摘要
目的探讨25羟维生素D[25(OH)D]缺乏与季节、血脂异常、超重/肥胖的关系。方法选取中国医科大学附属盛京医院体检中心2017年9月—2019年8月健康体检者共2677例,以血清25(OH)D水平分为25(OH)D正常组[25(OH)D>30 ng/mL]、25(OH)D不足组[25(OH)D>20~30 ng/mL]和25(OH)D缺乏组[25(OH)D≤20 ng/mL]。比较各组的体质量指数(BMI)及血清中血脂指标水平,比较不同季节25(OH)D水平及25(OH)D营养状态分布。结果25(OH)D检测结果显示,25(OH)D缺乏患者比率为66.23%(1773/2677),25(OH)D不足患者比率为25.03%(670/2677),25(OH)D正常患者比率为8.74%(234/2677)。夏季组25(OH)D水平最高为19.92 ng/mL,其次为秋季组17.54 ng/mL和春季组15.95 ng/mL,冬季组25(OH)D水平最低为13.61 ng/mL,组间两两比较差异有统计学意义(P<0.01)。冬季组25(OH)D缺乏率最高为78.61%,夏季组25(OH)D缺乏率最低为51.34%;夏季组25(OH)D正常率最高为13.55%,显著高于春季组、秋季组、冬季组(P<0.01)。25(OH)D正常组、25(OH)D不足组、25(OH)D缺乏组的BMI、甘油三酯(TG)呈上升趋势,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)呈下降趋势,差异有统计学意义(P<0.05或P<0.01)。Logistic回归分析提示,调整了年龄、性别后发现,与25(OH)D正常者相比,25(OH)D缺乏者TG异常的发生风险显著增高(OR=2.273,95%CI为1.636~3.159,P<0.001),HDL-C异常的发生风险显著增高(OR=2.817,95%CI为1.783~4.464,P<0.001),超重/肥胖的风险显著增高(OR=1.892,95%CI为1.394~2.569,P<0.005)。与25(OH)D正常者相比,25(OH)D不足者TG异常的发生风险显著增高(OR=2.100,95%CI为1.483~2.974,P<0.001),HDL-C异常的发生风险显著增高(OR=2.183,95%CI为1.353~3.534,P<0.001),超重/肥胖的风险显著增高(OR=1.603,95%CI为1.155~2.224,P<0.001)。结论维生素D缺乏受季节变化影响,且与血脂异常及超重/肥胖直接相关。
Objective To explore the relationship between 25 hydroxyvitamin D[25(OH)D]deficiency and seasons,dyslipidemia,overweight or obesity.Methods A total of 2677 healthy subjects with physical examination from September 2017 to August 2019 were collected and divided into three groups according to serum level of 25(OH)D.The recruiters with level of 25(OH)D>30 ng/mL was included in normal group,those with level of 25(OH)D>20~30 ng/mL was selected as 25(OH)D insufficiency group,and those with level of 25(OH)D≤20 ng/mL was selected as 25(OH)D deficiency group.The body mass index(BMI),serum lipid index levels among three groups,the distribution of 25(OH)D levels and nutritional status in four seasons were compared.Results 25(OH)D detection results showed that the ratios of patients with 25(OH)D deficiency,insufficiency and normal were 66.23%(1773/2677),25.03%(670/2677),8.74%(234/2677),respectively.The highest 25(OH)D level was 19.92 ng/mL in the summer group,followed by 17.54 ng/mL in the autumn group and 15.95 ng/mL in the spring group,and the lowest in the winter group(13.61 ng/mL).The between-group difference was statistically significant(P<0.01).The highest 25(OH)D deficiency rate was 78.61%in the winter group and its lowest rate was 51.34%in the summer group.The highest 25(OH)D normal rate was 13.55%in the summer group,which was significantly higher than that in the spring,autumn and winter groups(P<0.01).BMI and triglycerides(TG)increased in the 25(OH)D normal,deficiency,insufficiency groups,while high-density lipoprotein cholesterol(HDL-C),and apolipoprotein A1(ApoA1)decreased,with statistical significant difference(P<0.05 or P<0.01).Logistic regression analysis showed that after adjusting age and gender,risks of abnormity in TG(OR=2.273,95%CI:1.636~3.159,P<0.001),HDL-C(OR=2.817,95%CI:1.783~4.464,P<0.001),and overweight/obesity(OR=1.892,95%CI:1.394~2.569,P<0.005)were all increased compared with those with normal 25(OH)D level.Compared with those with normal 25(OH)D level,risks of abnormity in TG(OR=2.100,95%CI:1.483~2.974,P<0.001),HDL-C(OR=2.183,95%CI:1.353~3.534,P<0.001),and overweight/obesity(OR=1.603,95%CI:1.155~2.224,P<0.001)were all increased.Conclusion Deficiency of 25(OH)D is affected by the seasonal changes,and is directly related to the abnormal blood lipid and overweight/obesity.
作者
鞠香丽
裴冬梅
JU Xiangli;PEI Dongmei(Physical Examination Center,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning,110001)
出处
《实用临床医药杂志》
CAS
2020年第6期101-104,共4页
Journal of Clinical Medicine in Practice
基金
中国医科大学“十三五”医学教育科学研究课题(YDJK2016008)
美国中华基金会CMB(China Medical Board)项目(15-219)
2019年度辽宁省社会科学科学规划基金项目(L19BGL041)。
关键词
25羟维生素D
季节
超重
肥胖
血脂异常
甘油三酯
高密度脂蛋白胆固醇
相关性
25 hydroxyvitamin D
season
overweight
obesity
dyslipidemia
triglycerides
high density lipoprotein cholesterol
correlation
