血清25羟维生素D_3与糖尿病视网膜病变的相关性研究  

STUDY ON THE RELATIONSHIP BETWEEN SERUM 25-HYDROXYVITAMIN D_3 AND DIABETIC RETINOPATHY

作　　者：范乐平[1] 郭慕新 张玥[1] 朱杰[1] 林静娜[1] 

机构地区：[1]天津市人民医院内分泌科 [2]91366部队

出　　处：《营养学报》2017年第2期139-143,共5页Acta Nutrimenta Sinica

基　　金：天津市卫生局科技基金(No.2015KZ058)

摘　　要：目的研究2型糖尿病(T2DM)患者血清25羟维生素D_3[25(OH)D_3]水平与糖尿病视网膜病变(DR)的相关性。方法选取T2DM患者249例和正常对照者100名,其中2型糖尿病患者分为单纯糖尿病无DR组(NDR,94例)、T2DM合并非增殖期DR组(NPDR,82例)及T2DM合并增殖期DR组(PDR,73例)。ELISA法测定25(OH)D_3水平,常规测定肝、肾功能,空腹血糖,HbA1c,血脂,尿微量白蛋白等指标。25(OH)D_3与各指标之间进行相关性分析。结果与正常对照组相比,NDR组、NPDR组及PDR组25(OH)D_3水平均明显降低,以PDR组最低,各组间差异均有统计学意义(F=138.516,P=0.000),且PDR组维生素D(VD)缺乏患者比例明显高于NPDR组及NDR组(χ~2=36.970,P=0.000)。VD水平与DR、糖尿病病程、年龄、性别、BMI、收缩压、空腹血糖、HbA1c、尿素氮、肌酐、24 h尿微量白蛋白、总胆固醇、低密度脂蛋白-胆固醇均呈显著负相关(r值分别为-0.763^-0.135,均P<0.05)。多元Logistic回归分析显示,VD缺乏是DR的独立危险因素(OR=9.214,95%CI:4.354~19.499,P=0.000)。结论 VD缺乏参与了T2DM及DR的发生、发展,可作为DR的独立危险因素。Objective To evaluate the association of 25-hydroxyvitamin D3 with diabetic retinopathy （DR） in type 2 diabetic patients. Methods A total of 249 type 2 diabetes mellitus （T2DM） and 100 healthy subjects were tested in this study. The patients of T2DM were divided into no diabetic retinopathy （NDR） group（n=94）, no-preproliferative diabetic retinopathy （NPDR） group （n=82） and preproliferative diabetic retinopathy （PDR） group （ n=73 ）. ELISA was used to measure the level of 25（OH） D3, and conventional methods were used to determine the functions of liver and kidney, fasting plasma glucose, glycosylated hemoglobin, blood lipids, urinary microalbumin and other indexes. Correlation between 25（OH）D3 and other indexes was analysed. Results Compared with normal control group, 25（OH）D3 levels were lower in NDR, NPDR and PDR groups, especially in PDR group （F=138.516, P=0.000）. Moreover, the percentage of vitamin D deficiency in PDR group was much higher than that of NPDR group and NDR group （x2=36.970, P=0.000）. Vitamin D was negatively related with DR, diabetes duration, age, sex,BMI, systolic blood pressure, fasting plasma glucose, HbAlc, blood urea nitrogen ,serum creatinine, 24 h urinary microalbumin, total cholesterol and low density lipoprotein cholesterol （r=-0.763-0.135, respectively, all P〈0.05）. Multiple logistic regression analysis showed that vitamin D deficiency was an independent risk factor for DR （OR=9.214, 95% CI： 4.354-19.499, P=0.000）. Conclusion Vitamin D deficiency is an independent risk factor for DR, and may play a role in the occurrence and development of type 2 diabetes mellitus and DR.

关 键 词：2型糖尿病 维生素D缺乏 视网膜病变 

分 类 号：R587.2[医药卫生—内分泌]