摘要
目的探讨新诊断2型糖尿病患者血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]水平与血管内皮功能的相关性。方法选取2015年1月至2020年9月在战略支援部队特色医学中心内分泌科新诊断的2型糖尿病患者135例作为研究对象,采用Endo-PAT2000无创血管内皮功能检测仪测定反应性充血指数(reactive hypermia index,RHI)。按照25(OH)D四分位水平将患者分为四组:Q1组[25(OH)D<9.40 ng/mL]、Q2组[9.40 ng/mL≤25(OH)D<13.65 ng/mL]、Q3组[13.65 ng/mL≤25(OH)D<19.09 ng/mL]和Q4组[25(OH)D≥19.09 ng/mL],比较四组患者RHI、血糖、血脂、肾功能等指标。采用Spearman相关性分析评估25(OH)D水平与RHI的相关性,采用logistic回归分析25(OH)D水平对新诊断2型糖尿病患者RHI的影响。结果四组患者间RHI、女性比例均有统计学意义(P<0.05),年龄、吸烟史、体质量指数、腰臀比、血脂及血糖指标差异均无统计学意义(P>0.05)。Spearman相关性分析显示,血清25(OH)D水平与RHI呈正相关,差异有统计学意义(r=0.26,P<0.01),与女性比例、总胆固醇及高密度脂蛋白胆固醇水平均呈负相关,差异有统计学意义(r值分别为-0.28、-0.18和-0.19,P<0.05)。Logistic分析结果表明,在未排除混杂因素的条件下,与Q4相比,Q1、Q2组内皮功能障碍的风险分别提高4.71、4.12倍;在校正年龄、性别、糖化血红蛋白、胆固醇混杂因素后,与Q4相比,Q1、Q2组内皮功能障碍的风险分别提高5.75、5.92倍。结论25(OH)D水平升高是新诊断2型糖尿病患者血管内皮功能的保护因素,对于新诊断的2型糖尿病患者,需尽早进行25(OH)D水平测定,以便更好地进行临床干预。
Objective To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D]levels and vascular endothelial function in newly diagnosed type 2 diabetes mellitus patients.Methods 135newly diagnosed type 2 diabetes patients in the Endocrinology Department of PLA Strategic Support Force Medical Center from January 2015 to September 2020 were enrolled in this study.Reactive hypermia index(RHI)was measured by endo-PAT2000 non-invasive vascular endothelial function tester.Patients were divided into four groups according to 25(OH)D quartile level:group Q1[25(OH)D<9.40 ng/mL],group Q2[9.40 ng/mL≤25(OH)D<13.65 ng/mL],group Q3[13.65 ng/mL≤25(OH)D<19.09 ng/mL]and group Q4[25(OH)D≥19.09 ng/mL],RHI,blood glucose,blood lipids,renal function and other indicators of patients in the four groups were compared.Spearman correlation analysis was used to evaluate the correlation between 25(OH)D level and RHI,and logistic regression was used to analyze the influence of25(OH)D level on RHI in newly diagnosed type 2 diabetes patients.Results There were statistically significant differences in RHI and gender among the four groups(P<0.05),while there were no statistically significant differences in age,smoking history,BMI,WHR,blood lipids and blood glucose(P>0.05).Spearman correlation analysis showed that serum 25(OH)D level was positively correlated with RHI(r=0.26,P<0.01),and female,total cholesterol and serum cholesterol high density lipoprotein were negatively correlated(r=-0.28,-0.18,-0.19,P<0.05).In binary logistic analysis,normal and abnormal RHI as dependent variables and 25(OH)D as independent variables,the risk of endothelial dysfunction in group Q1was 4.71 times higher than that in group Q4 without excluding confounding factors.The risk of endothelial dysfunction increased 4.12 fold in Q2;After adjusting for confounding factors such as age,sex,HbA1c,and cholesterol,the risk of endothelial dysfunction was 5.75 times higher in Q1 than in Q4.The risk of endothelial dysfunction increased 5.92 fold in Q2.Conclusion Elevated 25(OH)D level is a protective factor for vascular endothelial function in patients with newly diagnosed type 2 diabetes.For newly diagnosed type2 diabetes patients,25(OH)D level should be measured as soon as possible for better clinical intervention.
作者
杨倩倩
肇炜博
薛婧
王爱红
李洪梅
YANG Qian-qian;ZHAO Wei-bo;XUE Jing;WANG Ai-hong;LI Hong-mei(North China University of Science and Technology,Tangshan,Hebei 063000,China;不详)
出处
《慢性病学杂志》
2022年第8期1121-1125,共5页
Chronic Pathematology Journal
基金
国家自然科学基金(青年科学基金项目)(82000358)
战略支援部队特色医学中心博士毕业生科研启动基金(21ZX01)
关键词
维生素D
血管内皮功能
反应性充血指数
新诊断2型糖尿病
Vitamin D
Vascular endothelial function
Reactive hypermia index
Newly diagnosed type 2 diabetes
