老年2型糖尿病病人25(OH)D_3水平与尿蛋白排泄率的相关性

Correlation of 25(OH)D_3 with urinary protein excretion ratein in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病(T2DM)病人的尿蛋白排泄率(UAER)及25(OH)D_3水平变化,并研究其相关性。方法 T2DM病人按UAER水平分为正常蛋白尿组(A组)、微量蛋白尿组(B组)和临床蛋白尿组(C组),每组30例。比较3组的体质量指数(BMI)、血压、空腹血糖(FPG)、餐后2h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、肌酐(Cr)和25(OH)D_3水平,并分析上述各指标与25(OH)D_3的相关性。结果 C组BMI、收缩压、舒张压、FPG、2hPG、TC、TG、LDL-C、FINS、HOMA-IR和Cr水平均高于B组和A组,B组高于A组;C组25(OH)D_3水平低于A、B组,且B组显著低于A组,差异有统计学意义(P<0.05)。相关性分析结果表明,25(OH)D_3与UAER、收缩压、舒张压、FPG、2hPG、TC、LDL-C、FINS、HOMA-IR和Cr呈负相关(P均<0.05),与BMI、TG、HDL-C无相关性(P均>0.05)。多元线性回归分析结果表明,UAER与25(OH)D_3独立相关(t=-4.469,P<0.05)。结论老年T2DM病人25(OH)D_3水平与T2DM及糖尿病肾病(DN)存在一定的相关性,可能是T2DM及DN发生及发展的重要影响因素。

Objective To investigate the correlation of 25（OH）D3 with urinary protein excretion rate（UAER） in elderly patients with type 2 diabetes mellitus（T2DM）.Methods Ninety patients with T2DM were divided into normal albuminuria group（group A,n = 30）,microalbuminuria group（group B,n = 30） and clinical proteinuria group（group C,n = 30） according to the level of UAER.Body mass index（BMI）,blood pressure,fasting plasma glucose（FPG）,2 h postprandial blood glucose（2 hPG）,total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,fasting insulin（FINS）,homeostasis model of assessment for insulin resistence index（HOMA-IR）,creatinine（Cr） and 25（OH）D3 levels were compared between the three groups,and the correlation of 25（OH）D3 with above indexes were analyzed.Results Compared with group A and B,the levels of BMI,systolic blood pressure,diastolic blood pressure,FPG,2 hPG,TC,TG,LDL-C,FINS,HOMA-IR and Cr in group C were higher; and the level of 25（OH）D3 was significantly lower.The level of 25（OH）D3 was the lowest in group C,followed by group B and group A（P0.05）; Correlation analysis showed that 25（OH）D3 was negatively correlated with UAER,systolic blood pressure,diastolic blood pressure,FPG,2 hPG,TC,LDL-C,FINS,HOMA-IR and Cr（all P0.05）.Multiple linear regression analysis showed that UAER was independently correlated with of 25（OH）D3（t=-4.469,P〈0.05）.Conclusions 25（OH）D3 may be an important factor in the occurrence and development of T2DM and DN.