血清25-羟维生素D水平与2型糖尿病的关系

Relationship between serum 25-hydroxyvitamin D levels and type 2 diabetes

目的 研究血清维生素D水平在2型糖尿病发病过程中的作用。方法采用随机分层抽样，共589例志愿者纳入本研究。根据空腹血糖及口服葡萄糖耐量试验结果将志愿者区分为糖尿病人群及非糖尿病人群。共计249例检测了血清25-羟维生素D水平，应用二元Logistic回归分析糖尿病与相关因素的关系，应用Cox—Staurt趋势检验分析各年龄段血清25-羟维生素D水平，按血清25（OH）D四分位值分层，分别计算糖尿病患病优势比OR值及95％置信区间。结果所有年龄段均存在不同程度的25-羟维生素D缺乏，调节年龄、HOMA．IR、BMI后，血清25．羟维生素D水平与糖尿病发病呈剂量依赖的负相关（r=-0．9271，P〈0．01），当血清25-羟维生素D水平达到94．6nmol／L以上时，糖尿病发病显著降低[OR=0．52，95％CI（0．23—0．78），P〈0．01]。结论血清25-羟维生素D水平与2型糖尿病发病呈明显负相关，血清25-羟维生素D水平降低增加糖尿病发病风险。

Objectives To study the relationship between serum vitamin D and type 2 diabetes. Methods By randomly stratified sampling, 589 volunteers were enrolled into this study. The volunteers were classified into diabetic and non-diabetic group according to the results of fasting plasma glucose or oral glucose tolerance test. The serum 25-hydroxyvitamin D levels were detected in 249 samples. The binary logistic regression analysis was used to analyze the relationship between diabetes and its related factors. The 25-hydroxyvitamin D levels in different age stage were analyzedby Cox-Staurt trend test. The odds ratios and 95% confidence interval of diabetes were calculated respectively according to quartiles of serum 25- hydroxyvitamin D. Results The 25-hydroxyvitamin D levels were insufficient in some extent in all age seetions of volunteers. Adjusting for age, HOMA-IR, BMI, odds ratios for diabetes varied inversely across quartiles of 25-hydroxyvitamin D in a dose-dependent pattern （ r = - 0. 9271, P 〈 0. 01 ）. When serum 25-hydroxyvitamin D levels were above 94. 6 nmol/L, the odds ratio of diabetes was significantly reduced COR=0.52, 95% CI （0.23 -0.78）, P 〈0.011. Conclusions The serum 25-hydroxyvitamin D level was negative related with type 2 diabetes. The decreased serum levels 25-hydroxyvitamin D increased onset risk of diabetes.