年龄对住院糖尿病患者25羟维生素D和甲状旁腺素相关性的影响  

Effects of aging on the correlation between 25-hydroxyvitamin D and parathyroid hormone in the inpatients with diabetes

作　　者：鲜彤章[1,2] 潘琦[2] 王晓霞[2] 张丽娜[2] 李铭[2] 李淼[2] 郭立新[1,2] 

机构地区：[1]北京协和医学院研究生院,北京100005 [2]北京医院内分泌科国家老年医学中心,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2016年第3期277-282,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的探讨年龄对住院糖尿病患者血清25-羟维生素D(25-hydroxyvitamin,25OHD)和甲状旁腺素(parathyroid hormone,PTH)相关关系的影响。方法本研究为回顾性分析,共纳入住院糖尿病患者252例,收集患者住院期间体质量指数、糖尿病分型、就诊季节等临床资料和血清PTH、25OHD、血钙、磷、肌酐和糖化血红蛋白等检查结果。根据年龄分为年龄<65岁组(n=172)和年龄≥65岁组(n=80),采用偏相关分析影响PTH的因素,线性回归分析25OHD与PTH之间的关系。结果住院糖尿病患者普遍存在维生素D不足或缺乏,45.6%患者25OHD低于25 nmol/L。偏相关分析显示,年龄<65岁组,调整血肌酐后PTH仅与25OHD负相关(r=-0.316,P=0.000);年龄≥65岁组,血清PTH仅与血钙(r=-0.238,P=0.037)、血磷(r=-0.237,P=0.038)呈负相关,与25OHD无关(P=0.380)。线性回归分析显示,调整血肌酐后,年龄<65岁组PTH随25OHD升高而下降,年龄≥65岁组PTH不受25OHD变化影响。结论住院糖尿病患者中普遍存在维生素D不足或缺乏,年龄对PTH与25OHD之间的相关性有明显影响。应加强老年糖尿病患者中PTH、25OHD、钙磷及相关激素的研究,以明确是否需要制订年龄特异的PTH和25OHD正常值标准。Objective To investigate the effects of aging on the correlation between 25-hydroxyvitamin D（ 25OHD） and parathyroid hormone（ PTH） in the inpatients with diabetes. Methods We retrospectively analyzed the clinical records of the inpatients. 252 patients with type 1 or type 2 diabetes mellitus were enrolled. The information of body bass index,type of diabetes,admission season and the laboratory data including serum 25 OHD,PTH,calcium,phosphorus,creatinine,and hemoglobin A1 c were collected. They were divided into group of age〈 65（ n = 172） and group of age ≥65（ n = 80）. The correlation of PTH and 25 OHD was analyzed with partial correlation analysis and linear regression. Results The prevalence of vitamin D deficiency was high in the diabetic inpatients,45. 6% of the subjects suffered from a serum 25 OHD lower than 25 nmol / L. Partial relationship adjusted with creatinine showed in the group of age〈 65,serum PTH had a significantly negative correlation with 25OHD（ r =- 0. 316,P = 0. 000）. In the group of age≥65,serum PTH had a significantly negative correlation with calcium（ r =- 0. 238,P = 0. 037）,phosphorus（ r =- 0. 237,P = 0. 038） and no correlation with 25 OHD or age. Linear regression revealed serum PTH decreased with the increase of 25 OHD in the group of age 65 and no such effect in the group of age≥65. Conclusions There is high prevalence of vitamin D insufficiency and deficiency in diabetic population. The aging influences the correlation between serum PTH and 25 OHD. The further research of PTH,25 OHD will be helpful in clarifying whether we should define an age-dependent normal range of PTH and 25 OHD.

关 键 词：糖尿病 25羟维生素D 甲状旁腺素 年龄 

分 类 号：R681[医药卫生—骨科学]