血清瘦素、25羟维生素D水平与2型糖尿病下肢血管病变关系的研究

Association analysis between serum leptin,25-hydroxyvitamin D concentration and lower limb peripheral arterial disease in type 2 diabetic patients

目的探讨血清瘦素、25羟维生素D[25(OH)D]水平与T2DM患者下肢血管病变(LLPAD)的关系。方法选取T2DM患者220例,根据下肢血管彩超检查结果分为LLPAD组100例和无下肢血管病变(Non-LLPAD)组120例,另选取健康体检者80名作为对照(NC)组。收集每组临床资料及生化指标,测定血清瘦素和25(OH)D水平。结果 LLPAD组血清25(OH)D水平低于Non-LLPAD组[(23±13)vs(42±24)nmol/L,P<0.05],LLPAD组瘦素水平高于Non-LLPAD组[(7.24±0.46)vs(5.66±0.84)pg/ml,P<0.05]。Pearson相关分析发现,在各种人群中,瘦素与25(OH)D均呈负相关(P<0.01)。Logistic回归分析发现,年龄、SBP、HbA_1c、LDL-C、瘦素、25(OH)D是糖尿病下肢病变的独立危险因素。结论高瘦素水平、低25(OH)D水平、高龄、高HbA_1 c、高SBP、高LDL-C与T2DM患者发生LLPAD密切相关。

Objective To explore the relationship between 25-hydroxyvitamin D[25（OH）D]and lower limb peripheral arterial disease（LLPAD）.Methods A total of 220 type 2 diabetic patients and 80 healthy subjects were enrolled in this study.All the diabetic patients were divided into two groups according to their B ultra-sound results of lower limb peripheral artery：LLP AD group（n=110） and nonLLPAD group（n=120）.Clinical data and routine biochemical indices were collected.Serum 25（OH）D and leptin were measured.Results 25（OH）D level was lower in LLP AD group than in Non-LLPAD group[（23＋13） vs（42 ± 24） nmol/L,P〈0.05].Leptin level was higher in LLP AD group than in NonLLPAD group[（7.24 ± 0.46） vs（5.66 ± 0.84） pg/ml,P 0.05].Multivariate logistic regression analysis revealed that age,SBP,HbA1c,LDL-C,leptin,and 25（OH）D were independent risk factors for LLP AD among diabetic patients.Pearson correlatim analysis showed that leptin was negatively associated with 25（OH）D in each group.Conclusion The development of LLP AD is siginificantly associated with increased levels of leptin,decreased level of 25（OH）D,old age,high level of HbA1c,SBP and LDL-C.