Relationship between serum 25-hydroxyvitamin D and indicators of glucose metabolism in inpatients with type 2 diabetes mellitus / 中华临床营养杂志

ABSTRACT

Objective To investigate the correlation between 25-hydroxyvitamin D [ 25 ( OH ) D ] and indicators of glucose metabolism in inpatients with type 2 diabetes mellitus .Method We retrospectively ana-lyzed the clinical records of 214 inpatients with type 2 diabetes mellitus , including age , body mass index (BMI), systolic blood pressure, diastolic blood pressure, and laboratory test results such as serum parathyroid hormone (PTH), 25(OH)D, creatinine, calcium, phosphorus, glycosylated hemoglobin A1c (HbA1c), fast-ing blood glucose , and fasting insulin .Results The prevalence of vitamin D deficiency was high in these pa-tients, with 47.2%of them having a serum 25(OH)D concentration lower than 10 ng/ml.Using 25(OH)D level less than 10 ng/ml as the cut-off point, the patients were divided into vitamin D severe deficiency (Vit-SD) group and vitamin D non-severe deficiency (Vit-NSD) group.Compared with the Vit-NSD group, the Vit-SD group had younger age [ (55.27 ±13.71) years vs.(60.76 ±12.32) years, P=0.001] and higher HbA1c level [ (9.00 ±2.01)% vs.(8.45 ±1.86)%, P=0.025].BMI [ (25.09 ±4.01) kg/m2 vs.(25.39 ± 3.53) kg/m2, P=0.523], fasting blood glucose [ (8.91 ±3.31) mmol/L vs.(8.16 ±3.02) mmol/L, P=0.063], fasting serum insulin [ (21.32 ±32.50) mIU/L vs.(21.92 ±26.95) mIU/L, P=0.873] and homeostasis model assessment of insulin resistance index (97.60 ±8.92 vs.7.53 ±9.39, P=0.954) in these two groups were with no statistically significant difference .The association analyses showed that HbA 1c was sig-nificantly negatively correlated with 25 ( OH ) D ( r =-0.190 , P=0.003 ) and not correlated with serum PTH, calcium, or phosphorus , after adjusting for age and creatinine .Multiple linear regression revealed that HbA1c had a significantly negative correlation with age (β=-0.220, P=0.000) and 25 (OH) D (β=-0.184 , P=0.000 ) .Conclusions There is high prevalence of vitamin D deficiency in inpatients with type 2 diabetes mellitus, which is even higher in relatively young patients .Serum 25 (OH) D may be negatively correlated with HbA1c in these patients independently from age , BMI, fasting serum insulin, and homeostasis model assessment of insulin resistance index .