2型糖尿病患者血清25-羟维生素D水平与代谢指标的相关性  

Correlation between serum 25-hydroxyvitamin D level and metabolic indicators in patients with type 2 diabetes mellitus

作　　者：侯小丽[1] 吴述光[2] 潘静[1] 李健[1] 邹慧[1] 曹在新 张秀英 HOU Xiaoli;WU Shuguang;PAN Jing;LI Jian;ZOU Hui;CAO Zaixin(0x09Department of Endocrinology,Xinxiang First People′s Hospital,Xinxiang 453000,Henan Province,China;Department of Respiratory and Critical Care Medicine,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China;Department of Endocrinology,Rheumatology and Immunology,Huojia County People′s Hospital,Huojia 453800,Henan Province,China)

机构地区：[1]新乡市第一人民医院内分泌科,河南新乡453000 [2]新乡市中心医院呼吸与危重症医学科,河南新乡453000 [3]获嘉县人民医院内分泌风湿免疫科,河南获嘉453800 [4]不详

出　　处：《新乡医学院学报》2024年第11期1043-1047,1054,共6页Journal of Xinxiang Medical University

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20200966)。

摘　　要：目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳�Objective To analyze the level of 25-hydroxyvitamin D[25(OH)D]in patients with type 2 diabetes mellitus,and preliminarily investigate the correlation between serum 25(OH)D level and metabolic indicators such as glycosylated hemoglobin(HbA1c)and pancreatic islet function in patients with type 2 diabetes mellitus.Methods A total of 459 patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology,Xinxiang First People′s Hospital from January 2020 to December 2020 were selected as the research subjects.Clinical data of the patients were collected,including gender,age,serum 25(OH)D,fasting insulin,C-peptide,HbA1c,fasting blood glucose,postprandial blood glucose,urinary microalbumin,urinary albumin-to-creatinine ratio,blood calcium,blood uric acid(UA),triglyceride(TG),total cholesterol(TCH),low-density lipoprotein(LDL),and high-density lipoprotein(HDL).According to the serum 25(OH)D level,the patients were divided into sufficient group[n=20,25(OH)D≥30μg·L^(-1)],insufficient group[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)],deficient group[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)],and severely deficient group[n=113,25(OH)D<10μg·L^(-1)].Differences in metabolic indicators of patients in the four groups were compared,and the correlation between 25(OH)D level and metabolic indicators was analyzed by using the Pearson correlation.Results The serum 25(OH)D level of patients with type 2 diabetes mellitus was 3.00-46.59(15.75±0.35)μg·L^(-1);the serum 25(OH)D level of male patients was significantly higher than that of female patients(P<0.05).The prevalence of 25(OH)D deficiency in patients with type 2 diabetes mellitus was 74.9%(344/459).The 25(OH)D deficiency mainly occurred in January,February,March,April,November,and December.Patients in the insufficient,deficient,and severely deficient groups had significantly higher HbA1c levels than those in the sufficient group(P<0.05),and the HbA1c levels of patients in the deficient and severely deficient groups were significantly highe

关 键 词：2型糖尿病 25-羟维生素D 胰岛素 C肽 糖化血红蛋白 尿微量白蛋白 尿白蛋白肌酐比值 

分 类 号：R587.2[医药卫生—内分泌]