Correlation among serum levels of 25 (OH)D,HbA1c,Hcy and intracranial arterial stenosis severity in patients with diabetes mellitus / 心血管康复医学杂志

ABSTRACT

Objective:To explore correlation among serum levels of 25-hydroxyl vitamin D [25(OH)D],glycosylated hemoglobin (HbA1c),homocysteine (Hcy)and severity of intracranial arterial stenosis (ICAS)in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 120 T2DM patients,whose ICAS was confirmed by transcranial Doppler ultrasound (TCD),were selected.According to TCD results,they were divided into stenosis group (n=45)and non-stenosis group (n= 75).Levels of blood glucose,blood lipids,serum 25 (OH)D,HbA1c and Hcy were measured and compared between two groups.Correlation among serum levels of 25(OH)D,HbA1c,Hcy and ICAS severity,and predictive value of these indexes for ICAS in T2DM patients were analyzed.Results:Compared with non-stenosis group,there were significant rise in age > 60 years (40.0% vs.60.0%),disease course > 5 years (36.0% vs.62.2%),smoking history (26.7% vs.46.7%),drinking history (36.0% vs.62.2%),percentages of CHD (25.3% vs.46.7%)and hypertension (26.7% vs.44.4%)in stenosis group,P <0.05 or <0.01. Compared with non-stenosis group,there were significant reductions in serum levels of high density lipoprotein cholesterol [(1.80±0.31)mmol/L vs.(1.02±0.23)mmol/L]and 25(OH)D [(68.37±15.29)nmol/L vs.(34.32±8.63) nmol/L],and significant rise in serum levels of low density lipoprotein cholesterol [(3.02 ± 0.75)mmol/L vs. (3.79±0.82)mmol/L],HbA1c [(6.35±2.36)% vs.(7.60 ±2.90)%]and Hcy [(10.24±3.98)μmol/L vs. (15.91±4.26)μmol/L]in stenosis group,P <0.05 or <0.01. Spearman correlation analysis indicated that ICAS severity was significant inversely correlated with serum 25(OH)D level (r = -0.840,P =0.001 ),and significant positively correlated with serum HbA1c,Hcy levels (r =0.454,0.812,P =0.023,0.001 ).ROC curve indicated that sensitivity and specificity of serum 25 (OH)D level predicting ICAS was 79.4% and 100% respectively;it's 40.3% and 67.6% for serum HbA1c,70.3% and 79.4% for serum Hcy.Conclusion:In T2DM patients with ICAS, serum 25(OH)D,HbA1c and Hcy levels are significantly correlated with ICAS,which can predict ICAS risk.