老年2型糖尿病患者血清25羟维生素D与能量代谢关系的研究

Relationship between the serum 25-hydroxyvitamin D level and energy metabolism in elderly T2DM patients

目的评估老年T2DM患者血清25羟维生素D[25(OH)D]水平与代谢的关系。方法选取141例住院的老年T2DM患者测定血清25(OH)D,并比较缺乏组(<25nmol/L)和不足组(25～74nmol/L)BMI、WC、FPG、HbA1c、FIns、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌指数(HOMA-β)、血脂及C-RP。另将患者分为肥胖组和非肥胖组,分别以25(OH)D为因变量,与上述各变量进行Pearson相关分析,并以25(OH)D缺乏为因变量行Logistic回归分析。结果 94%的老年T2DM患者存在25(OH)D水平下降。缺乏组BMI、HbA1c、HOMA-IR、C-RP高于不足组,HDL-C低于不足组(P<0.05)。肥胖组血清25(OH)D与FPG、HbA1c、HOMA-IR、C-RP呈负相关,与HOMA-β、HDL-C呈正相关;而非肥胖组25(OH)D仅与HbA1c、C-RP呈负相关,与HDL-C呈正相关(P<0.05)。与25(OH)D缺乏相关的独立危险因素分别是HbA1c和C-RP(P<0.05)。结论 25(OH)D水平下降在老年T2DM患者中十分普遍,25(OH)D下降与多种代谢异常关系密切,补充25(OH)D可能使患者获益。

Objective To evaluate the serum 25-hydroxyvitamin D [25（OH）D] level in elderly T2DM patients and its relationship with energy metabolism. Methods The 141 hospitalized T2DM patients were enrolled in this study, whose serum 25 （OH）D level was measured. Patients with low 25（OH）D level were divided into deficient group （〈25 nmol/L） and insufficient group （25-74 nmol/L）. The parameters of BMI, WC, FPG, HbAlc, Fins, HOMA-IR, HOMA-β, TC, riG, HDL-C, LDL-C, and C-RP were compared between the two groups. Patients were divided into obese and non-obese groups based on their body weight, and Pearson correlation coefficient was used to assess the association of 25（OH）D with variables mentioned above in both groups respectively. Logistic regression analysis was performed using 25 （OH）D deficiency （〈25 nmol/L） as the dependent variable. Results Serum 25（OH）D was lower than normal value in 94% of all elderly T2DM patients. BMI, HbA1c, HOMA-IR, and C-RP were higher, while HDL-C was lower, in the deficient group than in the insufficient group （P〈0. 05）. In obese group, 25（OH）D was negatively correlated with FPG, HbA1c, HOMA-IR, and C-RP, but positively correlated with HOMA-IR and HDL-C. In non-obese group, 25 （OH）D was negatively correlated with HbA1 c and C-RP, and positively related with HDL-C only （P〈0. 05）. HbA1 c and C-RP were independent risk factors for 25（OH）D deficiency （P〈0. 05）. Conclusion. Decline of 25（OH）D level is prevalent in elderly T2DM patients, which is correlated with metabolic disorders. These patients would benefit from supplementation of 25（OH）D.