糖尿病患者血清1,25-二羟维生素D3水平与颈动脉斑块形成的相关性研究

Correlation between carotid plaque and serum 1, 25-dihydroxyvitamin D3 in diabetic patients

目的 分析糖尿病患者血清1,25-二羟维生素D3[1,25（OH）2D3]水平与颈动脉斑块形成的相关性.方法 选取2013年9月至2014年2月在滨州医学院附属医院住院的糖尿病患者82例（糖尿病组）,根据颈动脉超声结果分为颈动脉斑块组（48例）和无颈动脉斑块组（34例）,并选取同期体检健康者40名作为对照组.收集受试者一般资料及相关生化指标,测定血清1,25（0H）2D3水平.结果 糖尿病组血清1,25（0H）2D3水平低于对照组[（12 ±5） μg/L比（22±5）μg/L],且颈动脉斑块组中血清1,25（OH）2D3水平明显低于无颈动脉斑块组[（8.3±1.4）μg/L比（18.0 ±2.8） μg/L] （P ＜0.01）.颈动脉粥样硬化斑块形成与年龄、吸烟、体重指数、收缩压、糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇（LDL-C）呈正相关（r =0.60、0.16、0.43、0.50、0.45、0.32,P＜0.05或P＜0.01）,与血清1,25（OH）2D3水平呈负相关（r=-0.55,P＜0.01）.多因素Logistic相关分析显示年龄[OR=1.076,95％置信区间（CI）：1.040 -1.115]、吸烟（OR=3.852,95％ CI：1.821 -7.905）、体重指数（OR=1.623,95％ CI：1.030 -1.720）、收缩压（OR=1.295,95％ CI：1.040 -1.493）、HbA1c （OR=1.054,95％ CI：1.032 -1.260）、LDL-L （OR=1.642,95％ CI：1.135 -2.320）是糖尿病颈动脉斑块形成的危险因素（均P＜0.05）,1,25（OH）2D3（OR=0.986,95％ CI：0.864 -0.996）是糖尿病颈动脉斑块形成的保护因素（P＜0.01）,并且在校正上述因素后,血清1,25（OH）2D3水平仍与颈动脉斑块形成具有独立相关关系.结论 糖尿病患者中血清1,25（OH）2D3水平降低与颈动脉斑块的形成密切相关.

Objective To investigate the relation between carotid plaque formation and serum 1,25-dihydroxyvitamin D3 in diabetes mellitus patients.Methods A total of 82 diabetes patients （diabetes group） from September 2013 to February 2014 were enrolled and divided into plaque subgroup （48 cases） and non plaque subgroup （34 cases） according to the results of ultrasound;40 healthy people were selected as control group.The general information and related biochemical indicators were collected;the level of serum 1,25 （OH）2 D3 was measured.Results The level of serum 1,25 （OH）2D3 in diabetes group was significantly lower than that in control group [（12 ±5） μg/L vs （22 ±5） μg/L],in plaque subgroup was significantly lower than that in non plaque subgroup [（8.3 ± 1.4） μg/L vs （18.0 ±2.8） μ/L] （P 〈0.01）.Pearson correlation analysis showed that carotid plaque formation was positively correlated with age,smoking,body mass index （BMI）,systemic blood pressure （SBP）,low-density lipoprotein cholesterol （LDL-C） and glycosylated hemoglobin A1c （HbA1c） （r =0.60,0.16,0.43,0.50,0.45,0.32,P 〈0.05 or P 〈0.01）;it was negatively correlated with serum 1,25 （OH）2D3 （r =-0.55,P 〈 0.01）.Multivariate logistic regression revealed that the risk factors of carotid plaque formation in diabetes patients included age [OR =1.076,95% confidence interval（CI）：1.040-1.115）,smoking （OR =3.852,95% CI：1.821-7.905）,BMI （OR =1.623,95% CI：1.030-1.720）,SBP （OR=1.295,95%CI：1.040-1.493）,HbA1c （OR =1.054,95%CI：1.032-1.260） and LDL-C （OR=1.642,95%CI：1.135-2.320） （all P 〈0.05）,while 1,25 （OH）2D3 was the protection factor for carotid plaque formation （OR =0.986,5%CI：0.864-0.996,P 〈0.01）.After adjusting correction factors,the level of serum 1,25 （OH）2D3 was independently correlated with carotid plaques formation.Conclusion Low level of serum 1,25 （OH）2D3 level is closely related to the formation of carotid plaque in diabetes patients.