Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible rel...Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.展开更多
BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopath...BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopathy(DR)can be hidden,with few symptoms.Therefore,the preliminary screening of diabetic patients should identify DR as soon as possible,delay disease progression,and play a vital role in its diagnosis and treatment.AIM To investigate the correlation between glycated hemoglobin A1c(HbA1c),urinary microalbumin(U-mALB),urinary creatinine(U-CR),mALB/U-CR ratio,β2 microglobulin(β2MG),retinol binding protein(RBP)and DR.METHODS A total of 180 patients with type 2 diabetes mellitus attending the Second People’s Hospital of Hefei from January 2022 to August 2022 were retrospectively enrolled by ophthalmologists.Based on whether they had combined retinopathy and its degree,68 patients with diabetes mellitus without retinopathy(NDR)were assigned to the NDR group,54 patients with non-proliferative DR(NPDR)to the NPDR group,and 58 patients with proliferative DR to the PDR group.General data,and HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR results were collected from the patients and compared among the groups.Pearson's correlation method was used to analyze the correlation between HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR indices,and multiple linear regression was applied to identify the risk factors for DR.Receiver operator characteristic(ROC)curves were also drawn.RESULTS The differences in age,gender,systolic and diastolic blood pressure between the groups were not statistically significantly(P>0.05),but the difference in disease duration was statistically significant(P<0.05).The differences in fasting blood glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,and triglyceride between the groups were not statistically significant(P>0.05).HbA1c in the PDR group was higher than that in the NPDR and NDR groups(P<0.05).The levels of mALB,β2MG,RBP,mALB/U-CR and UCR in the PDR group were higher than those in the NPDR and NDR groups(P<0.05).Multiple linear regression analysis showed that disease duration,HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR were risk factors for the development of DR.The ROC curve showed that the area under the curve(AUC)for the combination of indices(HbA1c+mALB+mALB/U-CR+U-CR+β2MG+RBP)was 0.958,with a sensitivity of 94.83%and specificity of 96.72%,which was higher than the AUC for single index prediction(P<0.05).CONCLUSION HbA1c,mALB,mALB/U-CR,U-CR,β2MG and RBP can reflect the development of DR and are risk factors affecting PDR,and the combination of these six indices has predictive value for PDR.展开更多
Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a medi...Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.展开更多
Objective This study assesses the impact of iodine-rich processed foods and dining places on the iodine nutritional status of children.Methods School-aged children(SAC) in seven provinces in China were selected by sch...Objective This study assesses the impact of iodine-rich processed foods and dining places on the iodine nutritional status of children.Methods School-aged children(SAC) in seven provinces in China were selected by school-based multistage sampling. Urinary iodine, salt iodine, and thyroid volume(TVOL) were determined. Questionnaires were used to investigate dining places and iodine-rich processed foods. The water iodine was from the2017 national survey. Multi-factor regression analysis was used to find correlations between variables.Results Children ate 78.7% of their meals at home, 15.1% at school canteens, and 6.1% at other places.The percentage of daily iodine intake from water, iodized salt, iodine-rich processed foods, and cooked food were 1.0%, 79.2%, 1.5%, and 18.4%, respectively. The salt iodine was correlated with the urinary iodine and TVOL, respectively(r = 0.999 and-0.997, P < 0.05). The iodine intake in processed foods was weakly correlated with the TVOL(r = 0.080, P < 0.01). Non-iodized salt used in processed foods or diets when eating out had less effect on children’s iodine nutrition status.Conclusion Iodized salt remains the primary source of daily iodine intake of SAC, and processed food has less effect on iodine nutrition. Therefore, for children, iodized salt should be a compulsory supplement in their routine diet.展开更多
Thyroid cancer is the most common malignancy of the endocrine system,and its incidence is increasing worldwide.In China,its incidence has increased from 1.78/104 in 1988 to 10.58/104 in2013.Thyroid cancers are mainly ...Thyroid cancer is the most common malignancy of the endocrine system,and its incidence is increasing worldwide.In China,its incidence has increased from 1.78/104 in 1988 to 10.58/104 in2013.Thyroid cancers are mainly classified into papillary thyroid cancer(PTC),follicular thyroid cancer(FTC),medullary thyroid cancer(MTC).展开更多
