Correlation of serum 25(OH)D3 and IGF-1 levels with glycolipid metabolism and predictive value of retinopathy in elderly patients with type 2 diabetes mellitus
Objective To investigate the correlation between 25-hydroxyvitamin D3(25(OH)D3),insu-lin-like growth factor 1(IGF-1)and glycolipid metabolism in patients with diabetes 2 mellitus(T2DM),as well as their predictive value in retinopathy.Methods A total of 120 T2DM patients admitted to Linyi Central Hospital of Shandong Province from Oct.2020 to Oct.r 2023 were selected as the study objects(defined as the study group).Another 120 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group.Serum 25(OH)D3,IGF-1,fasting blood glucose(FBG),2 h plasma glucose(2 hPG))and lipid levels(triglycerides)were compared between the two groups.The levels of TG,total cholesterol(TC)and serum 25(OH)D3 and IGF-1 were analyzed by Pearson correlation analysis.At the same time,the pa-tients in the study group were divided into diabetic group with retinopathy(DR Group,40 cases)and non-retinopa-thy group(NDR group,80 cases)according to the status of retinopathy.Multivariate analysis was used to analyze the risk factors affecting the occurrence of retinopathy in T2DM patients,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum 25(OH)D3 and IGF-1 levels in the occurrence of retinopathy in T2DM patients.Results The level of serum 25(OH)D3 was(36.15±4.25)nmol/L in the study group,lower than that in the control group(51.24±5.32)nmol/L(P＜0.05),and the level of IGF-1 was(30.26±4.52)mg/L was in the study group,higher than that in the control group(P＜0.05).The levels of FBG,2 hPG,TG and TC in the study group were(8.67±2.52)mmol/L,(11.36±2.43)mmol/L,(2.05±0.72)mmol/L,(5.05±1.54)mmol/L respectively,higher than those in the control group[(5.02±0.42)mmol/L,(6.32±0.54)mmol/L,(1.21±0.32)mmol/L,(3.42±0.68)mmol/L](P＜0.05).Pearson correlation analysis showed that serum 25(OH)D3 lev-els were negatively correlated with FBG,2 hPG,TG and TC levels in T2DM patients(r=-0.762,-0.782,-0.736,-0.721,P＜0.05).Serum IGF-1 levels were positively correlated with the levels of FBG,2 hPG,TG and TC in T2DM patients(r=0.741,0.756,0.715,0.698,P＜0.05).Family history of diabetes in DR group,FBG,2 hPG,TG,TC,IGF-1 levels was 35.00％,(9.31±2.49)mmol/L,(12.52±2.34)mmol/L,(2.76±0.61)mmol/L,(5.92±1.42)mmol/L,(37.89±4.41)mg/L respectively,higher than those in NDR group[16.25％,(8.35±2.15)mmol/L,(10.78±1.75)mmol/L,(1.69±0.52)mmol/L,(4.62±1.31)mmol/L,(26.45±4.06)mg/L](P＜0.05).25(OH)D3 in DR group was(30.21±3.51)nmol/L,lower than that in NDR group(39.12±3.85)nmol/L(P＜0.05).Logistic regression anal-ysis showed that family history of diabetes mellitus,duration of diabetes mellitus,25(OH)D3,IGF-1,FBG,2hPG,TG and TC levels were all risk factors for the occurrence of retinopathy in elderly T2DM patients(P＜0.05).ROC curve analysis showed that AUC and sensitivity of 25(OH)D3 and IGF-1 combined to predict retinopathy in el-derly T2DM patients were 0.854 and 92.50％,respectively,higher than that of 25(OH)D3 and IGF-1 alone(P＜0.05).Conclusion Serum 25(OH)D3 and IGF-1 levels are abnormally expressed in elderly patients with T2DM,and there is a close relationship between glucose and lipid metabolism in elderly patients with T2DM,and the combined detection of these indicators has a higher predictive value for the occurrence of DR In elderly pa-tients with T2DM.
Type 2 diabetes mellitus25-hydroxyvitamin D3Insulin-like growth factor-1Glycolip-id metabolismDiabetic retinopathy
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