05?,but there was no significant difference between T2DM+CHD group and pure CHD group?P>0.05?.2?Linear regression analysis of serum 25?OH?D₃ and Gensini integral showed that25?OH?D₃ has-0.239 effect on Gensini integral of coronary angiography.The regression model has statistical significance?F=16.187,P=0.000?,and the regression equation is that Gensini integral=51.634-1.048*25?OH?D₃.3?According to the level of serum 25?OH?D₃,the subjects were divided into three subgroups.For 25?OH?D₃ deficiency,insufficiency and adequacy,the incidence of25?OH?D₃ deficiency decreased in the T2DM+CHD group and the pure CHD group.25?OH?D₃ adequacy was the highest in healthy subjects?43.5%?.It is suggested that25?OH?D₃ deficiency is a risk factor for CHD,regardless of whether it is combined with T2DM or not.4?According to the level of serum 25?OH?D₃,the subjects were divided into three subgroups.The results showed that:?1?There were significant differences in FBG,HbA1C,HOMA-IR,HDL,APO-A1,TG and Hcy among the three subgroups?P<0.05?.FBG,HbA1C and HOMA-IR increased more significantly in the deficient group and the insufficient group than in the sufficient,on the contrary,HDL was higher in the deficient group than in the insufficient group and the sufficient group.?2?Serum 25?OH?D₃ levels were negatively correlated with BMI?r=-0.141,P=0.007?,FBG?r=-0.13,P=0.007?,Hcy?r=-0.295,P=0.007?,Gensini integral?r=-0.133,P=0.029?,T2DM?r=-0.15,P=0.014?.5?Gensini score decreased in turn in the three subgroups,and the difference was statistically significant?P<0.05?,suggesting that the lower the serum 25?OH?D₃ level,the higher the Gensini score,the more severe the coronary artery stenosis.6?25?OH?D₃ level was negatively correlated with demographic characteristics,biochemical indicators,Gensini score and multiple linear regression analysis.The results showed that:?1?Serum 25?OH?D₃ level was negatively correlated with the number of lesion branches?r=-0.325?,Hcy?r=-0.361?,Gensini score?r=-0.429??P<0.05?.?2?Multiple linear regression analysis ofserum 25?OH?D₃ level about the influencing factors showed that the regression model of serum 25?OH?D₃ level had statistical significance?P<0.05?,and that 25?OH?D₃ level=2.164-0.014*number of lesion branches-0.006*Gensini score-0.018*Hcy.7?Logistic regression analysis showed that smoking was a risk factor for coronary heart disease?CHD?,while 25?OH?D₃ was a protective factor for CHD.Conclusions:It studied the correlation between serum 25?OH?D₃ levels and coronary artery lesions in patients undergoing CAG.Obtained:1.Serum 25?OH?D₃ levels were negatively correlated with FBG and T2DM,suggesting that 25?OH?D₃ deficiency may increase the risk of T2DM.2.Serum 25?OH?D₃ level was negatively correlated with Gensini score and Hcy,suggesting that 25?OH?D₃ deficiency may increase the risk of cardiovascular and cerebrovascular diseases.