Correlation risk analysis of serum inflammatory factors and 25-hydroxyvitamin D in vascular lesions in type 2 diabetes patients

TL;DR

This study finds that lower vitamin D and higher inflammation are linked to vascular complications in type 2 diabetes patients.

Contribution

The study identifies specific inflammatory markers and vitamin D levels as risk factors for microvascular and macrovascular lesions in T2DM.

Findings

25(OH) D levels are significantly lower in T2DM patients with vascular lesions compared to those without.

CRP and IL-6 are elevated in macrovascular lesions, while IL-6 is elevated in microvascular lesions.

25(OH) D negatively correlates with inflammatory markers like CRP and IL-6.

Abstract

To explore serum inflammatory factors and 25-hydroxyvitamin D and diabetic vascular lesions in patients with T2DM.

A total of 362 adult (aged 18 years) patients with T2DM hospitalised from April 2022 to June 2024 were selected as research subjects. A patient's body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), age, sex, and length of illness were among the general data gathered. Blood parameters, glycated haemoglobin (HbA1c), fasting blood glucose (FPG), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6)], and 25-hydroxyvitamin D [25(OH) D] were determined. The homeostatic model assessment of insulin resistance index (HOMA-IR) and the systemic inflammatory index (SII) were computed. The vascular lesions were divided into three groups: the simple T2DM group (155 patients), the T2DM microvascular lesion group (122 patients), and the T2DM macrovascular lesion group (85 patients). One-way analysis of variance, the Kruskal-Wallis H test, or the c2 test was used for comparisons among multiple groups. The relationship between 25(OH) D and several inflammatory markers was examined using Spearman correlation analysis, and the factors influencing diabetic vascular lesions were analysed using multivariate logistic regression analysis.

The levels of 25(OH) D in both the T2DM microvascular lesion group and the T2DM macrovascular lesion group were significantly lower than those in the simple T2DM group (P<0.05). The level of IL-6 in the T2DM microvascular lesion group was significantly greater than that in the simple T2DM group (P<0.05). Compared to the simple T2DM group and the T2DM microvascular lesion group, the T2DM macrovascular lesion group had significantly higher levels of CRP IL-6, and the SII (P< 0.05). Multivariate logistic regression analysis results showed that after controlling for confounding variables. With the simple T2DM group as the reference, CRP (OR= 5.35, 95% CI 1.49-19.13) and 25(OH) D (OR= 0.88, 95% CI 0.78-0.98) were the influencing factors of microvascular lesions in T2DM patients; CRP IL-6, SII, and 25(OH) D were influencing factors of macrovascular lesions in type 2 diabetes mellitus (T2DM) patients (OR = 14.99, 95% CI 2.84-79.13; OR= 27.92, 95% CI 4.24-183.92; OR= 1.01, 95% CI 1.00-1.02; OR= 0.74, 95% CI 0.60-0.92). Spearman correlation analysis revealed a negative correlation between CRP and IL-6 (r= 0.600, P<0.001) and between CRP and the SII (r= 0.256, P<0.001), while IL-6 showed a positive correlation with the SII (r= 0.307, P< 0.001). Additionally, 25(OH) D had a negative correlation with CRP (r=-0.102, P= 0.052), IL-6 (r=-0.115, P= 0.028), and the SII (r=-0.141, P=0.007).

Compared with those in patients with T2DM microvascular lesions, the levels of the inflammatory factors CRP and IL-6 and the SII in the serum of patients with T2DM macrovascular lesions are greater, and the level of 25(OH) D is lower.