To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr...To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr ratio) has been developed. But as the ratio varies worldwide, reference values of the parameter in paediatric population are not developed. To determine reference value, the present study was conducted in healthy paediatric population in Burdwan district, West Bengal. This study was performed on 693 healthy paediatric subjects, aged between 3 months to 18 years and divided into five groups. Early morning non-fasting urine samples from all study groups were analyzed for Ca/Cr ratio. A negative correlation was observed between age and urinary Ca/Cr ratio, but there was no significant difference of urinary Ca/Cr ratio between two sexes. Considering 97.5th percentile of the underlying distribution of values as the upper limit of reference range, upper reference values of urinary Ca/Cr ratio for age groups展开更多
To the Editor:Chronic kidney disease(CKD)is a critical health threat.An elevated urinary albumin-creatinine ratio(UACR)is a marker of impaired renal function and is a key risk factor for cardiovascular disease.The rat...To the Editor:Chronic kidney disease(CKD)is a critical health threat.An elevated urinary albumin-creatinine ratio(UACR)is a marker of impaired renal function and is a key risk factor for cardiovascular disease.The rate-pressure product(RPP)[1]and pressure rate quotient(PRQ)are widely used as methods to quantify cardiac load and hemodynamic response to exercise in clinical practice.Therefore,to better predict CKD,it is of great signicance to explore the relationships between RPP or PRQ and UACR.展开更多
Objective The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population. Methods In 2011 and...Objective The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population. Methods In 2011 and 2014, the probability proportionate to size sampling(PPS) was used in each Chinese province to obtain the representative data. In each sampling unit, school children aged 8-10 years and pregnant women were selected. Key indicators included urinary iodine concentration(UIC), thyroid volume(TV), and the iodine content in edible household salt. Results The median urinary iodine concentration(MUIC) decreased between 2011 and 2014 from 238.6 to 197.9 μg/L in school-age children. The number of provinces with iodine excess decreased to zero. The proportion of children whose UIC was 〉 300 μg/L was 18.8% and decreased to 11% compared with 29.8% in 2011. There was no significant difference in UIC 〈 50 μg/L between 2014(4.3%) and 2011(3.7%)(P 〉 0.05). The MUIC among pregnant women in 2014 was more concentrated between 110 and 230 μg/L. The goiter rate among children aged 8-10 years was unchanged, both the goiter rate of 2011 and 2014 remaining below 5%, in view of the sustainable elimination of iodine deficiency disorders. Conclusion The National Standard GB26878-2011 'Iodine Content in Edible Salt' that was introduced in March 2012 resulted in an overall improvement in iodine status, reducing the risk of excessive iodine intake in the Chinese population.展开更多
Ammonium perchlorate (AP), mainly used as solid propellants, was reported to interfere with homeostasis via competitive inhibition of iodide uptake. However, detailed mechanisms remain to be elucidated. In this stud...Ammonium perchlorate (AP), mainly used as solid propellants, was reported to interfere with homeostasis via competitive inhibition of iodide uptake. However, detailed mechanisms remain to be elucidated. In this study, AP was administered at 0, 130, 260 and 520 mg/kg every day to 24 male SD rats for 13 weeks. The concentrations of iodine in urine, serum thyroid hormones levels, to- tal iodine, relative iodine and total protein, and malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) activity in thyroid tissues were measured, respectively. Our results showed that high-dose perchlorate induced a significant increase in urinary iodine and serum thyroid stimu- lating hormone (TSH), with a decrease of total iodine and relative iodine content. Meanwhile, free thyroxine (FT4) was decreased and CAT activity was remarkably increased. Particularly, the CAT activity was increased in a dose-dependent manner. These results suggested that CAT might be en- hanced to promote the synthesis of iodine, resulting in elevated urinary iodine level. Furthermore, these findings suggested that iodine in the urine and CAT activity in the thyroid might be used as biomarkers for exposure to AP, associated with thyroid hormone indicators such as TSH. FT4.展开更多
Objective To explore the clinical characteristics and risk factors of abnormal urinary albumin/creatinine ratio(UACR)in obese population.Methods Baseline data from 2011 to 2012 in Henan Sub-center of"Risk Evaluat...Objective To explore the clinical characteristics and risk factors of abnormal urinary albumin/creatinine ratio(UACR)in obese population.Methods Baseline data from 2011 to 2012 in Henan Sub-center of"Risk Evaluation of Cancers in Chinese Diabetic Individuals:A longitudinal(REACTION)study"were utilized and those of body mass index≥28 kg/m^(2) were screened.The patients were divided into UACR normal group and UACR abnormal group(101 pairs)upon being matched on a 1:1 basis by age and gender.Multivariate logistic regression analysis,receiver operating characteristic(ROC)curve,and restricted cubic spline(RCS)analysis were performed to explore the risk factors for abnormal UACR.Results Compared with the normal UACR group,the UACR abnormal group had a higher number of alcohol consumers,a higher prevalence of hypertension,elevated systolic blood pressure,and triglyceride(all P<0.05).Multivariate logistic regression analysis showed that alcohol consumption(P=0.008).展开更多
Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in applica...Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.展开更多
The objective of this study was to assess the prevalence of iodine deficiency and possible correlated factors among schoolchildren in the municipality of Novo Cruzeiro-MG by means of an evaluation of urinary iodine ex...The objective of this study was to assess the prevalence of iodine deficiency and possible correlated factors among schoolchildren in the municipality of Novo Cruzeiro-MG by means of an evaluation of urinary iodine excretion. Five hundred and forty schoolchildren aged 6 to 14 years selected by stratified sampling, were evaluated. Urine samples were analyzed using the Sandell-Kolthoff method preconized by the WHO and iodine concentrations in the salt were assessed by means of volumetric analysis, in accordance with recommendations from the Ministry of Health. Iodine deficiency was observed in 38.9% of the schoolchildren. Of these, 28.7% of them presented slight deficiency, 6.2% of them were moderately deficient and 4% of them were seriously deficient. Median urinary iodine levels in the urban and rural population were 150.8 and 119.2 μg/L, respectively, with a clear distribution of iodine deficiency among the populations (p < 0.001) being registered. It was also observed that there was a high prevalence of deficient urinary iodine excretion among schoolchildren that consumed salt with an insufficient iodine content. In relation to the quality of the salt consumed by families, in 12.2% of the residences studied the iodine content in salt was below the recommended level (20 mg/kg), while the iodine content was below 15 mg/kg in only 5.3% of them. The results indicated that, although not characterized as a public health issue, according to WHO criteria, iodine deficiency showed very high prevalence among schoolchildren in this region. Regarding the iodine content of salt found in household consumption, our findings indicated the National Program of Salt Iodination was not efficient in the city, since it did not hit the target proposed by the Ministry of Health. Furthermore, low urinary iodine excretion associated with the consumption of salt with low iodine content suggests the need for periodical evaluations in order to provide effective control of the endemic disease.展开更多
Objective:To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.Materials and Methods:In 2014,a nationwide cross-sectional survey was conducted in 31 provinces (in this study,provi...Objective:To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.Materials and Methods:In 2014,a nationwide cross-sectional survey was conducted in 31 provinces (in this study,provinces,autonomous regions and municipalities in China's Mainland were named as provinces).Probability proportional to size sampling method was adopted to recruit children ages 8-10 and pregnant women.47,467 children's and 18,994 pregnant women's urine samples were collected and 47,706 children's thyroid volumes were examined.Iodine content in salt was determined with 46,900 edible salt samples from children's households;urinary iodine concentration (UIC) was tested from children and pregnant women's urine samples;thyroid volume of children was assessed by ultrasound.Results:The national coverage rate of iodized salt and consumption rate of qualified iodized salt were 96.3% and 91.5%,respectively.Median iodine content in iodized salt was 25.2 mg/kg.In 22 of 31 provinces,the provincial coverage rates of iodized salt were over 95%.And consumption rates of qualified iodized salt were more than 90% in 21 provinces.In this study,the national median urinary iodine concentration (MUIC) of children in China was 197.9 μg/L.At the provincial level,MUIC of children in 19 provinces was 100-199 μg/L,which in 12 provinces was 200-299 μg/L.The national MUIC of pregnant women in 2014 was 154.6 μg/L,slightly higher than the lower limit of the WHO criteria for adequate (150-249 μg/L).At the provincial level,MUIC of pregnant women in 18 provinces was 100-149 μg/L,which in 13 provinces was 150-249 μg/L.The national prevalence of goiter among children in 2014 was 2.6%,of which only Shandong province (5.6%) exceeded the national standard (5%).Conclusions:In China,iodine deficiency disorders (IDD) has been eliminated since 2005.And in 2014,the IDD-free status still remained.展开更多
