Abstract
BACKGROUND: Young-onset type 2 diabetes mellitus (T2DM) is associated with adverse health outcomes and increased mortality. Vitamin D (VitD) deficiency is likewise linked to various adverse health outcomes and is significantly associated with lipid metabolism in patients with T2DM. However, little is known regarding the mechanisms of interaction between VitD and apolipoprotein A1 (apoA1) in young-onset T2DM. AIM: To evaluate the relationship between VitD and apoA1 levels in patients with young-onset T2DM. METHODS: This cross-sectional study was conducted at Zhejiang Provincial People's Hospital between January 2019 and December 2023. A total of 642 patients with T2DM who aged 18-40 years were included and matched with 642 individuals without diabetes (controls) based on age and sex. No specific intervention was applied, and data were collected from medical records and laboratory tests. The relationship between VitD and apoA1 levels was examined using Spearman's correlation and logistic regression models. RESULTS: We found that VitD levels were significantly lower in patients with T2DM compared to controls (15.9 ng/mL vs 17.4 ng/mL, P < 0.001), with a notable positive correlation between VitD deficiency and reduced apoA1 levels. Multifactor logistic regression analysis identified that severe VitD deficiency was an independent risk factor for apoA1 in young-onset T2DM patients (odds ratio = 3.43, 95% confidence interval: 1.16-10.20, β = 1.23, P = 0.026). CONCLUSION: Our findings reveal an association between VitD and apoA1 in young-onset T2DM, suggesting that VitD may play a crucial role in metabolic regulation and cardiovascular risk management.