中老年2型糖尿病患者血清25-羟维生素D水平及相关因素分析

Serum 25-hydroxy vitamin D level and its influencing factors in middle-old aged patients with type 2 diabetes

目的测定中老年2型糖尿病患者(type 2 diabetes,T2DM)患者血清25羟维生素D水平并分析其影响因素。方法选取中老年T2DM患者(T2DM组)548例及健康对照组(NC组)120名,测定血清25-羟维生素D、Ca、P、FINS、FPG、HbA1c、TG、TC、LDL-C、HDL-C水平。结果 T2DM组血清25-羟维生素D水平低于NC组[(36.89±16.82)vs(45.84±17.68)nmol/L,P<0.05]。T2DM组中,男性血清25-羟维生素D水平高于女性[(38.09±16.58)vs(35.63±16.26)nmol/L,P<0.05];同年龄段受试者男性血清25-羟维生素D水平普遍高于女性,除了50~59岁年龄组外,各年龄组男性女性25-羟维生素D水平差异均有统计学意义(P<0.05);男性患者中≥70岁年龄组血清25-羟维生素D水平最高,40~49岁年龄组的25-羟维生素D水平最低,各年龄段间水平差异具有统计学意义(F=17.68,P<0.01)。女性患者中≥70岁年龄组血清25-羟维生素D水平最高,40~49岁年龄组的25-羟维生素D水平最低,各年龄段间水平差异具有统计学意义(F=13.43,P<0.01);T2DM组中血清总25-羟维生素D缺乏率为58.39%,其中女性患者缺乏率为60.82%,男性患者为56.07%,女性25-羟维生素D缺乏率显著高于男性患者,差异具有统计学意义(P<0.01);T2DM患者血清25-羟维生素D水平与Ca(r=0.072)、HOMA-β(r=0.406)呈正相关(均P<0.05),与BMI(r=-0.574)、P(r=-0.098)、TC(r=-0.401)、TG(r=-0.325)、LDL-C(r=-0.457)、FPG(r=-0.238)、HbA1c(r=-0.363)、HOMA-IR(r=-0.251)呈负相关(均P<0.05)。结论中老年2型糖尿病患者血清25-羟维生素D水平低于正常人,且受年龄、性别、血糖、血脂、血清钙磷水平及胰岛功能等因素的影响。

Objective To investigate the serum 25-hydroxy vitamin D level and its influencing factors in middle-old aged patients with type 2 diabetes （T2DM）. Methods Total 548 middle-old aged patients with type 2 diabetes（280 males and 268 females） and 120 healthy subjects（60 males and 60 females） were enrolled in the study. Fasting blood samples were collected and serum 25-hydroxy vitamin D, Ca, P, FINS, FPG, HbAlc, TG, TC, LDL-C, HDL-C were measured. Results Serum 25-hydroxy vitamin D in diabetic patients was （36.89 ± 16.82 ） nmol/L, and that in healthy controls was （45.84±17.68 ） nmol/L （ P 〈 0.05 ）. The mean serum 25-hydroxy vitamin D level in male diabetic patients was higher than that in female patients[ （38.09 ±16.58 ） nmol/L vs（35.63± 16.26） nmol/L, P 〈 0.05 ]. Serum 25-hydroxy vitamin D level in male patients was significantly higher than female patients in all age group except 50 - 59 （ P 〈 0.05 ）. In male patients, 25-hydroxy vitamin D level in age group 〉I 70 was the highest, that in age group 40 -49 was the lowest, there were significant difference among different age group （ F = 17. 68, P 〈 0. 01 ）. In female patients, 25- hydroxy vitamin D level in age group ≥70 was the highest, that in age group 40 -49 was the lowest, there were significant difference among different age groups （ F = 13.43, P 〈 0.01 ）. The 25-hydroxy vitamin D deficiency rate in T2DM patients was 58.39% （60.82% for female and 56.07% for male, P 〈0.01 ）. 25-hydroxy vitamin D was positively correlated with Ca（ r = 0. 072）and HOMA-[3 （r = 0. 406） （ both P 〈 0.05 ）, and negatively correlated with BMI （ r = - 0.574 ）, P （ r = - 0.098 ）, TC （ r = -0.401）, TG（r = -0.325）, LDL-C（r = -0.457）, FPG（r = -0. 238）, HbAlc（r = -0. 363） and HOMA-IR（r = - 0. 251 ） （ all P 〈 0.05 ）. Conclusion Serum 25-hydroxy vitamin D concentration in middle-old aged patients with type 2 diabetes is significantly lower than in healthy subjects, and influenced by age, gender, serum Ca, P, blood glucose, cholesterol and pancreas islet function.