出 处:《国际内分泌代谢杂志》2014年第3期153-157,共5页International Journal of Endocrinology and Metabolism
摘 要:目的 调查分析2型糖尿病患者血清25羟维生素D3[25(OH)D3]的水平和缺乏程度,初步了解维生素D缺乏与糖尿病病程和糖化血红蛋白(HbA1c)的关系.方法 选择天津医科大学总医院2型糖尿病患者140例,其中男60例,女80例,年龄21~89岁,平均(58.25±13.76)岁.分析不同年龄组即<50岁、≥50且<70岁、≥70岁者,不同检测季节组即冬春季和夏秋季两组,不同糖尿病病程组即<10年、≥10且<20年、≥20年,及不同HbA1c水平组即<7%、≥7%且<10%、≥10%的血清25(OH)D3水平.结果 (1)140例患者血清25(OH)D3水平均明显降低[(40.07±16.12)nmol/L],维生素D严重缺乏者占13.57%,缺乏者占67.86%,充足者仅占4.29%,不同性别患者维生素D水平和缺乏程度的差异均无统计学意义(t =0.803,x2=0.189,P均>0.05).(2)男性≥50且<70岁组25(OH)D3水平较<50岁组明显降低(F=2.362,P<0.05);女性≥50岁的两组患者25(OH)D3水平均较<50岁组明显降低(F =3.928,P<0.05),维生素D缺乏者的比例均较<50岁组显著增多(x2=10.036,P <0.01).(3)冬春季组25(OH)D3水平显著低于夏秋季组(t=-4.681,P<0.01),严重缺乏者和缺乏者的比例也明显增加(x2=18.202,P<0.01).(4)病程≥10年的两组患者25(OH)D3水平均较<10年组明显下降(F =5.489,P<0.05),≥20年组严重缺乏者的比例也多于<10年组(x2=7.284,P<0.05).(5)HbA1c≥7%的两组患者25(OH)D3水平均较<7%组明显下降(F=3.963,P均<0.01),其严重缺乏者和缺乏者的比例也较<7%组明显增加(x2=6.712,P<0.05).结论 2型糖尿病患者普遍存在维生素D缺乏,尤其是病程长和持续血糖控制不佳者,特别需加强冬季维生素D的检测和补充.Objective To analyze the serum level of 25-hydroxy vitamin D3 and the degree of vitamin D deficiency in the patients with type 2 diabetes mellitus,and the relationships between the degree of vitamin D deficiency,durations of diabetes and glycosylated hemoglobin A1c (HbA1c) levels were also investigated.Methods 140 patients with type 2 diabetes mellitus (60 male and 80 female) were selected from the Department of Endocrinology of The General Hospital of Tianjin Medical University,aged 21 to 89,with an average age of (58.25 ± 13.76) years old.Serum 25-hydroxy vitamin D3 levels between different age groups (〈50,≥ 50 and 〈70,≥70years old group) and tested season groups (winter and spring,summer and autumn group),different duration of diabetes groups (〈 10,≥ 10 and 〈20,≥ 20 years group) and different HbA l c level groups (〈 7%,≥7% and〈 10%,≥ 10%) were compared.Results (1)The serum 25(OH)D3 levels of these 140 patients were all below normal range,and the average levels was (40.07 ± 16.12) nmol/L.The prevalence of severe vitamin D deficiency,deficiency and sufficiency were 13.57%,67.86% and 4.29%,respectively.But there was no significant difference between male and female both in the serum 25(OH)D3 levels and the degree of vitamin D deficiency(t =0.803,x2=0.189,both P 〉0.05).(2) The serum 25(OH)D3 levels of patients aged ≥ 50 and〈70 were lower than that of the subjects aged 〈50 in male (F =2.362,P 〈0.05).In female,the serum 25 (OH)D3 levels of patients aged ≥ 50 were lower than that of the subjects aged 〈50 (F =3.928,P 〈 0.05),and the percentages of vitamin D deficiency were also greater than that in patients younger than 50 years (x2=10.036,P 〈0.01).(3)The serum 25(OH)D3 levels in winter and spring were lower than that in summer and autumn (t =-4.681,P 〈0.01),and the percentage of severe vitamin D deficiency and deficiency were increased as well (x2=18.202,P 〈 0.01).(4)The serum 25
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