血清25羟维生素D3在糖尿病周围神经病变中的作用  

Effect of plasma 25(OH) D3 on diabetic peripheral neuropathy

作　　者：陈福莲[1] 江晓龙 赵佳[1] 郭世彪[1] 王慎田[1] 

机构地区：[1]潍坊医学院附属益都中心医院内分泌科,山东青州262500 [2]青州市黄楼卫生院,山东青州262500

出　　处：《中风与神经疾病杂志》2016年第6期496-499,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的观察2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)各阶段血清25羟维生素D3[25(OH)D3]水平变化,研究二者相关性及其临床意义。方法将106例2型糖尿病患者根据神经自觉症状和肌电图检查分为单纯糖尿病组(SDM组)、亚临床周围神经病变组(SDPN组)、周围神经病变组(DPN组),并设30例正常对照组(NC组)与糖调节受损组(IGR组)。测量所有受试者的身高、体重、血压、血清25(OH)D3浓度、血糖、糖化血红蛋白、血脂、肌酐、纤维蛋白原,比较各组间所测指标的差异性,并分析25(OH)D3与各指标的相关性。结果 NC组、IGR组、SDM组、SDPN组、DPN组血清25(OH)D3分别为:(70.23±21.45)nmol/L、(67.85±17.64)nmol/L、(58.86±15.79)nmol/L、(40.72±10.15)nmol/L、(38.55±8.95)nmol/L,SDM组、SDPN组、DPN组低于NC组、IGR组(P﹤0.05),NC组与IGR组、DPN组与SDPN组间无统计学差异。Pearson相关分析显示血清25(OH)D3与所测神经传导速度正相关(均P﹤0.05);与BMI、病程、Cr、FIB呈负相关(P﹤0.05或P﹤0.01),控制BMI、病程、Cr、FIB后,血清25(OH)D3仍然与神经传导速度相关。结论血清25(OH)D3缺乏是DPN的独立危险因素,补充维生素D可能对DPN起预防作用。Objective To investigate associations and clinical significance between plasma 25（ OH） D3 and diabetic peripheral neuropathy. Methods According to subjective symptoms and electromyographic recorder,106 type 2 diabetic patients were divided into simple diabetic group（ SDM）,sub-clinical neuropathic group（ SDPN）,clinical neuropathic group（ DPN）. 30 normal control（ NC） and 30 impaired glucose regulation（ IGR） subjects were admitted. Height,body weight,blood pressure,plasma 25（ OH） D3,blood glucose,Hb A1 c,blood fat,serum creatinine and fibrinogen were measured in all cases. The correlations between 25（ OH） D3 and other parameters were analyzed. All parameters were compared amomg different groups. The correlations between 25（ OH） D3 and other parameters were analyzed. Results In NC,IGR,SDM,SDPN,DPN groups,plasma 25（ OH） D3 levels were（ 70. 23 ± 21. 45） nmol / L、（ 67. 85 ± 17. 64） nmol / L、（ 58. 86 ±15. 79） nmol / L、（ 40. 72 ± 10. 15） nmol / L、（ 38. 55 ± 8. 95） nmol / L,respectively. In SDM,SDPN,DPN groups it was lower than that in NC and IGR groups（ P ﹤ 0. 05）,but there was no significant difference between NC and IGR groups or SDPN and DPN groups. Pearson correlated analysis showed that plasma 25（ OH） D3 was positively correlated with all nerve conductive velocity（ all P ﹤ 0. 05）,but negatively correlated with BMI,duration of diabetes,Cr,FIB. After control BMI,duration of diabetes,Cr,FIB,25（ OH） D3 remained relationship with all nerve conductive velocity. Conclusion Serum 25（ OH） D3 may be regarded as a predictor of DPN,it is possibly preventive to DPN by supplementing 25（ OH） D3.

关 键 词：25羟维生素D3 2型糖尿病 周围神经病变 

分 类 号：R587.2[医药卫生—内分泌]