Abstract：Objective: To investigate the clinical efficacy and mechanism of calcitriol combined with metformin in the treatment of type 2 diabetes mellitus(T2DM) patients with abdominal obesity and early diabetic nephropathy(EDN).Methods: 80 T2DM patients with abdominal obesity and EDN were selected and divided into observation group and control group according to the random number table method, 40 patients in each group.The observation group was treated with calcitriol combined with metformin, while the control group was treated with metformin. Waistline, body mass index, fasting plasma glucose, calcium, phosphorus,glycosylated hemoglobin(HbAlc), leptin(LP), adiponectin(ADP), urinary microalbumin/creatinine (ACR) and 25-(OH)D3 were compared between the two groups before and after treatment. Pearson corelation analysis was used to analyze the correlation between serum 25-(OH)D3 level and ACR. Results: Waistline, BMI, FPG, HbAlc, LP and ACR were significantly decreased in the two groups after treatment, and 25-(OH)D3 and ADP were significantly increased(P<0.05).Compared with the control group, waistline, BMI, FPG , HbAlc, LP and ACR were significantly decreased, while 25-(OH)D3 and ADP were significantly increased in the observation group(P<0.05). Conclusion: Early combination of calcitriol and metformin in T2DM patients with abdominal obesity can increase the level of 25-(OH)D3 and reduce urinary protein, which may be related to the regulation of ADP and LP levels。
[1] Senyigit A. The association between 25-hydroxy vitamin D deficiency and diabetic complications in patients with type 2 diabetes mellitus[J]. Diabetes Metab Syndr,2019,13(2):1381-1386. [2] Santos LR , Lima AGA , Braz AF , et al. Role of vitamin D in insulin resistance in obese individuals[J]. Nutrire, 2017, 42(1):17-22. [3] American Diabetes Association. Improving care and promoting health in populations: standards of medical care in diabetes-2018[J]. Diabetes Care, 2018,41(Suppl 1):S7-S12. [4] Ma RCW. Epidemiology of diabetes and diabetic complications in China[J]. Diabetologia,2018,61(6):1249-1260. [5] Zoppini G, Galletti A, Targher G, et al. Lower levels of 25-hydroxyvitamin D3 are associated with a higher prevalence of microvascular complications in patients with type 2 diabetes[J]. BMJ Open Diabetes Res Care,2015,3(1):e000058. [6] 高婷,陈培红,金华,等.新诊断的2型糖尿病患者血清25-(OH)D水平与体脂分布的相关性分析[J].山东医药,2014,54(6):4-7. [7] Zha D, Wu X, Gao P. Adiponectin and its receptors in diabetic kidney disease: molecular mechanisms and clinical potential. endocrinology[J]. 2017,158(7):2022-2034. [8] Rodriguez AJ, Nunes Vdos S, Mastronardi CA,et al.Association between circulating adipocytokine concentrations and microvascular complications in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of controlled cross-sectional studies[J]. Diabetes Complications,2016,30(2):357-367. [9] Naini AE, Vahdat S, Hedaiati ZP,et al.The effect of vitamin D administration on serum leptin and adiponectin levels in end-stage renal disease patients on hemodialysis with vitamin D deficiency: a placebo-controlled double-blind clinical trial[J].Res Med Sci,2016,21(1):1-6. [10] 何立芳,李青科,张秀香,等.骨化三醇对糖尿病肾病患者尿白蛋白排泄率影响的研究[J].河北医科大学学报,2017,38(2):142-145.
2020, Vol. 26 
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