老年2型糖尿病患者颈动脉粥样硬化与血清25-羟维生素D_3水平的关系

Relation between carotid atherosclerosis and serum D25(OH)D_3 level in elderly type 2 diabetes patients

目的探讨血清25-羟维生素D3[25(OH)D3]与老年2型糖尿病患者颈动脉粥样硬化发生、发展的相关性。方法选择2型糖尿病患者174例,根据颈动脉内膜中层厚度(IMT)水平分为IMT正常组84例,IMT增厚组90例;又根据颈动脉有无狭窄分为颈动脉无狭窄组141例,颈动脉狭窄组33例。测量血压、身高、体重,计算体质量指数(BMI),并检测空腹血糖、血脂、糖化血红蛋白等指标,采用酶联免疫分析法测定血清25(OH)D3水平。超声检测及计算IMT及狭窄情况。结果 IMT增厚组血清25(OH)D3水平明显低于IMT正常组(P<0.05);颈动脉狭窄组血清25(OH)D3水平明显低于颈动脉无狭窄组,空腹血糖、尿酸水平明显高于颈动脉无狭窄组(P<0.05)。相关分析显示,颈动脉IMT最大值与老年2型糖尿病患者25(OH)D3呈负相关(P<0.05),与尿酸呈正相关(P<0.01)。logistic回归分析显示,颈动脉狭窄与25(OH)D3、尿酸独立相关。结论在老年2型糖尿病患者中,低水平血清25(OH)D3可能是颈动脉粥样硬化的独立危险因素。

Objective To study the relation between serum D25 （OH） D3 level and carotid atherosclerosis in elderly type 2 diabetes patients.Methods One hundred and seventy-four type 2 diabetes patients were divided into normal IMT group （n=84） and higher IMT group （n=90） according to their IMT and into non-carotid artery stenosis group （n=141） and carotid artery stenosis group （n=33） according to their carotid artery stenosis.Their blood pressure,body weight,body height,BMI,and serum levels of fasting blood glucose,blood lipid and HbA1c were measured.Their serum D25 （OH） D3 level was measured by ELISA.Their carotid IMT and stenosis were measured by ultrasonography.Results The serum D25 （OH） D3 level was significantly lower in higher IMT group than in normal IMT group （P＜0.05） and significantly higher in non-carotid artery stenosis group than in carotid artery stenosis group （P＜0.05）.The serum fasting blood glucose and uric acid level were significantly higher in carotid artery stenosis group than in noncarotid artery stenosis group （P＜0.05）.Correlation analysis showed that the peak carotid artery IMT value was negatively related with the serum D25 （OH） D3 level （P＜0.05） and positively related with the serum UA level in elderly type 2 diabetes patients （P＜0.01）.Logistic regression analysis revealed that carotid artery stenosis was independently related with the serum D25 （OH）D3 and UA level.Conclusion Low serum D25 （OH） D3 level may be an independent risk factor for carotid atherosclerosis in elderly type 2 diabetes patients.