中老年人血清维生素D水平与血脂的相关性

Correlation of serum vitamin D with serum lipid in middle-aged and elderly people

目的探讨中老年人血清25羟-维生素D(25-OH-D)水平与血脂的相关性。方法选择2016年5月至2017年5月我院老年科就诊年龄40岁以上患者284例,根据血清25-OH-D水平分为严重缺乏组<10 ng/ml 72例、缺乏组10~19 ng/ml 96例、不足组20~29 ng/ml 80例、正常组≥30 ng/ml 36例。采集空腹血检测肝肾功能、血脂、钙、磷、25-OH-D等,利用单因素方差分析比较4组血脂水平,Pearson相关分析及多元线性回归分析血清25-OH-D与血脂的相关性。结果维生素D严重缺乏组、缺乏组、不足组三酰甘油(TG)(P=0.015)、低密度脂蛋白胆固醇(LDL-C)(P=0.035)、总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)(P=0.000)水平均显著高于维生素D正常组(P均<0.05);而HDL-C水平显著低于维生素D正常组(P=0.013)。HDL-C≥1.04 mmol/L组血清25-OH-D水平显著高于HDL-C<1.04 mmol/L组(女性P=0.007、男性P=0.034)。相关性分析结果示血清25-OH-D与HDL-C呈正相关(女性r=0.309,男性r=0.241,P=0.015)。多元线性回归分析结果示,校正年龄、人体质量指数(BMI)、肝肾功能、血钙、血磷后,25-OH-D与HDL-C仍呈正相关(女性β=0.259,P=0.047;男性β=0.217,P=0.049)。结论中老年人维生素D缺乏发生率高,血清25-OH-D水平与HDL-C呈正相关。

Objective To investigate the correlation of serum 25-hydroxy-vitamin D (25-OH-D) with lipid profiles in middle-aged and elderly patients. Methods A total of 284 patients aged over 40 years and admitted in our hospital from May 2016 to May 2017 were selected and divided into four groups according to 25-OH-D levels as the group of normal level which was not less than 30 ng/ml, the group of slight deficiency which was between 20 and 29 ng/ml, the group of moderate deficiency which was between 10 and 19 ng/ml, and the group of severely deficiency which was under 10 ng/ml. Fasting blood draw were taken to detect liver and renal functions, lipids, calcium, phosphorus and 25-OH-D levels. The level of lipids between groups was compared by one-way ANOVA, and the association between lipid profiles and 25-OH-D levels was assessed by Pearson correlation and multiple linear regression. Results The levels of triglyceride (TG), low density lipoprotein cholesterin (LDL-C) and total cholesterol/high density lipoprotein cholesterol (TC/ HDL-C) were significantly higher and the HDL-C levels were significantly lower in the groups of severely deficiency, moderate deficiency and slight deficiency than in the normal group (P=0.035, P=0.015, P=0.013). The levels of serum 25-OH-D were significantly higher in HDL-C≥1.04 mmol/L group than in HDL-C<1.04 mmol/L group (Female P=0.007, male P=0.034). The correlation analysis showed that serum 25-OH-D level was positively associated with HDL-C (female r=0.309, P=0.002, male r=0.241, P=0.002). The multiple linear regression analysis showed that 25-OH-D level was positively correlated with HDL-C, after adjusting age, BMI, liver and kidney function, serum calcium and serum phosphorus (female β=0.259, P=0.047, male β=0.217, P=0.049). Conclusion The incidence of vitamin D deficiency is high in middle-aged and elderly patients, and the level of serum 25-OH-D is positively correlated with HDL-C.