老年女性代谢综合征患者血清25-羟维生素D水平变化及临床意义研究  

Changes of Serum 25-hydrocyvitamin D Level in Elderly Women With Metabolic Syndrome and Its Clinical Significance

作　　者：褚琳[1] 孙芳[1] 刘杰[1] 陈陵霞[1] 苗懿德[1] 

机构地区：[1]北京大学人民医院老年科,北京市100044

出　　处：《中国全科医学》2015年第12期1376-1381,共6页Chinese General Practice

摘　　要：目的探讨老年女性患者25-羟维生素D〔25-（OH）VD〕水平与代谢综合征（MS）发生发展的相关性。方法收集2011年9月—2013年11月于北京大学人民医院老年科住院的老年女性患者188例,年龄60-94岁,均为绝经后。按照有无MS将患者分为MS组（79例）和非MS组（109例）;按照血清25-（OH）VD中位数（31.5 nmol/L）将患者分为〈31.5 nmol/L组（94例）和≥31.5 nmol/L组（94例）。测量血压、身高、体质量、计算体质指数（BMI）,并检测空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白（Hb A1c）、空腹胰岛素（FINS）、血钙（Ca）、血磷（P）、血清25-（OH）VD、骨特异性碱性磷酸酶（BAP）和抗酒石酸酸性磷酸酶（TRAP）水平,计算胰岛素抵抗指数（HOMA-IR）;比较MS组与非MS组血清25-（OH）VD缺乏程度;分析血清25-（OH）VD与观察指标的相关性。结果 MS组高血压病程、糖尿病病程、TG、HDL-C、FPG、Hb A1c、FINS、HOMA-IR与非MS组比较,差异有统计学意义（P〈0.05）。MS组患者血清25-（OH）VD水平低于非MS组（P〈0.05）。〈31.5 nmol/L组高血脂病程、TG、HDL-C、FPG、Hb A1c、FINS、HOMA-IR与≥31.5 nmol/L组比较,差异有统计学意义（P〈0.05）。≥31.5nmol/L组患者血清25-（OH）VD水平高于〈31.5 nmol/L组（P〈0.05）。MS组与非MS组血清25-（OH）VD缺乏程度比较,差异有统计学意义（P〈0.05）。血清25-（OH）VD水平与TG、FPG、HOMA-IR呈负相关,与HDL-C呈正相关（P〈0.05）。结论老年女性患者血清25-（OH）VD水平较低,且与血脂、血糖相关,为临床进一步研究提供了参考依据。Objective To investigate the relationship between serum 25-hydrocyvitamin D 〔25-（ OH） VD〕evel and occurrence of metabolic syndrome（ MS） in elderly women. Methods 188 elderly post-menopausal female patients（ 60-94 years old） who were admitted to the department of geriatrics of Peking University People＇ s Hospital from September 2011 to November 2013,were selected as study subjects. 79 cases with MS were included in MS group,109 without MS were included in non-MS group. According to the median serum 25-（ OH） VD level（ 31. 5 nmol / L）,94 cases were included in 31. 5nmol / L group,94 cases were included in ≥31. 5 nmol / L group. Blood pressure,body weight,body height,body mass index（ BMI） were measured and calculated. Serum levels of fasting plasma glucose（ FPG）,total cholesterol（ TC）,triglycerides（ TG）,low-density lipoprotein cholesterol（ LDL-C）,high-density lipoprotein cholesterol（ HDL-C）,glycosylated hemoglobin（ Hb A1c）,serum fasting insulin（ FINS）,calcium（ Ca）,phosphorus（ P）,25-（ OH） VD,bone-specific alkaline phosphatase（ BAP） and tartaric-resistant phosphatase（ TRAP） were measured. The degree of 25-（ OH） VD deficiency was compared between MS group and non-MS group,the correlation between serum level of 25-（ OH） VD and observation indicators was analyzed. Results There were significant differences in duration of hypertension and diabetes,levelsof TG,HDL-C,FPG,Hb A1 c,FINS and HOMA-IR between MS group and non-MS group（ P〈0. 05）. Serum level of25-（ OH） VD in MS group was significantly lower than that in non-MS group（ P〈0. 05）. There were significant differences in duration of hyperlipidemia,levels of TG,HDL-C,FPG,Hb A1 c,FINS and HOMA-IR between 31. 5 nmol/L group and ≥31. 5 nmol / L group（ P〈0. 05）. Serum level of 25-（ OH） VD in ≥31. 5 nmol / L group was significantly higher than that in〈 31. 5 nmol / L group（ P〈0. 05）. There was significant difference in degree of 25-（ OH） VD deficienc

关 键 词：代谢综合征X 老年女性 维生素D 

分 类 号：R589[医药卫生—内分泌]