1型糖尿病儿童青少年血清25-羟维生素D 3与糖化血红蛋白水平的关系  

Relationship between serum 25-hydroxyvitamin D 3 levels and glycosylated hemoglobin levels in children and adolescents with type 1 diabetes mellitus

作　　者：许东伟 刘洋 王丽娜[1] 田飞[1] 赵岩 陈志红[1] XU Dongwei;LIU Yang;WANG Li′na;TIAN Fei;ZHAO Yan;CHEN Zhihong(Department of Pediatric Endocrinology and Digestion,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院儿童内分泌消化科,山东青岛266003 [2]青岛大学医学部 [3]临沂市平邑县人民医院儿科

出　　处：《精准医学杂志》2024年第2期178-181,共4页Journal of Precision Medicine

基　　金：青岛市科技局科研基金资助项目(18-6-1-73-nsh)。

摘　　要：目的分析1型糖尿病(type 1 diabetes mellitus,T1DM)儿童青少年血清25-羟维生素D_(3)[25-(OH)D_(3)]水平,探讨其与糖化血红蛋白(HbA1c)水平的关系。方法收集2016年1月—2021年12月就诊于青岛大学附属医院儿童内分泌消化科的T1DM儿童青少年129例,设为T1DM组;根据HbA1c水平将T1DM组分为两亚组:血糖控制良好组(A组,HbA1c<7.5%)和血糖控制不良组(B组,HbA1c≥7.5%)。收集健康儿童青少年33例,设为对照组。收集所有入组儿童青少年的一般临床资料,检测其血清钙、磷、25-(OH)D_(3)、HbA1c水平。结果T1DM组儿童青少年BMI及血清钙、磷和25-(OH)D_(3)水平显著低于对照组(t=-15.665~-3.679,P<0.05),A组血清25-(OH)D_(3)水平明显高于B组(t=3.857,P<0.05),二元logistic回归分析显示,25-(OH)D_(3)水平降低是T1DM儿童青少年血糖控制不良的危险因素(OR=1.141,95%CI=1.051~1.239,P<0.05)。结论T1DM儿童青少年血清25-(OH)D_(3)水平低于健康青少年,且血糖控制不佳可能与血清25-(OH)D_(3)水平降低有关;T1DM儿童青少年应该适当补充维生素D,并加强其血糖管理。Objective To investigate the serum levels of 25-hydroxyvitamin D_(3) in children and adolescents with type 1 diabetes mellitus(T1DM),and to investigate the relationship between 25-(OH)D_(3) levels and glycosylated hemoglobin(HbA1c)levels.Methods We included 129 children and adolescents with T1DM who visited the Department of Pediatric Endocrinology,Metabolism&Gastroenterology of The Affiliated Hospital of Qingdao University from January 2016 to December 2021(T1DM group).They were divided into two subgroups according to HbA1c levels:patients with good glycemic control(group A,HbA1c<7.5%)and those with poor glycemic control(group B,HbA1c≥7.5%).Thirty-three healthy children and adolescents were selected as control group.The general data and serum calcium,phosphorus,25-(OH)D_(3),and HbA1c levels of the subjects were collected.Results The T1DM group showed a significantly lower body mass index and significantly lower serum calcium,phosphorus,and 25-(OH)D_(3) levels than the control group(t=-15.665--3.679,P<0.05).The 25-(OH)D_(3) level in group A was significantly higher than that in group B(t=3.857,P<0.05).The binary logistic regression analysis showed that decreased 25-(OH)D_(3) levels were a risk factor for poor blood sugar control in children and adolescents with T1DM(OR=1.141,95%CI=1.051-1.239,P<0.05).Conclusion Children and adolescents with T1DM have decreased 25-(OH)D_(3) levels compared with healthy children and adolescents,and the decrease may be closely related to poor blood glucose control.It is necessary for children and adolescents with T1DM to supplement vitamin D and strengthen blood glucose management.

关 键 词：糖尿病 1型 维生素D缺乏 糖基化血红蛋白A 骨化二醇 钙 

分 类 号：R725.871[医药卫生—儿科]