The Relationship Between 25-(OH)D And OPG In Patients With Type 2 Diabetes With Peripheral Arterial Disease And The Effect Of Vitamin D Intervention

Objective To explore the changes of serum 25-(OH)D and OPG levels in patients with T2 DM and PAD,and their relationship with glucose metabolism and lipid metabolism indexes.At the same time,short-term supplementation of Vit D3 in T2 DM patients with vitamin D deficiency or insufficiency and PAD was conducted to explore their effects on glucose,lipid metabolism and OPG levels in patients with T2 DM and PAD.Methods A total of 108 patients diagnosed with type 2 diabetes were selected from the Department of Endocrinology,the Third Affiliated Hospital of Inner Mongolia Medical University from October 2018 to March 2019(ABI < 0.9),51 patients in the non-PAD group(0.9 ? ABI <1.4),40 healthy people in the NC group during the same period,performed OPG,25-(OH)D,FBG,Hb Al C,TC,TG,LDL-c,HDL-c,BMI,FINS,HOMA-IR indicators to determine and record age,gender,height,weight,course of illness,whether smoking.Pearson method was used to analyze the correlation of 25-(OH)D and OPG with glucose metabolism and lipid metabolism indexes,and Logistic regression was used to analyze the risk factors of patients with T2 DM and PAD.Subjects with vitamin D deficiency and deficiency were given vitamin D3 supplementation,and 3 months later,the patients in the PAD group(32 cases)with Vit D3 supplementation were revisited to compare changes in various indicators after supplementation with Vit D3.Results 1.There was no significant difference in sex ratio among the three groups(P > 0.05).Compared with the NC group,the age,BMI,FBG,Hb Al C,FINS,HOMA-IR,TG,TC,LDL-c,OPG and smoking rates in the non-PAD group and PADgroup were increased(P < 0.05),HDL-c,25-(OH)D decreased(P < 0.05).The age,BMI,FBG,Hb Al C,FINS,HOMA-IR,OPG and smoking rates of the PAD group were higher than those of the non-PAD group(P < 0.05),HDL-c and 25-(OH)VD were lower than those of the non-PAD group P < 0.05),TG,TC,LDL-c in PAD group was higher than that in non-PAD group,but the difference was not statistically significant(P > 0.05).Patients in the PAD group had a longer disease course than the non-PAD group,and the ABI value was lower than that in the non-PAD group(P < 0.05).2.Compared with the NC group,the 25-(OH)D deficiency rate in the non-PAD group and the PAD group increased to varying degrees,and the serum25-(OH)D deficiency rate in the PAD group was significantly higher than that in the non-PAD group(P < 0.05).3.Correlation analysis: 25-(OH)D was negatively correlated with OPG,FBG,Hb Al C,HOMA-IR.OPG is positively correlated with FBG,Hb Al C and HOMA-IR.4.Logistic regression analysis: 25-(OH)D,OPG,age and smoking history are independent predictors of peripheral vascular disease in type 2 diabetes.25-(OH)D is a protective factor.OPG,age and smoking history are risk factors.5.Return visit: Compared with before treatment,25-(OH)D level increased after treatment,OPG level decreased,the difference was statistically significant(P < 0.05),and the other indicators were not significantly different(P > 0.05).Conclusion 1.Vitamin D levels in patients with T2 DM decrease,and gradually decrease with the progression of peripheral vascular disease.2.Serum OPG levels in T2 DM patients increased,and gradually increased with the progress of peripheral vascular disease.3.OPG is associated with the severity of T2 DM combined with PAD,and 25-(OH)D is negatively correlated with OPG.4.By supplementing vitamin D,OPG levels can be reduced.