2型糖尿病患者血清25-羟维生素D浓度与血黏度的关系

Correlation between serum 25-hydroxy vitamin D concentration and blood viscosity in type 2 diabetic patients

目的探讨在2型糖尿病(T2DM)患者中血清25-羟维生素D[25(OH)Vit D]浓度同血黏度的相关性。方法入选213例T2DM患者,用酶联免疫吸附试剂盒检测血清25(OH)Vit D浓度,用血液流变仪测定不同切变率(1/s、5/s、30/s、200/s)下全血黏度水平,同时检测血糖、血脂等生化指标。根据血清25(OH)Vit D浓度的四分位数分为4组:Q1组(53例)、Q2组(54例)、Q3组(53例)、Q4组(53例),分析血清25(OH)Vit D浓度与不同切变率下全血黏度的相关性。此外进行性别分层统计分析。结果在T2DM患者尤其是女性患者中,Q4组不同切变率下全血黏度均显著高于其他3组(P<0.0001)。Spearman相关分析显示血清25(OH)Vit D浓度与各全血黏度呈正相关(均P<0.05)。多元逐步回归分析发现女性患者血清25(OH)Vit D与不同切变率下(1/s、5/s、30/s)全血黏度水平均具有独立相关性(均P<0.05)。结论 T2DM患者中,尤其对于女性患者,血清25(OH)Vit D浓度与血黏度具有正相关性;在糖尿病诊治过程中,需综合评价血黏度、25(OH)Vit D等临床指标。

Objective To explore the correlation between serum 25-hydroxy vitamin D[25（OH） VitD]concentration and blood viscosity in type 2 diabetic（T2DM） patients.Methods Two hundred and thirteen T2 DM patients were enrolled and the serum 25（OH） VitD concentration and whole blood viscosity at different shear rates（1/s,5/s,30/s,and 200/s） were measured with enzyme-linked immunosorbent assay and electronic blood rheology analyzer.Biochemical indexes such as plasma glucose and serum lipids were also measured.Patients were assigned to Q1 group（53 cases）,Q2 group（54 cases）,Q3 group（53 cases）,and Q4 group（53cases） according to the quartiles of serum 25（OH） VitD levels.The correlation between serum 25（OH） VitD concentration and blood viscosity at different shear rates was analyzed and a gender-stratified analysis was performed.Results The whole blood viscosity at different shear rates in Q4 group was significantly higher as compared with other three groups（P〈0.0001） in T2 DM patients,especially in female patients.The results of Spearman correlation analysis showed that serum 25（OH） VitD concentration was positively correlated to the whole blood viscosity at different shear rates（P〈0.05）.Multivariate stepwise regression analysis suggested that serum 25（OH） VitD concentration in female patients was independently correlated to the blood viscosity at different shear rates（1/s,5/s,and 30/s）（P〈0.05）.Conclusion In T2 DM patients,especially in female patients,serum 25（OH）VitD concentration is positively correlated to the blood viscosity.Clinical indexes such as blood viscosity and 25（OH） VitD should be comprehensively evaluated during the diagnosis and treatment of diabetes mellitus.