Objective:To investigate the relationship of iodine nutritional status with thyroid function in pregnant women in Baotou,and provide a scientific basis for the guide of reasonable iodine supplementation.Methods:By use...Objective:To investigate the relationship of iodine nutritional status with thyroid function in pregnant women in Baotou,and provide a scientific basis for the guide of reasonable iodine supplementation.Methods:By use of As-Ce catalysis spectrophotometry,the urinary iodine concentration was determined in 90 women during different periods of pregnancy admitted to Baogang Hospital of Inner Mongolia from January 2017 to December 2017.The determination of thyroid function and the autoantibody level was carried out by electro-chemiluminescence immunoassay(ECLIA).Results:In the early trimester of pregnancy,pregnant women with iodine deficiency,iodine sufficiency and iodine excess accounted for 36.67%,40.00%and 23.33%respectively;in the middle trimester of pregnancy,they accounted for 66.67%,26.67%and 6.66%respectively;they made up 40.00%,40.00%and 20.00%respectively in the late trimester of pregnancy.The rate of iodine deficiency in women in the middle trimester of pregnancy was significantly higher than that in women in the early and the late trimesters of pregnancy respectively,and the difference was statistically significant(p<0.05).The rate of iodine deficiency in pregnant women was positively correlated to the positivity of thyroid peroxidase antibody.Moreover,it had no relationship with the positivity of thyroglobulin antibody.No matter in the pregnant women with iodine deficiency or with iodine excess,the abnormality rate of thyroid function and autoantibodies was significantly higher than that in the pregnant women with iodine sufficiency.The difference was statistically significant(p<0.05).Conclusions:The iodine deficiency in the women in the middle trimester of pregnancy is more severe than that in the women in the early and the late trimesters of pregnancy.Iodine deficiency during pregnancy is positively correlated with the positivity of thyroid peroxidase antibody.Pregnant women with iodine deficiency and iodine excess show a higher abnormality rate of thyroid function and autoantibodies.It is recommended to advocate health education on iodine nutrition to pregnant women,and conduct the dynamic monitoring of urinary iodine concentration and the screening of thyroid function and autoantibodies during pregnancy.展开更多
目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为...目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。展开更多
基金funded by the National Health Commission of People’s Republic of China Medical Reform Major Program‘2016-2017 National Nutrition and Health Surveillance of Children and Lactating Women’Major Public Health Project‘Survey and Evaluation of Iodine Nutrition and Thyroid Diseases of Chinese Population’[131031107000160007].
文摘Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.
文摘BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopathy(DR)can be hidden,with few symptoms.Therefore,the preliminary screening of diabetic patients should identify DR as soon as possible,delay disease progression,and play a vital role in its diagnosis and treatment.AIM To investigate the correlation between glycated hemoglobin A1c(HbA1c),urinary microalbumin(U-mALB),urinary creatinine(U-CR),mALB/U-CR ratio,β2 microglobulin(β2MG),retinol binding protein(RBP)and DR.METHODS A total of 180 patients with type 2 diabetes mellitus attending the Second People’s Hospital of Hefei from January 2022 to August 2022 were retrospectively enrolled by ophthalmologists.Based on whether they had combined retinopathy and its degree,68 patients with diabetes mellitus without retinopathy(NDR)were assigned to the NDR group,54 patients with non-proliferative DR(NPDR)to the NPDR group,and 58 patients with proliferative DR to the PDR group.General data,and HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR results were collected from the patients and compared among the groups.Pearson's correlation method was used to analyze the correlation between HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR indices,and multiple linear regression was applied to identify the risk factors for DR.Receiver operator characteristic(ROC)curves were also drawn.RESULTS The differences in age,gender,systolic and diastolic blood pressure between the groups were not statistically significantly(P>0.05),but the difference in disease duration was statistically significant(P<0.05).The differences in fasting blood glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,and triglyceride between the groups were not statistically significant(P>0.05).HbA1c in the PDR group was higher than that in the NPDR and NDR groups(P<0.05).The levels of mALB,β2MG,RBP,mALB/U-CR and UCR in the PDR group were higher than those in the NPDR and NDR groups(P<0.05).Multiple linear regression analysis showed that disease duration,HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR were risk factors for the development of DR.The ROC curve showed that the area under the curve(AUC)for the combination of indices(HbA1c+mALB+mALB/U-CR+U-CR+β2MG+RBP)was 0.958,with a sensitivity of 94.83%and specificity of 96.72%,which was higher than the AUC for single index prediction(P<0.05).CONCLUSION HbA1c,mALB,mALB/U-CR,U-CR,β2MG and RBP can reflect the development of DR and are risk factors affecting PDR,and the combination of these six indices has predictive value for PDR.
