维生素D缺乏与年轻1型糖尿病患者视网膜病变相关性的临床研究  

Clinical study on the relationship between Vitamin D deficiency and retinopathy in young patients with type 1 diabetes mellitus

作　　者：张久丹 郑杨[1] 陈晔[1] 倪海祥[1] 王坚[2] 

机构地区：[1]浙江中医药大学附属第一医院浙江省中医院内分泌科,浙江杭州310000 [2]解放军南京军区南京总医院内分泌科,江苏南京210000

出　　处：《中国现代医生》2017年第21期17-20,共4页China Modern Doctor

基　　金：国家自然科学基金面上项目(81370922)

摘　　要：目的观察维生素D缺乏(VDD)与年轻1型糖尿病(T1DM)患者视网膜病变的相关性。方法收集确诊的年轻1型糖尿病患者85例,测定入组患者的糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肾小球滤过率(eGFR)、血清25(OH)D_3等水平,并由糖尿病专家结合单视野眼底照相结果诊断是否合并糖尿病视网膜病变(DR)。根据检测结果纳入患者中26例合并维生素D缺乏(VDD),纳入A组;59例未合并维生素D缺乏,纳入B组。结果比较两组患者基线资料,两组间无明显差异。合并维生素D缺乏组患者糖尿病视网膜病变发生率高于非合并维生素D缺乏组患者(P<0.05)。糖尿病患者的年龄、糖尿病病程以及维生素D缺乏与DR有显著相关性(P均<0.05)。且糖尿病病程及VDD是糖尿病视网膜病变的独立危险因素。结论维生素D缺乏的年轻1型糖尿病患者视网膜病变的发生率明显增加,且糖尿病病程长短和维生素D缺乏是糖尿病视网膜病变的独立危险因素。Objective To investigate the correlation between vitamin D deficiency（VDD） and retinopathy in the young patients with type 1 diabetes mellitus（TIDM）. Methods 85 young patients with type 1 diabetes were collected. HbAlc, high density lipoprotein eholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C）, glomerular filtration rate （eGFR） and serum 25（OH）D3 level were measured in the patients. Whether the diabetic retinopathy （DR） was compli- cated was diagnosed by diabetes experts according to single vision eye-ground photography. According to the results of the test, 26 patients with vitamin D deficiency （VDD） were included in group A; 59 patients without VDD were included in group B. Results There were no significant differences between the baseline data of the two groups. The incidence rate of diabetic retinopathy in the patients with vitamin D deficiency was higher than that in patients without vitamin D deficiency（P〈0.05）. The age, course of diabetes and vitamin D deficiency in the patients with diabetes were significantly correlated with DR（P〈0.05 for all）. The course of diabetes and VDD were independent risk factors for diabetic retinopa- thy. Conclusion The incidence rate of retinopathy in young patients with type 1 diabetes complicated with VDD is sig- nificantly increased, and the course of diabetes and VDD are independent risk factors for diabetic retinopathy.

关 键 词：1型糖尿病 糖尿病并发症 视网膜病变 维生素D缺乏 

分 类 号：R589.1[医药卫生—内分泌]