摘要
目的了解2型糖尿病患者25羟基维生素D水平与动力性平衡功能的关系及影响因素。方法选取2016年8月至2017年6月在我科住院的2型糖尿病患者235例,并根据25羟基维生素D水平将患者分为严重缺乏组、缺乏组、不足组及充足组。所有患者测定身高、体重、腰围、血压、空腹血糖、Hb A1c、25羟基维生素D,测定股骨骨密度、下肢震动阈值、踝臂指数,测定动力性平衡指标:站起测试(CRT)、走直线步态测试(TGT)、2.4米行走测试。结果四组间年龄、空腹血糖、糖化血红蛋白、收缩压、舒张压、腰围、体重指数之间差异均无统计学意义。与缺乏组、不足组及充足组相比,严重缺乏组股骨骨密度显著降低,差异具有统计学意义(P<0.05),踝臂指数也显著降低;与不足组及充足组相比,缺乏组的踝臂指数显著降低,差异具有统计学意义(P<0.05)。与不足组及充足组相比,严重缺乏组及缺乏组下肢震动阈值显著降低,差异具有统计学意义(P<0.05)。与缺乏组、不足组及充足组相比,严重缺乏组的站起测试时间明显延长,缺乏组的站起测试时间较不足组延长,且缺乏组的站起测试较不足组及充足组延长,差异具有统计学意义。(P<0.05)。与缺乏组、不足组及充足组相比,严重缺乏组的2.4米行走测试时间明显延长,缺乏组的2.4米行走测试时间较不足组延长,差异具有统计学意义(P<0.05)。与缺乏组、不足组及充足组相比,严重缺乏组走直线步态测试正常的患者比例明显降低,差异具有统计学意义(P<0.05)。多元回归分析显示,站起测试、2.4米行走测试为25羟基维生素D的独立影响因素,应用Logistic回归分析,结果显示25羟基维生素D及年龄与走直线步态相关。结论在2型糖尿病患者中25羟基维生素D水平与站起测试、2.4米行走测试之间存在独立负相关,与走直线步态测试之间存在独立的正相关。对糖尿病患者进行25羟基维生素D的筛查及补充仍有待进一步研究。
Objects To analyze the difference of dynamic balance index among diverse 25-hydroxyvitamin D level groups in patients with type 2 diabetes mellitus,and to investigate the relationship between 25-hydroxyvitamin D and dynamic balance. Methods Two handred and thirty-five inpatients from 08/2016 to 06/2017 with type 2 diabetes were enrolled,aged from 30 to 80 years old.Height,weight,waistline,blood pressure,fasting blood glucose,HbA1 c,25-hydroxyvitamin D levels,calcaneal bone mineral density（CBMD）,ABI and vibration sensory threshold of lower limbs were measured. The dynamic balance were assessed with chair-rising test（CRT）, tandem gait test（TGT）,8-foot（ie, 2. 4 m） walk test. The patients were divided into 4 groups by the level of 25-hydroxyvitamin D： Serious deficiency group,deficiency group,insufficiency group,sufficiency group. Results There were no significantly difficiency of age,Fasting blood glucose,HbA1 c,Systolic blood pressure,waistline,BMI between the four groups. The CBMD in Serious deficiency group was significantly lower than deficiency group, insufficiency group and suffciency group（P〈0. 05）. The ABI in serious deficiency group was significantly lower than deficiency group, insufficiency group and suffciency group（P〈0. 05）. The ABI in deficiency group was also significantly lower than insufficiency group and suffciency group（P〈0. 05）. The vibration sensory threshold of lower limbs in serious deficiency group and deficiency group was significantly lower than insufficiency group and suffciency group（P〈0. 05）. The time of chair-rising test in Serious deficiency group was significantlyextender than those in deficiency group,insufficiency group and sufficiency group. The time of chair-rising test in deficiency group was significantly extender than those in insufficiency group and sufficiency group. The time of 8-foot（ie,2. 4 m） walk test in Serious deficiency group was significantly extender than those in deficiency group,insufficiency group and sufficiency group. The ability to perform tandem gait test（TGT） in Serious deficiency group is significantly lower than those in deficiency group,insufficiency group and sufficiency group（P〈0. 05）. Multiple stepwise regression analysis showed that the time of chair-rising test and 8-foot（ie,2. 4 m） walk test were independent influencing factors of the level of 25-hydroxyvitamin D. Logistic regression analysis showed that tandem gait test were positive correlated with the level of 25-hydroxyvitamin D. Conclusion There is independent negative correlation between the level of 25-hydroxyvitamin D and the time of chair-rising test and 8-foot walk test.There is independent positive correlation between the level of 25-hydroxyvitamin D and tandem gait test. The screening and supplement of vitamin D in patients with type 2 diabetes mellitus still needs further research.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2018年第3期295-300,共6页
Chinese Journal of Osteoporosis
