25-羟维生素D3、甲状旁腺激素与2型糖尿病动脉硬化的相关性研究

Association between serum 25-hydroxyvitamin D3 concentration, parathyroid hormone, and arterial stiffness in patients with type 2 diabetes

目的 评价血清25-羟维生素D3[25（OH）D3]、甲状旁腺激素（PTH）水平与2型糖尿病动脉硬化的相关性。方法 选取2011年10月至2012年2月住院,年龄大于30岁的2型糖尿病患者258例,测定血清25（OH）D3、PTH以及HbA1C、血脂、血清钙、超敏C反应蛋白等指标。动脉硬化的评价指标采用自动波分析仪VP-1000测定踝臂指数、脉搏波传导速度。结果 （1）2型糖尿病25（OH）D3缺乏的患病率为79.84%（206/258）;（2）维生素D缺乏组较非维生素D缺乏组脉搏波传导速度高[（1610.76 ± 142.70对1527.95 ± 58.02）cm/s,P〈0.05];（3）多元线性逐步回归分析显示,25（OH）D3是独立于年龄、收缩压、糖尿病病程,影响脉搏波传导速度的危险因素（β=-0.256,P〈0.01）;（4）PTH与脉搏波传导速度、收缩压正相关（r分别为0.210,0.229,P〈0.05）,与25（OH）D3负相关（r=-0.153,P〈0.05）。结论 2型糖尿病患者25（OH）D3缺乏的情况较为普遍,其25（OH）D3水平与动脉硬化独立相关。PTH可能是通过25（OH）D3和血压与动脉硬化相关。

Objective To evaluate the association between serum 25-hydroxyvitamin D3[25（OH）D3], parathyroid hormone, and arterial stiffness in patients with type 2 diabetes. Methods Serum 25（OH）D3 and parathyroid hormone（PTH）were determined in a cross-sectional sample of 258 patients aged 30 years and over. Arterial stiffness was assessed by pulse wave velocity（PWV）obtained with a VP-1000 pulse wave unit. Fasting plasma HbA1C, lipid profile, calcium, and high sensitive-C reactive protein were determined. Results （1）The prevalence of vitamin D3 deficiency was high（79.84%）in patients with type 2 diabetes. （2）Those with lowered serum vitamin D3 levels had raised PWV [（1 610.76 ± 142.70 vs 1 527.95 ± 58.02）cm/s, P〈0.05]. （3）Multiple stepwise regression analysis showed that 25（OH）D3 was an impact factor of PWV risk score, which was independent of age, duration of diabetes, and systolic blood pressure（β=-0.256, P〈0.01）. （4）Serum PTH was positively correlated with PWV（r=0.210, P〈0.05）and systolic blood pressure（r=0.229, P〈0.05）, but negatively correlated with 25（OH）D3（r=-0.153, P〈0.05）. Conclusions 25（OH）D3 deficiency is common in patients with type 2 diabetes, and a low serum 25（OH）D3 level is significantly associated with increased arterial stiffness in these patients. The association of serum PTH with arterial stiffness may result via changes in vitamin D and blood pressure.