初诊2型糖尿病患者血清25-羟基维生素D3与颈动脉内膜中层厚度及粥样硬化斑块相关性研究  

Correlation Between Serum 25-hydroxyvitamin D3 and Carotid Intima-media Thickness and Atherosclerotic Plaque in Newly Diagnosed Type 2 Diabetes Mellitus Patients

作　　者：陈赟 何瑶 林凤平 黄倩 CHEN Yun;HE Yao;LIN Feng-ping;HUANG Qian(Endocrinology Department of Xianning Central Hospital,Xianning,Hubei 437000,China;Geriatric Department of Xianning Central Hospital,Xianning,Hubei 437000,China)

机构地区：[1]咸宁市中心医院内分泌科,湖北咸宁437000 [2]咸宁市中心医院老年病科,湖北咸宁437000

出　　处：《湖北医药学院学报》2024年第4期412-415,421,共5页Journal of Hubei University of Medicine

摘　　要：目的:研讨初诊2型糖尿病(T2DM)患者25-羟基维生素D3[25-(OH)D3]水平和颈动脉内膜中层厚度(IMT)、动脉粥样硬化斑块的关系。方法:检测206例初诊T2DM患者空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、25-(OH)D3浓度等指标,完善血管彩超检测IMT及颈动脉粥样硬化斑块情况。结果:斑块组患者年龄、高血压病史、LDL-C、HbA1c、IMT均高于无斑块组(P<0.05),而25-(OH)D3浓度低于无斑块组(P<0.05)。Spearman相关性分析显示,颈动脉IMT与吸烟史(rs=0124,P=0.038)、高血压病史(rs=0.175,P=0.001)正相关。Pearson相关性分析,颈动脉IMT与年龄、HbA1c、LDL-C呈正相关(P均<0.05),与25-(OH)D3、血钙水平呈负相关(P均<0.05)。Logistic回归分析,年龄、HbA1c、LDLC、高血压病史是产生颈动脉粥样硬化斑块的危险要素,而25-(OH)D3水平可直接影响颈动脉粥样硬化斑块形成。结论:初诊T2DM患者25-(OH)D3水平与颈动脉IMT呈负相关联,低25-(OH)D3水平可能为颈动脉粥样硬化形成的一个危险信号。Objective To investigate the correlation between 25-hydroxyvitamin D3[25-(OH)D3]and carotid intimamedia thickness(IMT)and atherosclerotic plaque in newly diagnosed type 2 diabetes mellitus(T2DM)patients.Methods Fasting blood glucose(FBG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and 25-(OH)D3 were measured in 206 newly diagnosed T2DM patients.Vascular ultrasound was used to assess IMT and carotid atherosclerotic plaque.Results Patients with atherosclerotic plaques had higher age,history of hypertension,LDL-C,HbA1c,and IMT compared with those without plaques(P<005),while the 25-(OH)D3 was lower in the plaque group(P<0.05).Spearman correlation analysis indicated that ca⁃rotid IMT had a positive correlation with smoking history(rs=0.124,P=0.038)and history of hypertension(rs=0.175,P=0.001).Pearson correlation analysis revealed that carotid IMT was positively correlated with age,HbA1c,and LDL-C(all P<0.05),and negatively correlated with 25-(OH)D3 and blood calcium(both P<0.05).Logistic regression analysis showed that age,HbA1c,LDL-C,and history of hypertension were risk factors for the development of carotid atheroscle⁃rotic plaque,and 25-(OH)D3 directly affected plaque formation.Conclusion 25-(OH)D3 is inversely associated with carotid IMT in newly diagnosed T2DM patients,and low 25-(OH)D3 may be a potential risk factor for carotid atheroscle⁃rosis formation.

关 键 词：2型糖尿病 25-羟基维生素D3 颈动脉内膜中膜厚度 粥样硬化斑块 

分 类 号：R587.2[医药卫生—内分泌]