2型糖尿病患者维生素D缺乏与颅内动脉狭窄的关系

The relation of vitamin D deficiency to intracranial arterial stenosis in type 2 diabetic patients

目的探讨2型糖尿病患者维生素D缺乏与颅内动脉狭窄的关系。方法将连续纳入的122例2型糖尿病患者先按照颅内动脉狭窄的程度分为三组：A组为中重度狭窄或闭塞组;B组为轻度狭窄组;C组为无狭窄组。观察变量有性别、年龄、血清25-羟维生素D、甲状旁腺激素、钙、磷、血脂、空腹血糖、糖化血红蛋白、C反应蛋白、同型半胱氨酸,既往病史和吸烟嗜好等。再按照25-羟维生素D的四分位数由低到高的顺序分为a、b、c、d四组。观察变量为颅内动脉中重度狭窄或闭塞的患病率。结果血清总胆固醇、低密度脂蛋白胆固醇、25-羟维生素D等在三组间的差异均有显著性（P〈0.01）;组间多重比较结果低密度脂蛋白胆固醇在B组与C组（P〈0.01）、A组（P〈0.05）间差异具有显著性。总胆固醇只在B组和C组间的差异具有显著性（P〈0.01）。25-羟维生素D在A组与B组、C组间的差异均具有显著性（P〈0.01）。颅内动脉中重度狭窄或闭塞的患病率在四组间的差异具有显著性（P〈0.01）,组间多重比较结果a组与d组的组间差异具有显著性（P〈0.0083）,OR值=12.25（95%CI：2.464~60.91）。结论 2型糖尿病患者维生素D缺乏与颅内动脉狭窄或闭塞具有显著的相关性。

Objective To study the relation of vitamin D deficiency to intracranial arterial stenosis in type 2 diabetic patients. Method The continuous 122 type 2 diabetic patients were enlisted into study. They were divided into three groups, group A with moderate and severe stenosis or occlusion, group B with mild stenosis, group C without stenosis, according to degree of intracranial arterial stenosis. There were the surveyed variables, such as sex, age, serum 25（OH）D, serum parathyroid hormone, serum calcium and phosphorus, blood fat, fasting blood-glucose, glycosylated hemoglobin, C reactive protein, homocysteine, past medical history, smoking. The total subjects were divided into four groups（group a, group b, group c, group d） according to 25（OH）D quartiles again, and the surveyed variable was the prevalence of moderate and severe stenosis or occlusion in intracranial arterys. Result The statistical significance was found among three groups in serum total cholesterol（TC） difference, low density lipoprotein cholesterin（LDL-C） difference and 25（OH）D difference respectively（P〈0.01）. After among groups multiple comparisons, there were statistical significance in LDL-C difference between group B and group C（P〈0.01）, and between group A and group B（P〈0.05）. There were statistical significance in TC difference between group B and group C（P〈0.01）. There were statistical significance in 25（OH）D difference between group A and group B（P〈0.01） and between group B and group C（P〈0.01）. The statistical significance was found among four groups in prevalence difference of moderate and severe stenosis or occlusion in intracranial arterys（P〈0.01）. There were statistical significance in prevalence difference between group a and group d（P0.0083）, and OR was 12.25（95%CI 2.464 to 60.91）. Conclusion There are remarkable correlation of vitamin D deficiency to intracranial arterial moderate and severe stenosis or occlusion in type 2 diabetic patients.