苏州成人血清维生素D、甲状旁腺激素、钙与血糖升高的关系

Association between serum 25-hydroxyvitamin D, parathyroid hormone, serum calcium levels and hyperglycemia

目的探讨血清25-羟基维生素D(25-OH-D)、甲状旁腺激素(PTH)及血清钙与血糖升高之间的关系。方法于2013年按照整群随机抽样的方法从苏州市4个社区抽取621名40～75岁成年居民,收集人口统计学等资料,测量身高、体重和血压,检测空腹血糖、25-OH-D、PTH、钙、磷等指标。结果与25-OH-D<10.0μg/L者相比,25-OH-D介于10.0～19.9μg/L及≥20.0μg/L者的空腹血糖水平及血糖升高发生率均偏低(P<0.001)。PTH≥65.0 ng/L者与<65.0 ng/L者的血糖水平及血糖升高发生率差异无统计学意义。与血清钙为2.03～2.54 mmol/L者相比,血清钙≥2.54 mmol/L者的血糖水平均较高(P<0.001),而血糖升高者比例却随着血清钙浓度的增加而增加。多因素Logistic回归分析发现,25-OH-D为10.0～19.9μg/L组及≥20.0μg/L组血糖升高的危险性分别为<10.0μg/L组的0.467倍(95%CI 0.311～0.703,P<0.001)和0.402倍(95%CI 0.205～0.790,P=0.008);血清钙≥2.54 mmol/L组血糖升高的危险性是2.03～2.54 mmol/L组的1.884倍(95%CI 1.272～2.791,P=0.001)。结论维生素D缺乏、血清钙浓度的升高会增加血糖升高的危险性。

OBJECTIVE To explore the relationship between serum 25-hydroxyvitamin D(25-OH-D),parathyroid hormone(PTH)and calcium levels and hyperglycemia.METHODS Based on the previously studies,621 eligible subjects were selected in this research.Demographic data,lifestyle information,history of disease and medication were collected.Height,weight and blood pressure were measured.Fasting blood glucose(FBG),25-OH-D,PTH,calcium,phosphorus of all subjects were determined.RESULTS Compared with participants with 25-OH-D<10.0μg/L,those with 25-OH-D between 10.0μg/L and 19.9μg/L and≥20.0μg/L had lower FBG levels and prevalence of hyperglycemia(all P<0.001).The FBG levels and prevalence of hyperglycemia were not significantly different between individuals with PTH≥65.0 ng/L and PTH<65.0 ng/L.Individuals with calcium level≤2.03 mmol/L or≥2.54 mmol/L had higher FBG levels than those with moderate calcium level(2.03-2.54 mmol/L),however,the prevalence of hyperglycemia increased with the elevation of the calcium level.The adjusted Logistic analysis showed the risks of hyperglycemia in participants with 25-OH-D between 10.0μg/L and 19.9μg/L,and≥20.0μg/L were 0.467 times(95%CI 0.311-0.703,P<0.001),0.402 times(95%CI 0.205-0.790,P=0.008)as that in people with 25-OH-D<10.0μg/L,respectively.The individuals with serum calcium≥2.54 mmol/L was 1.884 times(95%CI 1.272-2.791,)as likely to have hyperglycemia as the median calcium level 2.03-2.54 mmol/L(P=0.001).CONCLUSION Vitamin D deficiency and the elevated serum calcium levels may increase the risk of hyperglycemia.