The Expression Level Of 25-Hydroxyl Vitamin D3 And The Correlation With Type 2 Diabetes Mellitus With Colorectal Cancer

Objective: To explore the level of serum 25 hydroxyvitamin D,glucose metabolism index,tumor marker level and tumor pathological characteristics in patients with type 2 diabetes mellitus and colorectal cancer,and analyze the relationship between serum 25 hydroxyvitamin D3 and type 2 diabetes mellitus and colorectal cancer,so as to provide basis for the prevention and treatment of colorectal cancer in patients with type 2 diabetes mellitus.Methods:1.Non diabetic and non colorectal cancer control group(group A),admitted colorectal cancer patients(group B),T2 DM patients(Group C),T2 DM patients with colorectal cancer(Group D)were selected as the study objects.2.The age,gender,body mass index(BMI)and other general clinical data were measured and recorded.Biochemical analysis was used to determine fasting blood glucose(FPG),fructosamine(FMN)and other glucose metabolism indexes;total protein(TP),albumin(ALB),globulin(GLB),alanine aminotransferase(ALT),glutamyltranspeptidase(?-GT),alkaline phosphatase(ALP or AKP)and other liver function indexes;urea(BUN / urea),uric acid(UA),creatinine(CR)and other renal function indexes;serum total bile Cholesterol(TC),triglyceride(TG)and other blood lipid indexes;calcium(CA)and phosphorus(P)electrolyte indexes;chemiluminescence determination,carcinoembryonic antigen(CEA),glycosyl antigen 19-9(CA19-9),carbohydrate antigen 724(CA72-4)and other tumor markers;chemiluminescence immunoassay determination of serum 25(OH)D3 level;record of patients with T2 DM and colorectal cancer(Group D),colorectal cancer The pathological characteristics of rectal cancer patients(group B)were analyzed by spss23.0.ANOVA was used to compare the measurement data among multiple groups;chi square test was used to compare the counting data among multiple groups;Pearson method or Spearman method was used to analyze the correlation;multiple linear stepwise regression analysis or logistic regression analysis was used to analyze the influencing factors;if the test level was = 0.05,bilateral test was used(P < 0.05),the difference was statistically significant.Results: 1.Comparison of general data among the four groups: there was statistical difference in age and BMI(P < 0.05).The follow-up data were compared with covariance analysis to eliminate the influence of age and BMI on the results.2.Comparison of biochemical data among four groups: compared with group A(73.80 ± 4.36),the total protein(TP)of group B(67.08 ± 7.05),group C(67.68 ± 4.51),and group D(66.90 ± 5.43)decreased(P < 0.05);compared with group A(45.45 ± 2.38),the alb of group B(38.56 ±5.31),group C(40.61 ± 2.74),group D(40.18 ± 4.62)decreased(P < 0.05);compared with group A(28.36± 3.67),.61)Fructosamine(FMN)increased(P < 0.05);compared with group A(4.33 ± 0.71),serum cholesterol(TC)in group D(3.89 ± 0.95)decreased(P < 0.05);compared with group A(1.43 ± 0.31),HDL-C in group B(1.22 ± 0.24)and group D(1.16 ± 0.28)decreased(P < 0.05),compared with group A(1.22 ± 0.23),HDL-C in group B(1.04 ± 0.20)and group C(1.04 ± 0.17))ApoA decreased in group D(1.09 ± 0.25)(P < 0.05);compared with group A(2.35 ± 0.11),serum CA decreased in group B(2.23 ±0.14)and group D(2.24 ± 0.15)(P < 0.05).Compared with group A(1.15 ± 0.13),group B(1.05 ± 0.18)had lower serum phosphorus(P)(P < 0.05).3.Comparison of tumor markers among the four groups:compared with group A(2.26 ± 1.71),CEA of group B(19.74 ± 44.84)and group D(12.44 ± 31.56)increased(P < 0.05);compared with group A(9.49 ± 7.83),CEA of group B(25.45 ± 42.13)and group D(27.63 ± 32.44)increased(P < 0.05).4.Comparison of 25(OH)D3 among four groups: compared with group A(37.18(26.49,71.33)),25(OH)D3 in group B(26.96(16.53,40.26))and group C(27.99(22.32,41.58))and group D(28.88(17.35,39.75))decreased(P < 0.05).5.25(OH)D3 correlation: Spearman correlation analysis found that 25(OH)D3 was negatively correlated with age r =-0.225,P = 0.004,negatively correlated with diabetes history r =-0.275,P < 0.001,positively correlated with albumin r =0.214,P = 0.007,The positive correlation with HDL was r = 0.175,P = 0.027,with serum calcium was r =0.310,P < 0.001,with total bilirubin was r = 0.209,P = 0.008,with alkaline phosphatase was r =-0.249,P= 0.002,with total bile acid was r =-0.167,P = 0.035,with glucose was r =-0.205,P = 0.009.25(OH)D3was negatively correlated with carbohydrate antigen 19-9(r =--0.191,P = 0.015)and colorectal cancer stage(r =-0.265,P = 0.018).6.Logistic regression analysis: single factor Logistic regression showed that age,FPG,CEA,CA19-9 increased,HDL-C,25(OH)D3,TC decreased were the risk factors of CRC combined with T2DM(or values were 1.150,2.393,1.570,1.078,0.022,0.982,0.403,respectively).Conclusion: 1.The decrease of 1.25(OH)D3 level is related to the occurrence of T2 DM combined with CRC,T2 DM and CRC.The low expression of 25(OH)D3 may promote the progression of CRC malignancy.2.Old age and high FPG are the risk factors that affect the occurrence of CRC with T2 DM.Therefore,T2 DM patients with old age,low ALB and low HDL-C should pay attention to the screening of CRC tumor indicators to prevent the occurrence and development of CRC.