An Investigation of the Level of Serum 25-Hydroxyvitamin D in Early Type 2 Diabetic Nephropathy and Its Relationship with Advanced Glycation End Products
CHEN Jiaoyue, SHAN Xiujie, LIU Min, et al
The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China
Abstract：Objective: To investigate the relationship between 25-hydroxyvitamin D [25 (OH) D3] levels and advanced glycation end products (AGEs) in patients with type 2 diabetic nephropathy. Methods: A total of 131 T2DM patients admitted from Nov. 2016 to Nov. 2018 were selected and divided into normal albuminuria group (n=46), microalbuminuria group (n=43) , and macroalbuminuria group (n=42) according to the urine microalbumin/creatinine value (UACR). 46 healthy volunteers were selected as the control group. The general clinical data and level of fasting blood glucose (FBG), urea nitrogen (BUN), creatinine (Scr), calcium (Ca), phosphorus (P), glycosylated hemoglobin (HbA1c), UACR, 25 (OH) D3, AGEs, and the soluble isoform receptor of AGE (sRAGE) were measured and compared. Results: The pairwise comparison between the four groups had significant difference with the 25-(OH)D3 levels of (35.78±4.99ng/mL,26.81±1.99ng/mL,24.10±4.41ng/mL, 20.63±4.60ng/mL, F = 108.228,P<0.01), AGEs levels of (27.85±9.57ng/L, 37.68±9.80ng/L,55.75±7.69ng/L,92.60±5.88ng/L,F =294.843,P<0.01), and sRAGE levels of (46.11±7.64ng/mL,36.79±8.88ng/mL,29.02±4.41ng/mL, 20.75±4.51ng/mL,F = 114.109,P<0.01). Pearson correlation analysis showed that 25-(OH)D3 was negatively correlated with BMI, WC, FBG, HbA1c, UACR and AGEs (r =-0.168,r =-0.337,r=-0. 662,r=-0.682,r=-0.535,r=-0.659, P<0.05 or 0.01), and positively correlated with sRAGE (r =0.691, P<0.01). Multiple stepwise regression analysis showed that WC, UACR, AGEs and sRAGE were independent influencing factors of 25-(OH)D3.Conclusion: 25-(OH)D3 decreased in the early diabetic nephropathy, and the decreased level was independently correlated with AGEs, which may be involved in the occurrence and development of early diabetic nephropathy through the AGEs-RAGE signaling pathway.
陈娇月, 山秀杰, 刘敏, 何建秋, 刘晓燕, 高宇, 韩桂艳. 2型糖尿病肾病早期血清25羟基维生素D水平及其与晚期糖基化终末产物的关系[J]. 河北医学, 2021, 27(1): 92-96.
CHEN Jiaoyue, SHAN Xiujie, LIU Min, et al. An Investigation of the Level of Serum 25-Hydroxyvitamin D in Early Type 2 Diabetic Nephropathy and Its Relationship with Advanced Glycation End Products. HeBei Med, 2021, 27(1): 92-96.
[1] 黄庆,韦彩城,杨大伟,等.2型糖尿病早期肾损伤患者血清Cys-C、HbA 1c及U-mAlb/Cr检测的意义[J].中国老年学杂志,2018,38(8):1817~1819. [2] 王雪.维生素D延缓糖尿病的研究进展[J]. 临床荟萃,2018,33(3):267~270. [3] Holick MF.The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention[J]. Rev Endocr Metab Disord, 2017,18(2):153~165. [4] Derakhshanian H, Shab-Bidar S, Speakman JR, et al.Vitamin D and diabetic nephropathy: a systematic review and meta-analysis[J]. Nutrition, 2015,31(10):1189~1194. [5] Chung S,Kim M,Koh ES,et a1.Serum 1,25-dihydroxyvitamin D better reflects renal Parameters than 25-hydoxyvitamin D in patients with gIomemlar diseases[J].Int Med Sci,2017,14(11):1080~1087. [6] Rafiq R, Walschot F, Lips P,et al.Associations of different body fat deposits with serum 25-hydroxyvitamin D concentrations. Clin Nutr,2019,38(6):2851~2857. [7] Kumar Pasupulati A, Chitra PS, Reddy GB. Advanced glycation end products mediated cellular and molecular events in the pathology of diabetic nephropathy[J]. Biomol Concepts,2016,7(5-6):293~309. [8] ZHU YX,SHU TT,LIN Y,et a1.Inhibition of the receptor for advanced glycation endproducts(RAGE)protects pancreatic beta-cells[J].Biochem Biophys Res Commun,2011,404(1):159~165. [9] 叶成松,叶山东,王贻坤.皮肤晚期糖基化终末产物与糖尿病慢性肾脏疾病的相关性研究[J].中国糖尿病杂志,2013,21(10):877~879. [10] Osawa S, Katakami N, Sato I, et al. Skin autofluorescence is associated with vascular complications in patients with type 2 diabetes[J].Diabetes Complications, 2018,32(9):839~844. [11] Sharma I,Tupe RS,Wallner AK, et al.Contribution of myo-inositol oxygenase in AGE:RAGE-mediated renal tubulointerstitial injury in the context of diabetic nephropathy[J]. Am Physiol Renal Physiol,2018,314(1): F107~F121. [12] Cheng M, Liu H, Zhang D, et al. HMGB1 enhances the AGE-induced expression of CTGF and TGF-β via RAGE-dependent signaling in renal tubular epithelial cells[J].Am Nephrol,2015,41(3):257~266. [13] 汪琼,金国玺,裴晓艳,等.血清可溶性晚期糖基化终产物受体与2型糖尿病肾病的相关性研究[J].齐齐哈尔医学院学报,2017,38(23):2732~2735. [14] Jhee JH, Nam KH, An SY,et al.Severe vitamin D deficiency is a risk factor for renal hyperfiltration[J]. Am Clin Nutr,2018,108(6):1342~1351. [15] Park M, Yoon E, Lim YH, et al. Renal hyperfiltration as a novel marker of all-cause mortality[J].Am Soc Nephrol,2015,26(6):1426~1433. [16] Krivosikova Z, Gajdos M, Sebekova K. Vitamin D levels decline with rising number of cardiometabolic risk factors in healthy adults: association with adipokines, inflammation, oxidative stress and advanced glycation markers[J].PLoS One,2015, 10(6): e0131753.
2021, Vol. 27 
冀公网安备13080202000677号