血清25-羟维生素D_(3)与非肥胖2型糖尿病患者大血管病变的相关性研究  

Study on the correlation between 25-dihydroxy Vitamin D_(3) and non obese type 2 diabetic macroangiopathy

作　　者：冯玲[1] 徐芳 刘依然 李子玲[1] Feng Ling;Xu Fang;Liu Yiran;Li Ziling(Department of Endocrinology,Inner Mongolia Steel Hospital,Inner Mongolia Baotou 014010,China;The Second Affiliated Hospital,Shijiazhuang People’s Hospital,Hebei Shijiazhuang 050011,China)

机构地区：[1]内蒙古包钢医院内分泌科,内蒙古包头014010 [2]石家庄市人民医院,河北石家庄050011

出　　处：《中国医刊》2022年第5期498-501,共4页Chinese Journal of Medicine

基　　金：包头市科技计划项目(2018C2007-3-14);内蒙古自治区科技计划项目(2021GG0362)。

摘　　要：目的 探讨血清25-羟维生素D_(3)[25 hydroxy vitamin D_(3),25(OH)D_(3)]与非肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者并发大血管病变(macro-vascular complications,MVC)的相关性及影响因素。方法 回顾性分析2017年1月至2019年10月内蒙古包头包钢医院内分泌科收治的160例非肥胖T2DM患者的临床资料,根据是否并发MVC分为并发MVC组(89例)与未并发MVC组(71例),观察两组患者的血清25(OH)D_(3)水平及血糖、空腹C肽、糖化血红蛋白、血脂、血压、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)等相关临床指标。通过多因素分析探讨血清25(OH)D_(3)与MVC的相关性及影响因素。结果 并发MVC组血清25(OH)D_(3)水平较未并发MVC组显著降低(P<0.05)。血清25(OH)D_(3)不同水平分组比较,血清25(OH)D_(3)水平越低,MVC发生率越高(P<0.05)。Logistic回归分析结果显示,MVC与血清25(OH)D_(3)水平、空腹C肽水平呈负相关,与年龄、收缩压、TNF-α呈正相关(P<0.05)。多元线性回归分析结果显示,血清25(OH)D_(3)水平与高密度脂蛋白胆固醇、空腹C肽水平呈正相关,与低密度脂蛋白胆固醇、糖化血红蛋白、TNF-α呈负相关(P<0.05)。结论 血清25(OH)D_(3)不足或缺乏与非肥胖T2DM患者并发MVC密切相关,其机制可能与血清25(OH)D_(3)对血糖、血脂、炎症因子的影响相关。Objective To investigate the correlation with serum 25 hydroxy vitamin D_(3)(25(OH)D_(3))in patients with non-obese type 2 diabetes mellitus(T2DM)without macrovascular disease and non obese type 2 diabetes mellitus combined with macrovascular diseases(MVC)and its influencing factors.Method The clinical data of 160 patients with non-obese T2DM were analyzed retrospectively,including non-MVC group(n=71)and MVC group(n=89).The serum 25(OH)D_(3)levels and related clinical indexes such as blood glucose,C-peptide、HbA1c、blood lipids、blood pressure and TNF-αwere observed in the two groups.The correlation and influencing factors of 25(OH)D_(3)and MVC were discussed by multivariate analysis.Result Compared with the non-MVC group,the serum 25(OH)D_(3)level of the MVC group was significantly lower(P<0.05).Compared with different levels of serum 25(OH)D_(3),the lower the serum 25(OH)D_(3)level,the higher the incidence of MVC(P<0.05).Logistic regression analysis showed that MVC was negatively correlated with serum 25(OH)D_(3)levels and C-peptide,and positively correlated with age,systolic blood pressure,and TNF-α(P<0.05).The results of multiple linear regression analysis showed that the serum 25(OH)D_(3)level was positively correlated with HDL-C and C-peptide,and negatively correlated with LDL-C,HbA1c,and TNF-α(P<0.05).Conclusion Insufficiency or lack of serum 25(OH)D_(3)is closely related to the occurrence of MVC in non-obese T2DM patients,and its internal mechanism may be related to the effect of serum 25(OH)D_(3)on blood sugar,blood lipids,and inflammatory factors.

关 键 词：非肥胖2型糖尿病 大血管病变 25-羟维生素D_(3) 

分 类 号：R587.2[医药卫生—内分泌]