血清全段甲状旁腺素及25羟维生素D与2型糖尿病患者血压的相关性研究

Association of serum-intact parathyroid hormone and serum 25-hydroxyvitamin D with blood pressure in hospitalized patients with type 2 diabetes mellitus

目的调查住院T2DM患者25羟维生素D[25(OH)D]的水平,分析其血清全段甲状旁腺素(iPTH)、25(OH)D水平及iPTH/25(OH)D比较与血压的相关性。方法收集iPTH在正常参考范围内的1055例住院T2DM患者临床资料,记录入院当日血压。Logistic回归分析iPTH、25(OH)D及iPTH/25(OH)D与血压升高的相关性。结果与血压正常组比较,血压升高组iPTH、iPTH/25(OH)D的中位数水平均增高(P<0. 01)。Logistic回归分析结果显示,与iPTH<27. 90组比较,iPTH≥38. 10 pg/ml组血压升高的风险加大[OR(95%CI)1. 581(1. 157～2. 162)];与iPTH/25(OH)D<1. 63×10-3组比较,iPTH/25(OH)D≥2. 57×10-3组血压升高的风险加大[OR(95%CI)1. 406(1. 030～1. 919)];与25(OH)D≥30 ng/ml组比较,20≤25(OH)D<30 ng/ml组及25(OH)D<20 ng/ml组血压无升高风险。结论住院T2DM患者25(OH)D降低,iPTH/25(OH)D比值高的患者易发生高血压。

Objective To investigate the nutritional status of 25-hydroxyvitamin D[25(OH)D]in hospitalized patients with type 2 diabetes mellitus(T2 DM),and to analyze the relationship between serum total parathyroid hormone(iPTH),25(OH)D and iPTH/25(OH)D and blood pressure.MethodsWe collected clinical data of 1055 hospitalized T2 DM patients with iPTH levels in reference range.Blood pres-sure was recorded on the day of admission.Statistical methods were analyzed using multivariate logistic re-gression analysis.ResultsCompared with the normotensive group,subjects with hypertension had higher iPTH(P<0.01)and higher iPTH/25(OH)D(P<0.01).Logistic regression analysis showed that com-pared with the patients with lowest tertile of iPTH(iPTH<27.90 pg/ml),the highest tertile group(iPTH≥38.10 pg/ml)had increased risk of hypertension with[OR(95% CI)1.581(1.157~2.162)].Compared with the[iPTH/25(OH)D<1.63×10-3]group,the risk of hypertension increased in group[iPTH/25(OH)D≥2.57×10-3][OR(95% CI)1.406(1.030~1.919)].There was no significant difference in blood pressure among the three 25(OH)D levels.Conclusion25(OH)D deficiency or insufficiency is common in hospitalized T2 DM patients.Patients with high iPTH/25(OH)D ratios are prone to hyperten-sion.