Effects of 25（OH）VD3 on blood cell indexes and islet cell autoantibodies in patients with type 2 diabetes mellitus
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摘要: 目的：研究2型糖尿病（T2DM）患者25羟维生素D3[25（OH） VD3]水平与血细胞指标和胰岛细胞自身抗体数量相关性以及对胰岛细胞自身抗体影响。方法：回顾性分析六安市人民医院T2DM患者99例，收集患者性别、年龄、身高、体重、25（OH） VD3、生化、血常规指标、胰岛细胞自身抗体结果，根据25（OH） VD3水平分为3组，A组为正常组（≥30 ng/mL），B组为不足组（20~30 ng/mL），C组为缺乏组（<20 ng/mL），比较各组间检测指标结果差异，分析25（OH） VD3与血常规指标和胰岛细胞自身抗体数量相关性，并通过二元Logistic回归分析判断抗体阳性影响因素。结果：C组病程、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）均高于A组，胰岛素β细胞功能（HOMA-β）、25（OH） VD3均低于A组，C组病程、HbA1c均高于B组，25（OH） VD3均低于B组，C组中性粒细胞（N）、白细胞（WBC）、红细胞分布宽度（RDW）、平均血小板体积（MPV）、中性粒细胞/淋巴细胞比值（NLR）均高于A组，B组N、MPV高于A组，差异均有统计学意义（均P<0.05）。谷氨酸脱羧酶抗体（GADA）阳性率、抗体阳性率、>2种抗体阳性率随25（OH） VD3降低而增高，趋势有统计学意义（χ2=3.967~4.680，均P<0.05），胰岛细胞自身抗体阳性数量与N、NLR、WBC、MPV呈正相关，r值分别为0.276、0.317、0.309、0.189，与25（OH） VD3水平呈负相关，r值为-0.401（均P<0.05），NLR、25（OH） VD3均为胰岛细胞自身抗体影响因素。结论：T2DM患者25（OH） VD3浓度越低，胰岛细胞抗体阳性率越高，抗体数量越多，25（OH） VD3、NLR为胰岛细胞自身抗体产生的独立影响因素。Abstract: Objective: To study the correlation between the level of 25 hydroxyvitamin D3[25(OH) VD3]and blood cell indexes and the number of islet cell autoantibodies in patients with type 2 diabetes mellitus(T2 DM), and its effect on islet cell autoantibodies.Methods: A total of 99 T2 DM patients were retrospectively analyzed in our hospital, and the results of gender, age, height, weight, 25(OH) VD3, biochemistry, blood routine indexes, and islet cell autoantibodies were collected, the patients were divided into three groups according to 25(OH) VD3 level, group A was normal group, group B was insufficient group, group C was deficient group. The differences in the detection index results between the groups were compared, and the correlation between 25(OH) VD3 and the blood routine indexes and the number of islet cell autoantibodies were analyzed, and the influencing factors of antibody positive were judged by binary Logistic regression analysis.Results: The disease course, fasting blood glucose(FPG), glycosylated hemoglobin(HbA1 c), and HOMA-IR in group C were higher than those in group A, HOMA-β and 25(OH) VD3 were lower than those in group A, and the disease course and HbA1 c in group C were higher than those in group B and 25(OH) VD3 was lower that those in group B, the neutrophil(N), white blood cell(WBC), red blood cell distribution width(RDW), mean platelet volume(MPV) and neutrophil/lymphocyte ratio(NLR) in group C were higher than those in group A. The N and MPV in group B were higher than those in group A, the differences were statistically significant(all P<0.05). The positive rate of GADA, antibody, and>2 kinds of antibodies increased with the decrease of 25(OH) VD3, and the trend was statistically significant(χ2=3.967-4.680, all P<0.05). The number of islet cell autoantibodies positively correlated with N, NLR, WBC and MPV, the r values were 0.276, 0.317, 0.309 and 0.189, respectively, and negatively correlated with 25(OH) VD3 levels, the r value was-0.401(all P<0.05). The NLR and 25(OH) VD3 were the influencing factors of islet cell autoantibody.Conclusion: The lower the concentration of 25(OH) VD3 in T2 DM patients, the higher the positive rate of islet cell antibodies and the greater the number of antibodies, and 25(OH) VD3 and NLR were independent factors of islet autoantibody production.
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