新诊断的2型糖尿病患者血清25-(OH) D水平与体脂分布的相关性分析  

Relationship of serum 25-(OH) D and body fat distribution in newly diagnosed patients with type 2 diabetes mellitus

作　　者：高婷[1] 陈培红[2,3] 金华[2,3] 杨莉丽[2,3] 谢心苗[2,3] 杨梅丽[2,3] 于雪梅[2,3] 

机构地区：[1]苏州大学研究生院,江苏苏州215006 [2]上海交通大学附属第六人民医院南院 [3]奉贤区中心医院

出　　处：《山东医药》2014年第6期4-7,共4页Shandong Medical Journal

基　　金：上海市医学重点专科建设计划资助项目(ZK2012B16);上海市科委资助项目(134119b2500);上海市奉贤区社会类科技发展基金资助项目(奉科2012-1201);上海市糖尿病重点实验室开放课题资助项目(SHKLD-KF-1103)

摘　　要：目的 探讨新诊断2型糖尿病患者体内血清25-（OH）D水平与体脂分布的相关性.方法 选择年龄40～60岁上海奉贤区常住居民460人,进行问卷调查、查体、生化指标、血清25-（OH）D和体脂成分等指标测定,筛查新诊断2型糖尿病患者、糖耐量正常者及25-（OH）D缺乏者.比较新诊断2型糖尿病患者与糖耐量正常者的体质量指数（BMI）、腰臀比、生化指标等临床特征及体脂分布情况;比较25-（OH）D缺乏者与无25-（OH）D缺乏者的BMI、腰臀比、生化指标等临床特征及体脂分布情况.采用Pearson相关系数评价各指标与血清25-（OH）D的相关性,采用Logistic回归分析方法分析25-（OH）D缺乏的独立危险因子.结果 共筛查出新诊断2型糖尿病患者62例、糖耐量正常者100例.新诊断2型糖尿病患者中25-（OH）D缺乏48例,糖耐量正常者中25-（OH）D缺乏70例.与糖耐量正常者相比,新诊断2型糖尿病患者BMI、腰围、腰臀比、体脂百分比、糖化血红蛋白（HbA1C）、HOMA-IR均增高（P＜0.05）.与无25-（OH）D缺乏者相比,25-（OH）D缺乏者去脂体质量、骨骼肌含量、右上肢肌肉含量、躯干肌肉含量、右下肢肌肉含量、左下肢肌肉含量明显降低（P＜0.05）,体脂百分比水平增高（P＜0.05）.血清25-（OH）D水平与体脂百分比、去脂体质量、骨骼肌含量、右上肢肌肉含量、躯干肌肉含量、右下肢肌肉含量、左下肢肌肉含量显著相关（P均＜0.05）.Logistic多元回归分析示体脂百分比、躯干肌肉含量是预测血清25-（OH）D水平的独立影响因子.结论 体脂百分比影响新诊断2型糖尿病患者血清25-（OH）D水平.维持体内血清25-（OH）D及体脂分布的恰当水平对2型糖尿病及糖耐量正常者有益.Objective To evaluate the correlation between serum 25-（OH） D and body fat distribution in newly diagnosed patients with type 2 diabetes mellitus.Methods A total of 460 permanent residents of Fengxian aged 40-60 years were enrolled.The questionnaire,physical examination,biochemical parameters,serum 25-（OH） D,body fat composition and other parameters were measured; and the newly diagnosed patients with type 2 diabetes,people with normal glucose tolerance and patients with 25-（OH） D deficiency were screened.Body mass index （BMI）,waist-hip ratio,biochemical indicators and body fat distribution were observed in both newly diagnosed patients with type 2 diabetes and people with normal glucose tolerance.Meanwhile,the above parameters were also detected in people with 25-（OH） D deficiency and without 25-（OH） D deficiency.Pearson correlation coefficients were applied in analyzing the correlations between various indicators and serum 25-（OH） D level.Independent risk factors of 25 （OH） D deficiency were analyzed by Logistic regression.Results There were 62 newly diagnosed patients with type 2 diabetes and 100 subjects with normal glucose tolerance.In newly diagnosed type 2 diabetes,48 patients had 25-（OH） D deficiency,and 70 persons had 25-（OH） D deficiency in normal glucose tolerance.Compared with the normal glucose tolerance group,the BMI,waist circumference,waist-hip ratio,triglycerides,percentage of body fat,glycosylated hemoglobin A1c （HbA1c）,insulin resistance index homeostasis model assessment were significantly higher in the newly diagnosed type 2 diabetes （P ＜ 0.05）.Compared with non 25-（OH） D deficiency,the lean body mass,muscle content,right upper limb muscle content,trunk muscle content,lower limbs muscle content were decreased （P ＜ 0.05）,and percentage of body fat was significantly higher in 25-（OH） D deficiency persons （P ＜0.05）.We found that serum 25-（OH） D level was related to the percentage of body fat,lean body mass,muscle content,r

关 键 词：糖尿病 2型 25-(OH)D 体脂分布 

分 类 号：R591.44[医药卫生—内科学] R587.1[医药卫生—临床医学]