老年2型糖尿病患者血清25羟维生素D与糖代谢、蛋白尿及hsCRP的相关性研究  

Associations of 25 hydroxy vitamin D level with energy metabolism,albuminuria and hsCRP level in elderly patients with type 2 diabetes mellitus

作　　者：张立娟[1] 田冬梅[1] 童平[1] 王芳[1] 

机构地区：[1]上海市普陀区人民医院内分泌科,上海200060

出　　处：《同济大学学报（医学版）》2015年第4期86-89,共4页Journal of Tongji University(Medical Science)

摘　　要：目的分析老年2型糖尿病患者血清25-羟维生素D与糖代谢、尿蛋白及Hs CRP之间的关系。方法随机选取临床资料完善的住院老年糖尿病患者118例,分为维生素D缺乏组[25（OH）D〈25 nmol/L]和维生素D不足组[25（OH）D 25～74 nmol/L]。测定其25-羟维生素D、糖脂代谢指标、肾功能、电解质、尿白蛋白肌酐比及hsCRP,采用Person相关分析,比较25-羟维生素D与其他糖脂代谢指标、尿蛋白及Hs CRP的相关性。并对维生素D缺乏组和不足组的糖脂代谢指标,尿蛋白及Hs CRP行t检验。结果老年糖尿病患者的血清25-羟维生素D与FPG、Hb A1c、hs CRP、ACR呈负相关,与Fins、Ca呈正相关。与Bun,Cr,P,PTH,TC,TG,LDL,HDL无关。25-羟维生素D缺乏组的Hb A1c、hs CRP、ACR明显高于25-羟维生素D不足组（P〈0.05）,25-羟维生素D缺乏组的Fins、Ca明显低于25-羟维生素不足组,差异有统计学意义（P〈0.05）。但两组的血脂、肾功能、FBG、PTH等差异无统计学意义。结论老年2型糖尿病患者的25-羟维生素D水平普遍低下,维生素D缺乏可影响糖代谢,并可能通过炎症因子hs CRP影响蛋白尿产生。Objective To evaluate association of serum 25 -hydroxyvitamin D ~25 （OH）D] with energy metabolism, albuminuria and hsCRP level in elderly type 2 diabetes mellitus （T2DM） patients. Methods One hundred and eighteen elderly T2DM patients were enrolled in this study. Serum 25 （OH）D was measured, 25 （OH）D levels 〈 25 nmol/L was defined as deficient and 25 -74 nmoL/L as insufficient. Fasting blood glucose （ FBG ）, fasting insulin （ Fins ）, total cholesterol （ TC ）, triglyceride （ TG）, high-density lipoprotein （ HDL-C ）, low-density lipoprotein （ LDL-C ）, blood urea nitrogen （ Bun ）, creatinine （ Cr）, calcium （ Ca ）, phosphorus （ P ）, urine albumin-creatinine ratio （ ACR ） and high sensitive C-reactive protein （hsCRP） were compared. Pearson correlation coefficient wasused to assess the association of 25 （OH） D with variables mentioned above in both groups. T test were used to assess the difference between the deficient 25 （OH） D group and the insufficient 25 （OH） D group. Results Based on the 25（OH） D levels 62 patients （52.5%） were in 25（OH） D deficient group and 56 patients （47.5%） were in 25 （OH） D insufficient group. Serum 25 （OH） D was negatively correlated with FBG, HbAlc, ACR and hsCRP （P 〈 0.05 ）, and was positively correlated with Fins and Ca （ P 〈 0.05 ） ; there were no significance correlation of 25 （OH） D with TG, TC, LDL-C, HDL-C, Bun, Cr and PTH. Serum HbAlc, hsCRP, ACR were significantly higher, while Fins and Ca were lower in 25 （OH） D deficient group than that in 25 （OH） D insufficient group （P 〈 0.05）, but there was no significant difference in lipid profile and renal function between two groups. Conclusion Declined 25 （OH） D level is prevalent in elderly T2DM patients. The deficiency of 25 （OH） D may affect energy metabolism, and may be also involved in progression of albuminuria through inflammatory factors hsCRP.

关 键 词：2型糖尿病 25-羟维生素D 尿白蛋白肌酐比 超敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]