基金sponsored by the Fujian Provincial Health Technology Project[2020CXA020]Fujian Provincial Natural Science Funding[2020J01093]Construction of Fujian Provincial Scientific and Technological Innovation Platform[2019Y2001]
文摘Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.
基金supported by the National Nature Fund[No.81773370]the 2019 China Hygiene and Health Standard Project[No.20190502]。
文摘Objective This study assesses the impact of iodine-rich processed foods and dining places on the iodine nutritional status of children.Methods School-aged children(SAC) in seven provinces in China were selected by school-based multistage sampling. Urinary iodine, salt iodine, and thyroid volume(TVOL) were determined. Questionnaires were used to investigate dining places and iodine-rich processed foods. The water iodine was from the2017 national survey. Multi-factor regression analysis was used to find correlations between variables.Results Children ate 78.7% of their meals at home, 15.1% at school canteens, and 6.1% at other places.The percentage of daily iodine intake from water, iodized salt, iodine-rich processed foods, and cooked food were 1.0%, 79.2%, 1.5%, and 18.4%, respectively. The salt iodine was correlated with the urinary iodine and TVOL, respectively(r = 0.999 and-0.997, P < 0.05). The iodine intake in processed foods was weakly correlated with the TVOL(r = 0.080, P < 0.01). Non-iodized salt used in processed foods or diets when eating out had less effect on children’s iodine nutrition status.Conclusion Iodized salt remains the primary source of daily iodine intake of SAC, and processed food has less effect on iodine nutrition. Therefore, for children, iodized salt should be a compulsory supplement in their routine diet.
基金supported by the Natural Science Foundation of China[NSFC 81602808]Natural Science Foundation of Heilongjiang Province of China[H2016017]Postdoctoral Scientific Research Development Fund[LBH-Q17088].
文摘Thyroid cancer is the most common malignancy of the endocrine system,and its incidence is increasing worldwide.In China,its incidence has increased from 1.78/104 in 1988 to 10.58/104 in2013.Thyroid cancers are mainly classified into papillary thyroid cancer(PTC),follicular thyroid cancer(FTC),medullary thyroid cancer(MTC).
文摘To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr ratio) has been developed. But as the ratio varies worldwide, reference values of the parameter in paediatric population are not developed. To determine reference value, the present study was conducted in healthy paediatric population in Burdwan district, West Bengal. This study was performed on 693 healthy paediatric subjects, aged between 3 months to 18 years and divided into five groups. Early morning non-fasting urine samples from all study groups were analyzed for Ca/Cr ratio. A negative correlation was observed between age and urinary Ca/Cr ratio, but there was no significant difference of urinary Ca/Cr ratio between two sexes. Considering 97.5th percentile of the underlying distribution of values as the upper limit of reference range, upper reference values of urinary Ca/Cr ratio for age groups
文摘To the Editor:Chronic kidney disease(CKD)is a critical health threat.An elevated urinary albumin-creatinine ratio(UACR)is a marker of impaired renal function and is a key risk factor for cardiovascular disease.The rate-pressure product(RPP)[1]and pressure rate quotient(PRQ)are widely used as methods to quantify cardiac load and hemodynamic response to exercise in clinical practice.Therefore,to better predict CKD,it is of great signicance to explore the relationships between RPP or PRQ and UACR.
