Association between serum vitamin D level and inflammatory markers in non-obese patients with type 2 diabetes / 中国基层医药

ABSTRACT

Objective To investigate the association between serum 25(OH)D3 and high sensitive C -reac-tive protein (hs-CRP),tumor necrosis factor -alpha (TNF-α),interleukin-6 (IL-6) inflammatory markers in non-obese patients with type 2 diabetes mellitus (T2DM).Methods From June 2015 to September 2015,in this cross-sectional study,120 non-obese patients with T2DM(female in 58 cases,male in 62 cases) in Taiyuan Central Hospital were selected as T2DM group,and 120 non-obese patients with T2DM and 96 healthy subjects ( control group) were recruited.The serum concentrations of glucose,HbA1c,insulin,25( OH) D3 and inflammatory markers including TNF-α,IL-6 and hs-CRP were measured.A homeostatic model of insulin resistance (HOMA-IR) was also evaluated.The clinical and biochemical characteristics of T 2DM were observed in the group of vitamin D deficien-cy group,vitamin D insufficiency group and vitamin D normal group.And the relativities were analyzed between it with hs-CRP,TNF-α,IL-6,HOMA-IR,INF,FBG,BMI,WHR,and so on.The relativities were observed between 25(OH)D3 with all the factors.Results The mean serum concentration of 25(OH)D3 in the non -obese T2DM group was (10.65 ±3.55)ng/mL,which was significantly lower than (18.44 ±5.21)ng/mL in the normal control group (t＝-6.84,P ＝0.012).The levels of serum TNF -αand IL -6 in the T2DM group were (15.51 ± 4.87)ng/L and (18.12 ±4.13) ng/L,respectively,which were significantly higher than those in the control group [(8.99 ±2.54)ng/L,(8.89 ±2.07)ng/L](t＝7.95,10.04,P＝0.017,0.007).The proportions of deficiency,insufficiency and normal of vitamin D in T2DM patients were 60.83%,31.67%and 7.50%,respectively .The levels of TNF-αand IL-6 in the serum 25(OH) D3 deficiency group were significantly higher than those in the normal 25(OH)D3 group [(17.93 ±4.94)ng/L vs.(10.30 ±4.52)ng/L,F＝6.897,P＝0.026;(20.14 ±4.99)ng/L vs. (16.39 ±5.06)ng/L,F＝10.589,P＝0.017].There was a significant correlation between serum 25(OH)D3 and HOMA-IR(r＝-0.041;P＝0.030),TNF-α(r＝-0.229;P＝0.040) and IL -6 levels (r＝-0.299;P＝0.032),but there was no significant correlation with inflammatory factor hs -CRP and fasting blood glucose. Conclusion Vitamin D deficiency is common in patients with T2DM,and systemic chronic inflammation may also play an important role in the pathogenesis of T 2DM.This study shows that vitamin D may play an important role in the pathogenesis of insulin resistance and chronic systemic inflammatory response,an important pathogenesis of T2DM.