2型糖尿病肾脏病变患者血清25羟维生素D水平与肾功能不全的相关性研究

Correlation between serum 25-hydroxy-vitamin D and renal insufficiency in the patients with type 2 diabetic kidney disease

目的分析2型糖尿病肾脏疾病(T2DKD)患者血清25羟维生素D[25(OH)D]水平与肾功能不全的相关性。方法根据估算肾小球滤过率(e GFR)将133例T2DKD患者分为肾功能不全组及肾功能正常组,采用liason化学发光法测定2组血清25(OH)D水平,收集患者临床指标和生化结果并进行统计学分析。结果 133例T2DKD患者血清25(OH)D水平为(13.07±6.62)nmol/L,其中肾功能不全78例(58.65%),肾功能正常55例(41.35%)。肾功能不全组血清25(OH)D水平明显低于肾功能正常组(P<0.05);肾功能不全组25(OH)D缺乏/不足发生率及缺乏发生率均明显高于肾功能正常组(P均<0.05);多因素线性回归分析提示25(OH)D缺乏/不足(OR=2.383,P=0.013)及血尿酸(OR=8.338,P<0.001)与肾功能不全呈正相关,年龄(OR=0.674,P=0.02)、Hb A1c(OR=0.493,P=0.027)、TG(OR=0.355,P=0.048)与肾功能不全呈负相关。结论 T2DKD患者中25(OH)D缺乏/不足发生率高,25(OH)D缺乏/不足可能是T2DKD患者发生肾功能不全的易患因素。

Objective It is to investigate the relationship of serum 25-hydroxy-vitamin D [25（ OH） D]and renal insufficiency in hospitalized patients with type 2 diabetic kidney disease（ T2DKD）. Methods 133 patients with T2 DKD were selected and divided in renal insufficiency（ RI） group and non-renal insufficiency（ non-RI） group according to Glomerular filtration rate（ e GFR）. Serum 25（ OH） D were detected by chemiluminescence method of liason. Clinical data were recorded and biochemical indexes were also detected. Statistical analysis was performed. Results The level of serum 25（ OH） D was（ 13. 07 ±6. 62） nmol / L in 133 patients with T2 DKD,in which there were 78 cases（ 58. 65%） of RI and 55 cases（ 41. 35%） of non-RI; The level of serum 25（ OH） D in RI group was significantly lower than that in the non-RI group（ P 〈0. 01）; 25（ OH） D deficiency / insufficiency in RI group was significantly higher than that in non-RI group（ P 〈0. 01）; Multiple linear regression analysis demonstrated that 25（ OH） D deficiency / insufficiency（ OR = 2. 383,P = 0. 013） and serum uric acid level（ OR =8. 338,P 〈0. 001） were positively correlated with RI,age（ OR = 0. 674,P = 0. 02）,hemoglobin Alc（ Hb A1c） level（ OR =0. 493,P = 0. 027）,tiglyceride（ TG） level（ OR = 0. 355,P = 0. 048） were negatively correlated with RI. Conclusion 25（ OH） D deficiency / insufficiency was with high prevalence in T2 DKD patients; 25（ OH） D deficiency / insufficiency may be the independent risk factor of renal insufficiency in T2 DKD patients.