伴与不伴维生素D缺乏对2型糖尿病患者并发代谢综合征风险的影响及预测效能  

Effect and predictive efficacy of concomitant and non-concomitant vitamin D deficiency on the risk of metabolic syndrome in patients with type 2 diabetes mellitus

作　　者：孟祥雨 尹清风[1] 徐云 王旭 白立炜[1] MENG Xiang-yu;YIN Qing-feng;XU Yun;WANG Xu;BAI Li-wei(Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan,CHINA)

机构地区：[1]新乡医学院第一附属医院内分泌科,河南卫辉453100

出　　处：《海南医学》2024年第13期1830-1834,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190458)。

摘　　要：目的探讨伴与不伴维生素D(VitD)缺乏对2型糖尿病(T2DM)患者并发代谢综合征(MS)风险的影响及预测效能。方法前瞻性选取2020年8月至2023年8月新乡医学院第一附属医院收治的T2DM患者136例,检测VitD水平,根据VitD水平分为伴VitD缺乏与不伴VitD缺乏患者,根据是否并发MS分为MS组(n=72)与无MS组(n=64)。比较两组患者的代谢指标[空腹血糖(FBG)、空腹胰岛素(FBI)、胰岛素抵抗指数(HOMA-IR)、稳态模型评估β细胞功能指数(HOMA-β)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平,采用Pearson法分析VitD与代谢指标的相关性,采用相对危险度分析VitD对T2DM并发MS风险的影响,采用受试者工作特征曲线(ROC)分析VitD对T2DM并发MS风险的预测效能。结果136例T2DM患者平均VitD水平为(21.63±4.23)ng/mL,其中VitD缺乏患者51例,不伴VitD缺乏患者85例;136例T2DM患者中,MS发生率为52.94%(72/136),其中伴VitD缺乏患者MS发生率为84.31%(43/51),高于不伴VitD缺乏患者的34.12%(29/85),差异有统计学意义(P<0.05);MS组患者的FBG、FBI、HOMA-IR、HOMA-β、TG、TG/HDL-C水平分别为(7.44±0.42)mmol/L、(12.13±1.79)μIU/mL、3.05±0.38、110.11±22.65、(1.92±0.42)mmol/L、1.64±0.30,明显高于无MS组的(6.58±0.22)mmol/L、(8.15±1.26)μIU/mL、2.20±0.31、91.27±14.58、(1.12±0.36)mmol/L、0.77±0.19,HDL-C、VitD水平分别为(1.17±0.25)mmol/L、(17.63±3.15)ng/mL,明显低于无MS组的(1.46±0.33)mmol/L、(26.13±4.20)ng/mL,差异均具有统计学意义(P<0.05);Pearson法分析结果显示,VitD与FBG(r=-0.582)、FBI(r=-0.519)、HOMA-IR(r=-0.504)、HOMA-β(r=-0.511)、TG(r=-0.528)、TG/HDL-C(r=-0.557)呈负相关(P<0.05),与HDL-C(r=0.497)呈正相关(P<0.05);RR的假设检验显示,伴VitD缺乏与不伴VitD缺乏患者并发MS风险比较差异具有统计学意义(P<0.05);RR=2.471,提示伴VitD缺乏患者并发MS风险是不伴VitD缺乏的2.471倍(95%CI:1.798~3.397);ROC分析�Objective To investigate the influence and predictive efficacy of concomitant and non-concomitant vitamin D(VitD)deficiency on the risk of complicating metabolic syndrome(MS)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 136 patients with T2DM who were admitted to the First Affiliated Hospital of Xinxiang Medical University from August 2020 to August 2023 were prospectively selected.According to the VitD levels,the patients were divided into patients with VitD deficiency and patients without VitD deficiency,and according to whether MS was concomitant,the patients were divided into MS group(n=72)and non-MS group(n=64).The levels of metabolic indexes[fasting blood glucose(FBG),fasting insulin(FBI),insulin resistance index(HOMA-IR),homeostasis model assessment ofβ-cell function index(HOMA-β),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)]were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between VitD and metabolic indexes,and relative risk was applied to analyze the effect of VitD on the risk of MS in T2DM.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of VitD on the risk of MS in T2DM.Results The average VitD level in 136 T2DM patients was(21.63±4.23)ng/mL,including 51 patients with VitD deficiency and 85 patients without VitD deficiency.The incidence of MS was 52.94%(72/136)among the 136 T2DM patients,and the incidence was 84.31%(43/51)in patients with VitD deficiency,which was higher than 34.12%(29/85)in patients without VitD deficiency(P<0.05).Levels of FBG,FBI,HOMA-IR,HOMA-β,TG,TG/HDL-C in MS group were(7.44±0.42)mmol/L,(12.13±1.79)μIU/mL,3.05±0.38,110.11±22.65,(1.92±0.42)mmol/L,1.64±0.30,which were significantly higher than(6.58±0.22)mmol/L,(8.15±1.26)μIU/mL,2.20±0.31,91.27±14.58,(1.12±0.36)mmol/L,0.77±0.19 in non-MS group;the levels of HDL-C and VitD were(1.17±0.25)mmol/L,(17.63±3.15)ng/mL,signific

关 键 词：维生素D 2型糖尿病 代谢综合征 相关性 危险度 预测 

分 类 号：R587.1[医药卫生—内分泌]