2型糖尿病患者血清25-羟维生素D水平及其与骨密度的关系

Serum 25-hydroxy vitamin D level in type 2 diabetic patients and its relationship with bone mineral density

目的了解2型糖尿病患者血清25-羟维生素D(25-hydroxylvitamin D,25OHD)营养状况及其与骨密度(bone mineral density,BMD)的关系。方法选择2015年2月-2017年3月在北京同仁医院住院的2型糖尿病患者716例(男性410例,女性306例),年龄32~93岁,平均年龄(58.78±11.31)岁,检测血清25OHD水平,应用双能X线吸收检测法测定腰1-4、全髋及股骨颈的BMD。结果在716例2型糖尿病患者中,维生素D严重缺乏者为230例(32.1%),缺乏357例(49.9%),不足97例(13.5%),充足仅32例(4.5%)。不同年龄组别中,血清25OHD水平以及缺乏程度差异均无统计学意义(P>0.05)。Logistic回归分析显示年龄增长、女性及维生素D缺乏为2型糖尿病患者发生骨质疏松的危险因素。结论 2型糖尿病患者维生素D缺乏严重,女性更为明显。血清25OHD缺乏程度越重,骨质疏松的发生风险越高。

Objective To measure serum 25-hydroxyvitamin D （25OHD） levels in type 2 diabetic patients and to investigate its relationship with bone mineral density （BMD）. Methods Totally 716 type 2 diabetes mellitus （T2DM） patients （410 male, 306 female, 58.78±11.31 years） were admitted to Beijing Tongren Hospital from February 2015 to March 2017. The serum 25OHD levels, total lumbar BMD, femoral neck BMD and total hip BMD were tested. Results Among the 716 patients, the patients with vitamin D severe deficiency, deficiency, insufficiency, and sufficiency were 230 cases （32. 1%）, 357 cases （49. 9%）, 97 cases （13.5%）, and 32 cases （4. 5%）, respectively. There was no significant difference of vitamin D status in different age groups. Logistic regression analysis suggested that older age, female, and lack of vitamin D were risk factors to osteoporosis in type 2 diabetic patients. Conclusion Vitamin D deficiency and insufficiency is a quite common problem in type 2 diabetic patients, especially in female patients. The lower level of serum 25OHD, the higher the incidence of osteoporosis.