摘要
目的：探讨住院2型糖尿病患者血清25-羟维生素D [25（OH）D]与糖代谢指标的相关性。方法回顾性分析214例住院2型糖尿病患者的年龄、体质量指数（ BMI ）、收缩压、舒张压等临床资料和血清甲状旁腺激素、25（OH）D、血肌酐、血钙、血磷、糖化血红蛋白（HbA1c）、空腹血糖、空腹胰岛素等检验结果。结果住院2型糖尿病患者普遍存在维生素D不足或缺乏，有47.2％患者25（OH）D低于10 ng／ml。以25（OH）D浓度分为维生素D严重缺乏组[25（OH）D＜10 ng／ml]和维生素D非严重缺乏组[25（OH）D≥10 ng／ml]，维生素D严重缺乏组比非严重缺乏组年龄较轻[（55.27±13.71）岁比（60.76±12.32）岁， P＝0.001]，而HbA1c更高[（9.00±2.01）％比（8.45±1.86）％， P＝0.025]。两组BMI [（25.09±4.01） kg／m2比（25.39±3.53） kg／m2， P＝0.523]、空腹血糖[（8.91±3.31） mmol／L比（8.16±3.02） mmol／L， P＝0.063]、空腹胰岛素[（21.32±32.50） mIU／L比（21.92±26.95） mIU／L， P＝0.873]和稳态模型评估的胰岛素抵抗指数（7.60±8.92比7.53±9.39， P＝0.954）差异均无统计学意义。偏相关性分析显示，校正年龄和血肌酐因素后， HbA1c与血清25（OH）D呈显著负相关（r＝－0.190， P＝0.003），与血清甲状旁腺激素、血钙、血磷无关。多元线性回归显示， HbA1c与年龄（β＝－0.220， P＝0.000）和血清25（OH）D （β＝－0.184， P＝0.000）呈显著负相关。结论住院2型糖尿病患者维生素D严重缺乏的患病率高，在相对年轻患者中比例更高。患者HbA1c与25（OH）D呈显著负相关，并独立于年龄、 BMI、空腹胰岛素和稳态模型评估的胰岛素抵抗指数。
Objective To investigate the correlation between 25-hydroxyvitamin D [ 25 （ OH ） D ] and indicators of glucose metabolism in inpatients with type 2 diabetes mellitus .Method We retrospectively ana-lyzed the clinical records of 214 inpatients with type 2 diabetes mellitus , including age , body mass index （BMI）, systolic blood pressure, diastolic blood pressure, and laboratory test results such as serum parathyroid hormone （PTH）, 25（OH）D, creatinine, calcium, phosphorus, glycosylated hemoglobin A1c （HbA1c）, fast-ing blood glucose , and fasting insulin .Results The prevalence of vitamin D deficiency was high in these pa-tients, with 47.2%of them having a serum 25（OH）D concentration lower than 10 ng/ml.Using 25（OH）D level less than 10 ng/ml as the cut-off point, the patients were divided into vitamin D severe deficiency （Vit-SD） group and vitamin D non-severe deficiency （Vit-NSD） group.Compared with the Vit-NSD group, the Vit-SD group had younger age [ （55.27 ±13.71） years vs.（60.76 ±12.32） years, P=0.001] and higher HbA1c level [ （9.00 ±2.01）% vs.（8.45 ±1.86）%, P=0.025].BMI [ （25.09 ±4.01） kg/m2 vs.（25.39 ± 3.53） kg/m2, P=0.523], fasting blood glucose [ （8.91 ±3.31） mmol/L vs.（8.16 ±3.02） mmol/L, P=0.063], fasting serum insulin [ （21.32 ±32.50） mIU/L vs.（21.92 ±26.95） mIU/L, P=0.873] and homeostasis model assessment of insulin resistance index （97.60 ±8.92 vs.7.53 ±9.39, P=0.954） in these two groups were with no statistically significant difference .The association analyses showed that HbA 1c was sig-nificantly negatively correlated with 25 （ OH ） D （ r =-0.190 , P=0.003 ） and not correlated with serum PTH, calcium, or phosphorus , after adjusting for age and creatinine .Multiple linear regression revealed that HbA1c had a significantly negative correlation with age （β=-0.220, P=0.000） and 25 （OH） D （β=-0.184 , P=0.000 ） .Conclusions There is high prevalence of vitamin D deficiency in inpatients with type 2 diabetes mellitus, which is even higher in relatively young patients .Serum 25 （OH） D may be negatively correlated with HbA1c in these patients independently from age , BMI, fasting serum insulin, and homeostasis model assessment of insulin resistance index .
出处
《中华临床营养杂志》
CAS
CSCD
2016年第3期144-148,共5页
Chinese Journal of Clinical Nutrition
关键词
糖尿病
25羟维生素D
甲状旁腺激素
糖化血红蛋白
糖代谢
Diabetes mellitus
25-hydroxyvitamin D
Parathyroid hormone
Glycosylated hemoglobin
Glucose metabolism
