摘要
目的 探讨老年患者胰岛素抵抗与血清维生素D水平及动脉僵硬度间的关系. 方法 入选住院老年患者（年龄≥60岁）162例,检测空腹胰岛素、空腹血糖、肌酐及维生素D等指标.胰岛素抵抗（IR）用稳态模型评估公式计算IR指数（HOMA-IR）进行评价.根据HOMA IR水平,将患者分为低IR组（HOMA-IR＜2） 78例、中IR组（HOMA-IR 2～6）43例和高IR组（HOMA-IR＞6）41例,采用肢体动脉搏动波检测仪测定肢体动脉搏动波作为动脉僵硬度的评价指标,比较3组动脉僵硬度及维生素D差异. 结果 高IR组血清维生素D水平较低IR组明显降低[（13.2±5.7）μg/L比（17.8±6.2）μg/L],高IR组动脉僵硬度较低IR组增高[（14.3±5.2） m/s比（11.9±3.0）m/s];在校正年龄、性别等因素后相关分析显示,IR与维生素D水平呈显著负相关（r=-0.63,P＜0.05）,IR与动脉僵硬度呈显著正相关（r=0.45,P＜0.05）. 结论 老年高IR患者可能存在维生素D水平降低,动脉僵硬度增加.
Objective To explore the relationship of insulin resistance with serum 25-hydroxyvitamin D levels and arterial stiffness in elderly patients.Methods A total of 162 elderly inpatients （aged 60 years or over） were recruited from 2012 to 2014.Levels of fasting serum insulin,fasting serum glucose,creatinine and vitamin D were determined.Insulin resistance （IR） was evaluated by the homeostasis model assessment of insulin resistance （HOMA-IR）.The patients were divided into the following three groups according to HOMA-IR：the low IR group with HOMA-IR less than 2 （n=78）,the median IR group with HOMA-IR between 2 and 6 （n=43）,and the high IR group with HOMA-IR greater than 6 （n=41）.Arterial stiffness was assessed by carotid-femoral pulse wave velocity （cfPWV）.Arterial stiffness and serum vitamin D levels were compared among the three groups.Results cfPWV was increased and the serum 25-hydroxyvitamin D level was decreased in the high insulin resistance group compared with the low insulin resistance group[（13.2± 5.7） μg/L vs.（17.8±6.2） μg/L,（14.3±5.2） m/s vs.（11.9±3.0） m/s].Multiple liner regression analysis showed that IR was negatively correlated with the serum 25 hydroxyvitamin D level （r=-0.63,P〈0.05） and positively correlated with arterial stiffness （r=0.45,P〈0.05） after adjustment for age,sex and other confounders.Conclusions Elderly patients with high insulin resistance may have lower levels of serum vitamin D and higher arterial stiffness.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2015年第3期253-255,共3页
Chinese Journal of Geriatrics
基金
北京市保健科研课题基金（京13-13）
