男性2型糖尿病患者维生素D营养状况及其对骨代谢指标的影响  

Vitamin D Nutritional Status in Male Patient with Type 2 Diabetes and Its Effects on Bone Turnover Markers

作　　者：瞿卫[1] 林艳丽[1] 立彦[1] 刘春燕[1] 张瑞生[2] 

机构地区：[1]南京医科大学附属南京医院南京临床核医学中心,江苏南京210006 [2]南京医科大学附属南京医院检验科,江苏南京210006

出　　处：《标记免疫分析与临床》2015年第3期161-163,共3页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 了解男性2型糖尿病患者维生素D营养状况及其对骨代谢指标的影响。方法 采用Roche E170全自动电化学发光免疫分析仪检测258例男性2型糖尿病患者血清的25羟维生素D[25（OH）D]、总I型前胶原氨基端肽（t PINP）和I型胶原羧基端肽（β-CTX）。根据血清25（OH）D水平分为维生素D严重缺乏（〈25nmol/L）、缺乏（≥25nmol/L且〈50nmol/L）、不足（≥50nmol/L且〈75 nmol/L）和充足（≥75nmol/L）。结果 男性2型糖尿病患者总体25（OH）D浓度为33.80±18.43nmol/L,为维生素D缺乏水平。根据年龄将受试者分为中年组（35~49岁）、老年前期组（50~59岁）、老年1组（60~69岁）、老年2组（〉70岁）,发现随着年龄的增长,25（OH）D的浓度呈逐渐降低趋势,老年2组的25（OH）D显著低于中年组（P=0.044）,而骨标志物在各年龄组间差异均无统计学意义（P〉0.05）。258例男性2型糖尿病患者中维生素D严重缺乏、缺乏、不足、充足的比例分别为36.43%（94/258）、48.45%（125/258）、11.63%（30/258）和3.49%（9/258）。维生素D严重缺乏组的β-CTX明显高于其他各营养状况组（均P〈0.05）,而t PINP在各营养状况组间差异均无统计学意义（P〉0.05）。相关分析表明,血清25（OH）D水平与β-CTX呈负相关（r=-0.197,P=0.001）,与t PINP无相关性（r=-0.046,P=0.464）。结论 男性2型糖尿病患者存在严重维生素D缺乏和不足状况,维生素D严重缺乏对骨吸收可能有影响。Objective To evaluate the Vitamin D nutritional status in male patient with type 2 diabetes（ T2DM）and its effects on bone markers. Methods 258 cases of male patients with T2 DM were recruited,their serum levels of 25-hydroxyvitamin D[25（ OH） D ],t PINP and β-CTX were measured by Roche E170 automatic electrochemiluminescence immunoassay analyzer. According to 25（ OH） D levels,patients were divided into 4groups： severe deficiency（〈25 nmol / L）,deficiency（ ≥25 nmol / L and 50 nmol / L）,insufficiency（ ≥50nmol / L and 75 nmol / L） and sufficiency（ ≥75 nmol / L） groups. Results The total 25（ OH） D level in T2 DM patients was 33. 80 ± 18. 43 nmol / L,which indicated vitamin D deficiency. The participants were divided into 4age groups,middle-aged group（ 35-49 year old）,presenium group（ 50-59 year old）,gerontism group 1（ 60-69 year old）,gerontism group 2（〉70 year old）. As the increase of age,the concentration of 25（ OH） D decreased gradually. The 25（ OH） D levels in gerontism group 2 was significantly lower than that of middle-aged group,but bone markers had no significant difference among various age groups. The proportion of vitamin D in severe dificiency,defiency,insufficiency and sufficiency groups were 36. 43%（ 94 /258）,48. 45%（ 125 /258）,11. 63%（ 30 /258） and 3. 49%（ 9 /258） respectively. The level of β-CTX in severe deficiency group was apparently higher than other groups（ P 0. 05）. t PINP had no difference between various nutritional status groups. The level of serum 25（ OH） D was negatively correlated with serum β-CTX（ r =- 0. 197,P = 0. 001）,however 25（ OH） D had no relevance with t PINP（ r =- 0. 046,P = 0. 464）. Conclusion Vitamin D severe deficiency and insufficiency are highly prevalent among male patient with type 2 diabetes. There is no evidence shows that the serum 25（ OH） D severe deficiency is associated with bone formation,while the bone absorption increases.

关 键 词：男性 2型糖尿病 25羟维生素D 骨代谢指标 

分 类 号：R587.1[医药卫生—内分泌] R580[医药卫生—内科学]