文摘Objective The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population. Methods In 2011 and 2014, the probability proportionate to size sampling(PPS) was used in each Chinese province to obtain the representative data. In each sampling unit, school children aged 8-10 years and pregnant women were selected. Key indicators included urinary iodine concentration(UIC), thyroid volume(TV), and the iodine content in edible household salt. Results The median urinary iodine concentration(MUIC) decreased between 2011 and 2014 from 238.6 to 197.9 μg/L in school-age children. The number of provinces with iodine excess decreased to zero. The proportion of children whose UIC was 〉 300 μg/L was 18.8% and decreased to 11% compared with 29.8% in 2011. There was no significant difference in UIC 〈 50 μg/L between 2014(4.3%) and 2011(3.7%)(P 〉 0.05). The MUIC among pregnant women in 2014 was more concentrated between 110 and 230 μg/L. The goiter rate among children aged 8-10 years was unchanged, both the goiter rate of 2011 and 2014 remaining below 5%, in view of the sustainable elimination of iodine deficiency disorders. Conclusion The National Standard GB26878-2011 'Iodine Content in Edible Salt' that was introduced in March 2012 resulted in an overall improvement in iodine status, reducing the risk of excessive iodine intake in the Chinese population.
基金supported by the National Natural Science Foundation of China(No.30972452)
文摘Ammonium perchlorate (AP), mainly used as solid propellants, was reported to interfere with homeostasis via competitive inhibition of iodide uptake. However, detailed mechanisms remain to be elucidated. In this study, AP was administered at 0, 130, 260 and 520 mg/kg every day to 24 male SD rats for 13 weeks. The concentrations of iodine in urine, serum thyroid hormones levels, to- tal iodine, relative iodine and total protein, and malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) activity in thyroid tissues were measured, respectively. Our results showed that high-dose perchlorate induced a significant increase in urinary iodine and serum thyroid stimu- lating hormone (TSH), with a decrease of total iodine and relative iodine content. Meanwhile, free thyroxine (FT4) was decreased and CAT activity was remarkably increased. Particularly, the CAT activity was increased in a dose-dependent manner. These results suggested that CAT might be en- hanced to promote the synthesis of iodine, resulting in elevated urinary iodine level. Furthermore, these findings suggested that iodine in the urine and CAT activity in the thyroid might be used as biomarkers for exposure to AP, associated with thyroid hormone indicators such as TSH. FT4.
文摘Objective To explore the clinical characteristics and risk factors of abnormal urinary albumin/creatinine ratio(UACR)in obese population.Methods Baseline data from 2011 to 2012 in Henan Sub-center of"Risk Evaluation of Cancers in Chinese Diabetic Individuals:A longitudinal(REACTION)study"were utilized and those of body mass index≥28 kg/m^(2) were screened.The patients were divided into UACR normal group and UACR abnormal group(101 pairs)upon being matched on a 1:1 basis by age and gender.Multivariate logistic regression analysis,receiver operating characteristic(ROC)curve,and restricted cubic spline(RCS)analysis were performed to explore the risk factors for abnormal UACR.Results Compared with the normal UACR group,the UACR abnormal group had a higher number of alcohol consumers,a higher prevalence of hypertension,elevated systolic blood pressure,and triglyceride(all P<0.05).Multivariate logistic regression analysis showed that alcohol consumption(P=0.008).
文摘Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.
文摘The objective of this study was to assess the prevalence of iodine deficiency and possible correlated factors among schoolchildren in the municipality of Novo Cruzeiro-MG by means of an evaluation of urinary iodine excretion. Five hundred and forty schoolchildren aged 6 to 14 years selected by stratified sampling, were evaluated. Urine samples were analyzed using the Sandell-Kolthoff method preconized by the WHO and iodine concentrations in the salt were assessed by means of volumetric analysis, in accordance with recommendations from the Ministry of Health. Iodine deficiency was observed in 38.9% of the schoolchildren. Of these, 28.7% of them presented slight deficiency, 6.2% of them were moderately deficient and 4% of them were seriously deficient. Median urinary iodine levels in the urban and rural population were 150.8 and 119.2 μg/L, respectively, with a clear distribution of iodine deficiency among the populations (p < 0.001) being registered. It was also observed that there was a high prevalence of deficient urinary iodine excretion among schoolchildren that consumed salt with an insufficient iodine content. In relation to the quality of the salt consumed by families, in 12.2% of the residences studied the iodine content in salt was below the recommended level (20 mg/kg), while the iodine content was below 15 mg/kg in only 5.3% of them. The results indicated that, although not characterized as a public health issue, according to WHO criteria, iodine deficiency showed very high prevalence among schoolchildren in this region. Regarding the iodine content of salt found in household consumption, our findings indicated the National Program of Salt Iodination was not efficient in the city, since it did not hit the target proposed by the Ministry of Health. Furthermore, low urinary iodine excretion associated with the consumption of salt with low iodine content suggests the need for periodical evaluations in order to provide effective control of the endemic disease.
