Correlation of glycated hemoglobin and 25-hydroxyvitamin D levels with peripheral vascular disease in patients with diabetes mellitus
10.3760/cma.j.cn341190-20240608-00709
- VernacularTitle:糖尿病患者糖化血红蛋白及25-羟维生素D水平与外周血管病变的相关性研究
- Author:
Yue LI
1
;
Yijuan SUN
1
Author Information
1. 商洛市中心医院医学检验科，商洛 726000
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 2;
Diabetic angiopathies;
25-Hydroxyvitamin D2;
Hemoglobin A, glycosylated;
Factor analysis, statistical
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(1):21-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between glycated hemoglobin (HbA1c) and 25-hydroxyvitamin D [25(OH)D] levels with peripheral vascular disease in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 165 patients with T2DM who were treated at Shangluo Central Hospital from April 2021 to April 2023 were included in this retrospective study. Based on the presence or absence of peripheral vascular disease, the patients were divided into two groups: the positive group (115 patients with T2DM and peripheral vascular disease) and the negative group (50 patients with T2DM only). Data on general clinical characteristics including age, gender, duration of diabetes, family history of the disease, and the presence of hypertension were collected from both groups. Laboratory data, including 25(OH)D, serum calcium, phosphorus, apolipoprotein B, lipoprotein(a), uric acid, and apolipoprotein AⅠ, were also gathered. Logistic regression analysis was performed to identify high-risk factors for peripheral vascular disease, while Pearson or Spearman correlation analyses were used to evaluate the correlation between HbA1c, 25(OH)D, and peripheral vascular disease. The diagnostic efficiency of the high-risk factors for peripheral vascular disease was assessed using receiver operating characteristic analysis.Results:Long disease duration ( t = 2.74, P = 0.007), a history of hypertension ( χ2 = 6.60, P = 0.010), poor control of HbA1c ( χ2 = 12.14, P < 0.001), vitamin D deficiency ( χ2 = 10.20, P < 0.001), high levels of low-density lipoprotein cholesterol ( t = 2.58, P = 0.024), low levels of high-density lipoprotein cholesterol ( t = 3.65, P = 0.008), high HbA1c levels ( t = 6.68, P < 0.001), and low levels of 25(OH)D ( t = 6.60, P < 0.001) are the independent risk factors for peripheral vascular disease in patients with T2DM. Logistic regression analysis revealed that long disease duration ( OR = 2.327, P = 0.008), vitamin D deficiency ( OR = 1.255, P = 0.034), high HbA1c levels ( OR = 3.124, P < 0.001), and low 25(OH)D levels ( OR = 4.256, P = 0.002) are significant risk factors for peripheral vascular disease. Pearson correlation analysis indicated a negative correlation between HbA1c levels and 25(OH)D levels ( r = -0.810, P < 0.001). Spearman correlation analysis showed a positive correlation between HbA1c levels and peripheral vascular disease ( r = 0.472, P < 0.001), while 25(OH)D levels were negatively correlated with peripheral vascular disease ( r = -0.443, P < 0.001). Receiver operating characteristic curve analysis revealed that the area under the curve (AUC) for HbA1c predicting peripheral vascular disease was 0.797 (95% CI: 0.719, 0.874), with a sensitivity of 0.817 and specificity of 0.760 at a cutoff value of 8.27%. The AUC for 25(OH)D predicting peripheral vascular disease was 0.778 (95% CI: 0.695, 0.861), with a sensitivity of 0.748 and specificity of 0.780 at a cutoff value of 63.49 nmol/L. The prediction of peripheral vascular disease using both HbA1c and 25(OH)D yielded an AUC of 0.805 (95% CI: 0.730, 0.876), with a sensitivity of 0.815 and specificity of 0.800. Conclusions:The duration of the disease, HbA1c levels, and 25(OH)D levels are high risk factors for peripheral vascular disease in patients with T2DM. When patients with T2DM exhibit vitamin D deficiency and poor control of HbA1c levels, prompt intervention should be implemented to reduce the risk of developing peripheral vascular disease.
