2型糖尿病患者血清25(OH)VD水平与糖尿病肾病、糖尿病视网膜病变的相关性  

Associations of serum 25-hydroxyvitamin D levels with diabetic nephropathy and diabetic retinopathy in patients with type 2 diabetes mellitus

作　　者：陈玲[1] 周翔海[1] 纪立农[1] CHEN Ling;ZHOU Xianghai;JI Linong(Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院,北京100044

出　　处：《山东医药》2018年第39期61-64,共4页Shandong Medical Journal

基　　金：国家高新技术研究与发展计划(863计划2012AA02A509)

摘　　要：目的探讨2型糖尿病患者血清25-羟胆骨化醇[25(OH) VD]水平与糖尿病肾病、糖尿病视网膜病变的相关性。方法选取未接受维生素D补充治疗的2型糖尿病患者1 244例,按照尿白蛋白定量/肌酐比值(u ACR)不同分为临床蛋白尿者59例(A组,u ACR≥300 mg/g)、非临床蛋白尿者1 185例(B组,u ACR <300 mg/g),根据免散瞳眼底照相和(或)眼底镜检查结果不同分为糖尿病视网膜病变(DR)者262例(C组)和非糖尿病视网膜病变者982例(D组),比较各组血清25(OH) VD等相关临床资料,分析血清25(OH) VD水平与DN、DR的关系。结果与B组比较,A组血清25(OH) VD水平降低,维生素D缺乏比例增加(P均<0. 05);多因素回归分析显示,血清25(OH) VD水平与DN风险呈负相关。与D组比较,C组血清25(OH) VD水平降低,维生素D缺乏比例增加(P均<0. 05);多因素回归分析显示,血清25(OH) VD水平与DR风险呈负相关。结论血清25(OH) VD水平与2型糖尿病患者微血管并发症患病风险呈负相关。Objective To investigate the associations between serum 25-hydroxyvitamin D levels and diabetic nephropathy and diabetic retinopathy in a large sample of patients with type 2 diabetes mellitus.Methods A total of 1 244 patients with type 2 diabetes mellitus without vitamin D supplement therapy were included.According to the urine albumin/creatinine ratio(uACR),they were divided into the overt proteinuria group of 59 cases(group A,uACR≥300 mg/g)and non-overt proteinuria group of 1 185 cases(group B,uACR﹤300 mg/g),and according to ophthalmoscopy examination,they were divided into the diabetic retinopathy(DR)group of 262 cases(group C)and non-diabetic retinopathy group of 982 cases(group D).The associations between serum 25(OH)VD level and DN and DR were analyzed.Results Compared with the group B,the serum 25(OH)VD level in the group A was lower,and the proportion of vitamin D deficiency was higher(both P<0.05).Multivariate regression analysis showed that serum 25(OH)VD level was negatively correlated with DN risk.Compared with the group D,the serum 25(OH)VD level in the group C was lower and the proportion of vitamin D deficiency was higher(both P<0.05).Multivariate regression analysis showed that serum 25(OH)VD level was negatively correlated with DR risk.Conclusion The serum 25(OH)VD level is negatively correlated with the risk of microvascular complications in patients with type 2 diabetes mellitus.

关 键 词：25-羟胆骨化醇 2型糖尿病 糖尿病肾病 糖尿病视网膜病变 

分 类 号：R587.1[医药卫生—内分泌]