血清维生素D水平、骨密度与2型糖尿病的相关性

The relationship of hydroxyvitamin D level in serum and bone mineral density with type 2 diabetes mellitus

目的 探讨血清维生素D水平、骨密度与2型糖尿病患者临床相关指标的相关性。方法 选取住院100例2型糖尿病患者为糖尿病组,选取同年龄段非2型糖尿病100例为对照组。所有对象测25-（OH）D、用QCT测量腰椎L1~3密度取平均值、计算体质量指数、测空腹血浆胰岛素、空腹血糖、糖化血红蛋白、甲状旁腺素、血钙、血磷等指标并进行分析。结果 糖尿病组患者维生素D缺乏高达76%,糖尿病组患者平均血25-（OH）D值为（11.54±3.16）ng/m L,与对照组比较差异有统计学意义（P〈0.05）。骨质疏松平均值（0.77±0.12）mg/cm3,与对照组比较差异有统计学意义（P〈0.05）。测试者总体血清25-（OH）D水平与PTH、钙磷乘积、lg（HOMA-B）、lg（HOMA-IR）、BMI呈负性相关;与腰椎骨密度、尿微量白蛋白呈正相关性。结论 2型糖尿病患者维生素D缺乏较非糖尿病患者更显著,与骨密度呈正相关性,发生骨质疏松的风险更高。

Objective To explore the relationship of serum vitamin D and bone mineral density with type 2 diabetes mellitus. Methods 100 patients of T2DM and 100 normal were recruited,which were measured with serum 25 （OH）D, the average of measure- ment of lumbar E1-3 bone mineral density with take after QCT, physical fitness index, serum insulin,fasting serum glucose, glycosylated hemoglobin, parathyroid hormone, serum calcium and serum phosphorus indicators. Results The deficiency of vitamin D in patients with type 2 diabetes was 76% ,the average value of serum 25 - （OH） D in diabetic patients was （ 11.54 ± 3.16） ng/ml,whieh was signifi- cantly lower than that of the control group （P 〈0.05） ;and osteoporosis was （0.77 ±0. 12） mg/cm3 ,which was significantly lower than that of the control group （P 〈 0.05 ）. Serum 25 - （OH）D in patients with type 2 diabetes was negatively related with PTH, total plasma calcium phosphorus product, lg（ HOMA- IR） ,lg （HOMA- B） and BMI, BMD of lumbar spine, micro- albuminuria was positively cor- relation with serum 25 （OH）D. Conclusion 25 （OH）D level in patients with type 2 diabetes is lower than that in those without diabe- tes, which is positively correlated with bone mineral density, and higher risk for osteoporosis.