昆明地区家族性2型糖尿病伴糖尿病视网膜病变患者中血清25羟维生素D3的检测意义

Significance of serum 25-hydroxyvitam in D3 level in familial type 2 diabetes mellitus with diabetic retinopathy in Kunming

目的:探讨昆明地区家族性2型糖尿病(diabetes mellitus,T2DM)伴糖尿病视网膜病变(diabetic retinopathy,DR)患者中血清25(OH)D3的检测意义。方法:183例有T2DM家族史的T2DM伴DR(DR1组)、有T2DM家族史的T2DM不伴DR(DR0组)79例、156例健康人群(NC组),记录所有研究对象的一般临床资料,检测其血糖、血脂、糖化血红蛋白、胰岛素C肽等指标,用ELISA法测定3组人群25(OH)D3水平,将25(OH)D3水平按通用参考标准和可供参考标准分组,比较各组人群中不同水平25(OH)D3所占的比例以及将2种标准进行比较,同时在DR1组中行25(OH)D3相关分析和多元逐步回归分析。结果:3组人群中维生素D不足/缺乏的比例较高,占90%以上,且与NC组相比,DR1组维生素D不足/缺乏的比例更高[NC组25(OH)D3浓度为(23.03±1.77)ng/ml,DR1组为(22.90±1.51)ng/ml,DR0组为(23.01±1.75)ng/ml];通过比较参考标准和通用标准中3组人群的比例发现并无统计学意义(χ2=5.052、0.904,P=0.282、0.342)。DR1组25(OH)D3相关分析显示其与T2DM病程、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均呈正相关(r=0.162、0.164、0.189、0.175;P均<0.05),多元逐步回归分析发现进入模型的变量仅有高密度脂蛋白胆固醇(回归系数为0.887,P=0.010)。结论:昆明地区人群中维生素D水平普遍较低,3组人群采用参考标准和通用标准划分25(OH)D3水平无差别。

Objective：To investigate the significance of serum 25-hydroxyvitamin D3 level in familial type 2 diabetes mellitus（T2DM）with diabetic retinopathy（DR） in Kunming. Methods：Totally 183 T2 DM patients with family history of T2 DM and DR（DR1group）,79 patients with family history of T2 DM and without DR（DR0 group） and 156 healthy individuals（NC group）were enrolled.Clinical data of all subjects including height,weight,blood pressure and other clinical indexes were recorded. Biochemical indexes including blood glucose,blood lipids,Hb A1 c,insulin-C peptide were examined in three groups. The levels of 25（OH）D3 were measured by ELISA;3 groups were divided based on levels of 25（OH）D3 according to the common criterions and referenced criterions.Percentages of patients in each level of 25（OH）D3 and the difference between the two criterions were compared. Correlation analysis and logistic regression analysis of 25（OH）D3 in DR1 group,as well as multiple stepwise regression analysis of risk factors for DR were conducted. Results：The prevalence of vitamin D insufficiency/deficiency was as high as up to 90% in three groups;the prevalence was higher in DR1 group than in NC group. There was no statistically significance in ratio of the different 25（OH）D3 levels of the common criterions and reference criterions in three groups（P 0.05）. Pearson correlation analysis of 25（OH）D3 in DR1 group showed that duration of T2 DM,total cholesterol,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol was positively correlated（r=0.162,0.164,0.189,0.175;P0.01）,and logistic regression analysis showed that the only variable in the model was HDLC（r=0.887,P=0.010）. Conclusion：Vitamin D level is generally low in the south population of China. There is no difference between common criterions and reference criterions of different 25（OH）D3 levels in three groups.