Effect of Vitamin D Deficiency on Ace2 And Inflammatory Factors in Patients with Type 2 Diabetes

Abstract

Xing Chenhao, LU Yamin, Zhang Cuigai, LIU Guangxia, Chen Fang,Hou Zhan and Lu Xiuqin

Objective: To analyze the levels and correlation of vitamin D, ACE2, ACE and inflammatory factors in patients with type 2 diabetes,To explore the effect of vitamin D deficiency on ACE2 and inflammatory factors and the mechanism of action on the occurrence and development of diabetes.

Methods: Non-diabetic control 87 cases and type 2 diabetes 96 cases,According to the level of serum 25-hydroxyvitamin D, 47 cases of non-diabetic vitamin D normal group and 40 cases of vitamin D deficiency group were divided into two groups.52 patients in the normal vitamin D group and 44 patients in the vitamin D deficient group were tested for ACE, ACE2, IL-6, TNF-A and other inflammatory indexes.The correlation and influencing factors of vitamin D and each index were analyzed.

Results: The levels of HOMA-IR, ACE, AngII, IL-6 and TNF-a in vitamin D deficient group were significantly higher than those in vitamin D normal group.ACE2 and IL-10 were significantly decreased (P < 0.05);Compared with non-diabetic vitamin D deficiency group, BMI, waist circumference, blood pressure, blood lipids, blood glucose, INS, HOMA-IR, ACE, AngII, IL-6 and TNF-A were significantly increased with the severity of vitamin D deficiency.Insulin resistance was more severe, ACE2 and IL-10 decreased significantly(P < 0.05);Pearson correlation analysis showed that vitamin D in non-diabetic group was negatively correlated with AngII and IL-6, but positively correlated with IL-10 (P < 0.05 or P < 0.01).Vitamin D in diabetic group was positively correlated with ACE2 and IL-10, and negatively correlated with ACE, AngII, IL-6, TNF-A, HOMA-IR and HbA1c (all P < 0.01).Multiple linear regression analysis showed that IL-10 and AngII were the main influencing factors of vitamin D

Foundation Item: 2020 Government Funded Clinical Medical Talents Training Program (NO: 2020, 124) deficiency in the Non-Diabetic Group (P < 0.05).33.6% of the total variation of regression equation was explained.In diabetic group, ACE2, IL-6, TNF-A, IL-10 and HOMA-IR were the main influencing factors of vitamin D deficiency (P < 0.05), explaining 55.8% of the total variation of regression equation.

Conclusion: Vitamin D deficiency may change the improper regulation of ACE2 and ACE/AngII and the release of inflammatory factors, destroy the autoimmune state of the body, and participate in the occurrence and development of diabetes mellitus. The degree of vitamin D deficiency can aggravate insulin resistance by mediating RAS system and inflammatory factors, and increase the potential pathogenic effect of diabetes.ACE2, ACE/AngII and inflammatory factors can be used as markers of diabetes vitamin D deficiency.

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