| ObjectiveThe mortality rate of type 2 diabetes mellitus combined with infection is high and the treatment is difficult.Vitamin D has important functions such as regulating immunity,anti-inflammation and improving metabolism.However,vitamin D deficiency is common in China,especially in patients with T2DM.Studies have reported that there is a correlation between T2DM,infection and vitamin D deficiency.Therefore,this study analyzed the clinical characteristics of T2DM combined with infection,the correlation between serum 25-hydroxyvitamin D and T2DM combined with infection,as well as the analysis of risk factors,in order to provide new ideas for the prevention,diagnosis and treatment of T2DM combined with infection.MethodsRetrospective analysis was conducted on T2DM patients hospitalized in the Department of Endocrinology of Jinan Central Hospital from January 2019 to January 2021.We screened 301 patients with complete data,reviewed their electronic medical records and examination reports and accurately recorded general information and the examination results.The subjects were divided into two groups according to whether they were combined with infection or not:infected group and non-infected group.According to serum 25(OH)D level,the subjects were divided into four groups:normal group(≥75nmol/L),mild deficiency group(≥50nmol/L,<75nmol/L),moderate deficiency group(≥25nmol/L,<50nmol/L),and severe deficiency group(<25nmol/L).SPSS26 was used for statistical analysis.For the data with normal distribution,t test was used for the analysis of two groups,and one-way ANOVA analysis was used for the analysis of multiple groups.The nonparametric rank sum test was used for the data that did not fit the normal distribution.Spearman correlation test was used to analyze the correlation between 25(OH)D and other indicators.Risk factors of T2DM complicated with infection were analyzed by multivariate Logistic regression analysis.Results1.There were no significant differences in gender,smoking,alcohol consumption,systolic blood pressure,diastolic blood pressure,cerebral infarction,diabetic nephropathy,TG,TC,HDL-C,LDL-C,APOA1 and APOB between the infected group and the non-infected group(P>0.05).In the infected group,the age,course of diabetes mellitus,coronary heart disease,hypertension,peripheral nerve complications,peripheral vascular complications and retinopathy,length of hospital stay,duration of antibiotic use,HCY,PCT,CRP,FPG,PG2h and HbAlc levels were all higher than those in the non-infected group.The difference was statistically significant(P<0.05).The serum 25(OH)D level in the infected group was lower than that in the non-infected group,and the difference was statistically significant(P<0.05).2.There was no statistical significance in gender,smoking,alcohol consumption,systolic blood pressure,diastolic blood pressure,length of hospital stay,complicated hypertension and cerebral infarction,diabetic retinopathy,diabetic nephropathy,PCT,TG,TC,HDL-C,LDL-C and APOB levels among 25(OH)D groups(P>0.05).Patients with lower 25(OH)D level had higher age,course of diabetes,combined coronary heart disease,peripheral nerve complications and peripheral vascular complications,combined infection,duration of antibiotic use,HCY,CRP,FPG,PG2h,HbA1c,TG and APOA1 levels,and the differences were statistically significant(P<0.05).3.Spearman correlation analysis showed that the serum 25(OH)D level in patients with diabetes complicated with infection was positively correlated with HDL-C and APOA1,and negatively correlated with age,HCY,CRP,PCT,FPG,PG2h,HbA1c and TG levels.4.Binary Logistic regression analysis showed that elevated HCY level(>15umol/L),elevated PG2h level>11.1mmol/L)and coronary heart disease were risk factors for T2DM complicated with infection.5.The common types of T2DM combined infection were respiratory tract infection(45.2%),urinary tract infection(26.0%),and diabetic foot(17.1%).Among the isolated pathogens,Gram-negative bacteria accounted for 67.1%,among which Escherichia coli accounted for 32.9%,Gram-positive bacteria accounted for 28.9%,and Staphylococcus aureus accounted for 21.1%.Conclusions1.Compared with T2DM patients without infection,patients in the T2DM combined with infection group had lower serum 25(OH)D level,more severe vitamin D deficiency,older age,longer course of T2DM,more previous complications of coronary heart disease and hypertension,and more peripheral nerve,peripheral vascular and retinal complications,longer hospital stays,longer antibiotic use,and worse blood glucose control.2.Patients with more severe vitamin D deficiency had older age,longer duration of diabetes,more previous coronary heart disease,more peripheral nerve complications and peripheral vascular complications,higher proportion of co-infections,longer duration of antibiotic use,poorer glucose and lipid metabolism.3.In patients of T2DM combined with infection,the lower serum 25(OH)D level,the lower levels of HDL-C and APOA1,the older the patients,the higher the inflammatory markers and HCY,and the worse the glucose and lipid metabolism.4.Higher HCY level(>15umol/L),higher PG2h level(>11.1mmol/L)and coronary heart disease were the risk factors for T2DM combined with infection.5.The most common type of T2DM combined with infection was respiratory tract infection,followed by urinary tract infection and diabetic foot.The isolated pathogens were mainly Gram-negative bacteria,among which Escherichia coli was the most common,followed by Gram-positive bacteria,among which Staphylococcus aureus was the most common. |
