Abstract
The correlation between serum 25-hydroxy vitamin D (25(OH)D) levels and lower extremity atherosclerotic disease and the predictive value of 25(OH)D for early-stage lower extremity atherosclerotic disease in patients with type 2 diabetes mellitus (T2DM) were explored. In total, 620 subjects (590 T2DM patients and 30 healthy subjects) completed a questionnaire. All subjects were divided into four groups according to serum 25(OH)D concentration quartile: Q1 (<12.18 ng/ml), Q2 (12.18~20.65 ng/ml), Q3 (20.65~31.97 ng/ml), and Q4 (>31.97 ng/ml). Participants were also divided into four groups based on the degree of lower extremity arteriostenosis: A1 (T2DM), A2 (T2DM with mild lower extremity vascular lesions (LEVL)), A3 (T2DM with moderate LEVL), and A4 (T2DM with severe LEVL). The incidence of lower extremity artery plaque was significantly higher in groups Q1 and Q2 than in group Q4 (both P < 0.05). The concentration of 25(OH)D was significantly lower in group A4 than in groups A1 and A2. Pearson correlation analysis revealed that the degree of lower extremity vascular stenosis was positively correlated with age, smoking, and HbA1c, CRP, and LDL-C levels and negatively correlated with 25(OH)D concentrations. Logistic regression analysis demonstrated that 25(OH)D concentrations exerted a protective effect against LEVL in T2DM patients. Serum 25(OH)D concentrations may be correlated with the incidence of macrovascular disease in T2DM patients. A low serum 25(OH)D concentration is an independent risk factor for lower extremity vascular pathological changes and acts as a prognostic index for lower extremity atherosclerotic disease.
Highlights
Diabetic atherosclerosis (AS), especially lower extremity macrovascular complications, which is the primary cause of lower extremity amputation is one of the most severe diabetic complications [1]
Zhou et al reported that a low level of 25(OH)D is significantly associated with the occurrence of type 2 diabetes mellitus (T2DM) complicated with lower extremity arterial disease (LEAD) [9], this study focused on only the association of vitamin D with T2DM complicated with noticeable LEADs and did not explore the preventive index of early lower extremity AS in diabetes patients
The T2DM group showed significant differences in Body mass index (BMI), HbA1C, blood glucose before and after food intake, triglycerides (TGs), total cholesterol (TC), and γ-GGT compared with the same parameters in the normal control group
Summary
Diabetic atherosclerosis (AS), especially lower extremity macrovascular complications, which is the primary cause of lower extremity amputation is one of the most severe diabetic complications [1]. Ultrasound, computed tomography angiogram (CTA), magnetic resonance angiography (MRA), digital subtraction angiography (DSA), and ankle-brachial index (ABI) are used to assess the state of the lower extremity arteries. These techniques are associated with complex examination procedures and high cost. These techniques require specialized equipment and professional operators and have many requirements in terms of techniques and equipment. They are not proper for the early
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