Abstract: Objective  To investigate the level of 25hydroxy vitamin D3 (25［OH］D3)  and lipoprotein associated phospholipase A2 (LpPLA2) in diabetic nephropathy(DN) patients and explore the correlation between serum level of 25(OH)D3 and LpPLA2 and the early DN. Methods  A total of 160 patients with type 2 diabetes mellitus(T2DM) were randomly divided into microalbuminuria group (n=80) and normal albuminuria group (n=80) according to the urinary albumin excretion rate (UAER). Another 80 health volunteers served as the control group. Serum LpPLA2 level was measured by enzyme linked immunoadsorption determination (ELISA). Serum 25(OH)D3 level was measured by chemiluminescence method,  and the biochemical indicators were measured by automatic biochemical analyzer. The differences of LpPLA2 and 25(OH)D3 among three groups were compared,  and the correlation between serum level of 25(OH)D3 and LpPLA2 and the early  DN  was analyzed. Results  ①Seurm LpPLA2 was significantly higher in normal albuminuria and microalbuminuria group than that in control group,  but serum 25(OH)D3 was significantly lower in normal albuminuria and microalbuminuria group than that in control group (P<0.05). Seurm LpPLA2  was significantly higher in microalbuminuria group than that in normal albuminuria group,  but seurm 25(OH)D3  was significantly lower in microalbuminuria group than that in normal albuminuria group (P<0.05). ②The level of UAER was positively correlated with the low density lipoprotein cholesterin(LDLC),  systolic blood pressure (SBP),  diastolic blood pressure (DBP),  disease  course, fasting plasma glucose (FPG),  glycosylated hemoglobin (HbA1c),  uric acid(UA),  homocysteine(Hcy),  Cys C and LpPLA2(P<0.05 or P<0.01),  but was negatively correlated with 25(OH)D3 (P<0.01). ③SBP,  DBP,  course of sisease, FPG,  HbA1c,  CysC and LPPLA2 were independent risk factors for early DN,  but 25(OH)D3 was protective factor for it. Conclusion  The levels of 25( OH) D3 and LPPLA2 are closely related to the occurrence and development of  early DN.  25(OH)D3 is the protective factor, while LPPLA2 is a risk factor for it．

Key words: diabetic nephropathy, calcifediol, phospholipases A2, urinary albumin excretion rate