2型糖尿病患者维生素D与周围血管病的相关因素分析

Correlation factor analysis on vitamin D level and peripheral vascular disease in patients with type 2 diabetes mellitus

目的:探讨血清25-羟维生素D3(25-OH-D3)水平与糖尿病合并周围血管病(PVD)的相关性及糖尿病合并PVD患者的危险因素与保护因素。方法:将2015年11月~2016年6月确诊2型糖尿病(T2DM)住院患者98例,根据入院T2DM患者的踝肱指数(ABI)分为两组,ABI≤0.9共46例为观察组,ABI>0.9共52例为对照组。观察两组患者25-OH-D3及空腹C肽、胱抑素C(CysC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、体质量指数(BMI)、糖化血红蛋白(HbA1c)、尿酸及患者年龄、发病时间有无差异,并行二分类Logistic回归分析。结果:两组患者25-OH-D3、LDL-C、年龄、病程等指标差异有统计学意义,且观察组血清25-OH-D3水平低于对照组,LDL-C高于对照组。两组BMI、空腹C肽、尿酸、HbA1c及HDLC、CysC等差异无统计学意义。通过二分类Logistic回归分析,提示糖尿病合并PVD的发生与25-OH-D3、LDL-C、病程的相关性有统计学意义。结论:血清低25-OH-D3水平对糖尿病合并PVD的发生有潜在预测价值。足量维生素D及LDL-C的达标对PVD并发症的控制与发生有积极意义。

Objective:To investigate the correlation of serum25hydroxyvitamin D3(25OH D3)level with peripheral vascular disease(PVD)in patients with type diabetes mellitus for clarifying the risk factors and protective factors for diabetics concomitant with PVD and providing clinical guidance in therapy.Methods:Ninety eight inpatients confirmed as type2diabetes in our hospital between November2015and June2016were included,and divided into two groups based on the ankle brachial index(ABI)upon admission.Patients with ABI index≤0.9were included in observational group(n=46),and those with ABI>0.9in control group(n=52).The two groups were observed concerning serum levels of vitamin D3,fasting C pepide,cystatin C(Cys C),low density lipoprotein cholesterol(LDL C)and high density lipoprotein cholesterol(HDL C)as well as body mass index(BMI),content of glycosylated hemoglobin and uric acid,patient′s age and disease time.Then all factors were analyzed using binary Logistic regression analysis method.Results:The two groups were significantly different in serum levels of vitamin D3and LDL C as well as the ages and disease time.Patients in the observational group had lower vitamin D3level,yet higher LDL C level than those in the control group.However,the two groups were not significant in BMI,levels of fasting C pepide,uric acid,glycosylated hemoglobin,HDL C and Cys C.Binary logistic regression analysis indicated that diabetics concomitant with PVD were associated with serum vitamin D3,LDL C levels and disease time.Conclusion:Lower serum25OH D3level can be predictive value in estimating whether type2diabetics will be concomitant with PVD,and maintaining sufficient vitamin D and standard LDL C levels can be positive significance for controlling such complications.