文摘Objective:To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.Materials and Methods:In 2014,a nationwide cross-sectional survey was conducted in 31 provinces (in this study,provinces,autonomous regions and municipalities in China's Mainland were named as provinces).Probability proportional to size sampling method was adopted to recruit children ages 8-10 and pregnant women.47,467 children's and 18,994 pregnant women's urine samples were collected and 47,706 children's thyroid volumes were examined.Iodine content in salt was determined with 46,900 edible salt samples from children's households;urinary iodine concentration (UIC) was tested from children and pregnant women's urine samples;thyroid volume of children was assessed by ultrasound.Results:The national coverage rate of iodized salt and consumption rate of qualified iodized salt were 96.3% and 91.5%,respectively.Median iodine content in iodized salt was 25.2 mg/kg.In 22 of 31 provinces,the provincial coverage rates of iodized salt were over 95%.And consumption rates of qualified iodized salt were more than 90% in 21 provinces.In this study,the national median urinary iodine concentration (MUIC) of children in China was 197.9 μg/L.At the provincial level,MUIC of children in 19 provinces was 100-199 μg/L,which in 12 provinces was 200-299 μg/L.The national MUIC of pregnant women in 2014 was 154.6 μg/L,slightly higher than the lower limit of the WHO criteria for adequate (150-249 μg/L).At the provincial level,MUIC of pregnant women in 18 provinces was 100-149 μg/L,which in 13 provinces was 150-249 μg/L.The national prevalence of goiter among children in 2014 was 2.6%,of which only Shandong province (5.6%) exceeded the national standard (5%).Conclusions:In China,iodine deficiency disorders (IDD) has been eliminated since 2005.And in 2014,the IDD-free status still remained.
文摘Objective:To investigate the relationship of iodine nutritional status with thyroid function in pregnant women in Baotou,and provide a scientific basis for the guide of reasonable iodine supplementation.Methods:By use of As-Ce catalysis spectrophotometry,the urinary iodine concentration was determined in 90 women during different periods of pregnancy admitted to Baogang Hospital of Inner Mongolia from January 2017 to December 2017.The determination of thyroid function and the autoantibody level was carried out by electro-chemiluminescence immunoassay(ECLIA).Results:In the early trimester of pregnancy,pregnant women with iodine deficiency,iodine sufficiency and iodine excess accounted for 36.67%,40.00%and 23.33%respectively;in the middle trimester of pregnancy,they accounted for 66.67%,26.67%and 6.66%respectively;they made up 40.00%,40.00%and 20.00%respectively in the late trimester of pregnancy.The rate of iodine deficiency in women in the middle trimester of pregnancy was significantly higher than that in women in the early and the late trimesters of pregnancy respectively,and the difference was statistically significant(p<0.05).The rate of iodine deficiency in pregnant women was positively correlated to the positivity of thyroid peroxidase antibody.Moreover,it had no relationship with the positivity of thyroglobulin antibody.No matter in the pregnant women with iodine deficiency or with iodine excess,the abnormality rate of thyroid function and autoantibodies was significantly higher than that in the pregnant women with iodine sufficiency.The difference was statistically significant(p<0.05).Conclusions:The iodine deficiency in the women in the middle trimester of pregnancy is more severe than that in the women in the early and the late trimesters of pregnancy.Iodine deficiency during pregnancy is positively correlated with the positivity of thyroid peroxidase antibody.Pregnant women with iodine deficiency and iodine excess show a higher abnormality rate of thyroid function and autoantibodies.It is recommended to advocate health education on iodine nutrition to pregnant women,and conduct the dynamic monitoring of urinary iodine concentration and the screening of thyroid function and autoantibodies during pregnancy.
文摘目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。