Relationship between RBP4 and lower extremity arterial disease in patients with type 2 diabetes mellitus and the intervention effect of vitamin D

ZHOU Wan; YE Shandong

doi:10.3969/j.issn.1002-266X.2018.01.006

Abstract：Objective To investigate the relationship between retinol binding protein 4 ( RBP4) and lower extremity arterial disease (LEAD) in patient with type 2 diabetes mellitus ( T2DM) and the intervention effect of vitamin D on LEAD.Methods A total of 220 T2DM patients were assigned into T2DM group (group DM1) and T2DM complicated with LEAD group (group DM2), then the group DM2 were divided into the group DM3 who received oral hypoglycemic a-gents and group DM4 who received oral hypoglycemic drugs and vitamin D therapy , meanwhile, 80 cases of non-diabetic subjects were recruited as the control group (group NC).The fasting plasma glucose (FPG), high-density lipoprotein cho-lesterol (HDL-C), fasting insulin (FINS), serum 25-hydroxyvitamin D [25(OH)D], serum RBP4, low-density lipopro-tein cholesterol (LDL-C), HbA1C, triglycerides (TG), and total cholesterol (TC) were detected, and the ankle brachia index ( ABI) , waist-hip ratio ( WHR) , homeostasis model assessment for insulin resistance ( HOMA-IR) , and body mass index (BMI) were calculated.Results Compared with the group NC and group DM1, RBP4, HbA1C, FPG, and LDL-C increased, and 25(OH)D and HDL-C decreased in the group DM2 (all P<0.05); compared with the group DM3, ABI and 25(OH)D increased, and RBP4, LDL-C, TG, FINS, and HOMA-IR decreased in the group DM4 (all P<0.05). RBP4 was positively correlated with TG , LDL-C, HOMA-IR, BMI, and WHR ( r=0.438, 0.112, 0.115, 0.443, and 0.475;all P<0.05), and was negatively correlated with 25(OH)D and HDL-C (r=-0.527, -0.277; both P<0.05).Conclusion The increased serum RBP4 level is correlated with the progression of T2DM complicated with LEAD,and vitamin D supplementation can down-regulate the level of RBP 4 and improve the prognosis of LEAD .