摘要
Abstract
Objective:Diabetic nephropathy is a common and severe microvascular complication of diabetes and a leading cause of end-stage renal disease(ESRD).Its incidence has been rising alongside the prevalence of diabetes,making early intervention crucial.This study aims to explore the association between serum 25-hydroxy-vitamin D[25(OH)D]levels and albumin-to-creatinine ratio(ACR)in patients with Type 2 diabetes mellitus(T2DM).
Methods:A total of 508 hospitalized T2DM patients with serum creatinine levels ranging from 50 to 90 μmol/L,admitted to Xiamen Humanity Hospital between January 1,2022,and October 1,2024,were enrolled in the study.Among them,313 were male and 195 female,aged 20 to 80 years.Based on ACR,the patients were divided into a normal albuminuria group(ACR<30 μg/mg,DM group,n=392)and a microalbuminuria group(30 μg/mg≤ACR<300 μg/mg,DN group,n=116).ACR,glycated hemoglobin,triglycerides,low-density lipoprotein,blood pressure,and bone mineral density were measured and analyzed.
Results:Compared with the DM group,the DN group showed significantly higher rates of hypertension and smoking,and significantly lower 25(OH)D(all P<0.05).Logistic regression analysis showed that blood pressure,smoking,and 25(OH)D levels were significantly associated with early diabetic nephropathy(all P<0.05).Pearson correlation analysis indicated a weak negative correlation between 25(OH)D and ACR(r=-0.2796,P<0.05).Receiver operating characteristic(ROC)curve analysis revealed an area under the curve(AUC)of 0.684(95%CI 0.624 to 0.743,P<0.05)for 25(OH)D in predicting early diabetic nephropathy,and combining it with hypertension improved the sensitivity.Restricted cubic spline(RCS)curve analysis demonstrated a nonlinear inverse association between 25(OH)D levels and the risk of diabetic nephropathy(P for overall<0.001,P-Nonlinear=0.001).When 25(OH)D was below 45.605 nmol/L,there was a significant inverse correlation with the incidence of early microalbuminuria(P-Nonlinear=0.04).
Conclusion:In patients with T2DM,serum 25(OH)D levels are associated with early renal impairment as indicated by microalbuminuria.25(OH)D may serve as a potential predictor for the progression of diabetic nephropathy.关键词
糖尿病肾病/微量蛋白尿/尿蛋白/肌酐值/高血压/25-羟维生素DKey words
diabetic nephropathy/microalbuminuria/albumin-to-creatinine ratio/hypertension/25-hydroxy-vitamin D
