Objective:To analyze the relativity between 25-hydroxyvitamin D3 (25 (OH) D3) and vascular complications in type 2 diabetes mellitus (T2DM) patients at different body mass index (BMI) levels.Methods:A total of 113 T2DM patients admitted to Chizhou People’s Hospital from Oct. 2021 to Oct. 2023 were selected as the study objects. The enrolled patients were divided into normal group, overweight group and obese group according to BMI level. General data (gender, age, course of disease, smoking history, drinking history, family history of hypertension and diabetes) and laboratory indicators were collected, including triglyceride (TG), creatinine (Cr), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), urinary albumin/creatinine ratio (UACR), albumin (Alb), blood calcium, blood phosphorus, 25 (OH) D3, etc. Spearman correlation analysis was used to analyze the correlation between diabetic vascular complications and 25 (OH) D3, and Logistic regression was used to analyze the risk factors of diabetic vascular complications among different BMI groups.Results:The disease course of overweight and obesity group was (8.51±2.39) years, (10.82±3.02) years, TG was (2.58±0.45) mmol/L, (3.24±0.64) mmol/L, TC was (6.23±1.45) mmol/L, (9.32±2.01) mmol/L, and BMI was (26.48±1.53) kg/m 2, (30.12±1.62) kg/m 2, higher than those of the control group ( P<0.05). The level of LDL-C (3.58±1.02) mmol/L and HbA1c (10.78±1.68) were higher in obese group (45.00%) ( P<0.05). Compared with those of the overweight group, the levels of hypertension, disease duration, TG, TC, LDL-C, HbA1c and BMI in the obese group were higher ( P<0.05). The levels of serum 25 (OH) D3 [ (40.25±3.35) mmol/L, (33.18±2.78) mmol/L] in overweight and obese group were lower than those in the normal group ( P<0.05), and the incidence of diabetic vascular complications was 65.22% and 87.50%, respectively, higher than those in the normal group ( P<0.05). Compared with that in the overweight group, serum 25 (OH) D3 level was lower in the obese group ( P<0.05), and the incidence of diabetic vascular complications was higher ( P<0.05). Spearman correlation analysis showed that disease duration, TG, TC, HbA1c were positively correlated with diabetic vascular complications ( P<0.05), and 25 (OH) D3 was negatively correlated with diabetic vascular complications ( P<0.05). Logistic regression analysis showed that disease duration and HbA1c level were risk factors for diabetic vascular complications in the three groups ( P<0.05), while TG, TC and low 25 (OH) D3 were risk factors for diabetic vascular complications in the hyperrecombination and obesity groups ( P<0.05) . Conclusion:The level of 25 (OH) D3 in overweight/obese T2DM patients is negatively correlated with vascular complications of diabetes, and vitamin D supplementation should be paid attention to overweight/obese T2DM patients to reduce the risk of vascular complications of diabetes.

Primary hypertrophic osteoarthropathy(PHO)is a rare disease also known as pachydermo-periostosis.We reported a painless case whose diagnosis was confirmed by genetic test.A 24-year-old male presented a series of symptoms that first began at 14.He suffered from progressive clubbed-fingers accompa-nied by swelling of the wrist and ankle joints.Facial skin concentric thickening and alar nose broadening ap-peared simultaneously and increased progressively.He was also prone to acne and hyperhidrosis.X-rays showed thickening of the metacarpal and phalangeal bones,as well as symmetrical periosteal ossification of both the tibia and fibula.Clinical diagnosis of PHO is difficult because of the variable features.With acromeg-aly excluded,the diagnosis was confirmed by a genetic test.Whole exome sequencing revealed a heterozygous SLCO2A1 c.611C＞T(p.Ser204Lue)and SLCO2A1 c.1602C＞A(p.Asn534Lys)mutation from each par-ent.It suggests that primary hypertrophic osteoarthropathy should be considered for young limb hypertrophic patients especially when periosteal thickening signs were showed in X-ray.A confirmatory diagnosis can be made through the genetic test.