2型糖尿病不同血管并发症与脂溶性维生素及营养代谢指标的关系

Association of fat-soluble vitamins and nutritional metabolism indicators with vascular complications in patients with type 2 diabetes

目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者血管并发症与脂溶性维生素A、D、E(Vit A、D、E)及营养代谢指标之间的关系。方法随机抽取2018年1月—2018年8月住院糖尿病患者共200例,将患者分为单纯糖尿病组(n=65)、糖尿病合并大血管病变组(n=70)、糖尿病合并微血管病变组(n=65)。分别记录患者的年龄、性别、生活习惯;计算患者的BMI、腰臀比(waist-to-hip ratio,WHR);检测患者的空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)和同型半胱氨酸(homocysteine,Hcy)。比较3组患者一般情况、营养代谢指标、Vit A、E、25(OH)D水平,并分3组患者Vit A、Vit E、25(OH)D与营养代谢指标的相关性。结果单纯糖尿病组,糖尿病合并大血管病变组,糖尿病合并微血管病变组3组患者TC、TG、HDL、LDL、FPG差异有统计学意义(P<0.05);BMI、WHR、HbA1c、TP、ALB、PA、Hcy差异无统计学意义(P>0.05);25(OH)D水平差异有统计学意义(P<0.05);Vit A、Vit E水平差异无统计学意义(P>0.05);25(OH)D水平与TP、ALB、HDL呈正相关(P<0.05),与TC、TG、LDL、FPG呈负相关(P<0.05),其余均无相关(P>0.05)。结论随着糖尿病并发症的出现,Vit D的水平逐渐下降,Vit D与2型糖尿病及糖尿病血管并发症关系密切。

Objective To analyze the relationship between vascular complications and fat-soluble vitamin A(Vit A),vitamin D(Vit D),vitamin E(Vit E)and nutritional metabolism in patients with type 2 diabetes mellitus(T2DM).Methods Two hundred patients with T2DM admitted from January to August 2018 were recruited in the study,including 65 cases with simple diabetes(group A),70 cases with macrovascular disease(group B)and 70 cases with microvascular disease(group C).The age,gender and living habits of patients were recorded;the BMI and waist-to-hip ratio(WHR)were calculated;the fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),total protein(TP),albumin(ALB),prealbumin(PA),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)and homocysteine(Hcy)were measured.The general conditions,nutritional metabolic indicators,Vit A,E and 25(OH)D levels of three groups were compared,and the correlations of Vit A,Vit E,25(OH)D with nutritional metabolic indicators were analyzed.Results There were significant differences in TC,TG,HDL,LDL and FPG levels among three groups(P<0.05);however,there were no significant differences in BMI,WHR,HbA1c,TP,ALB,PA and Hcy(P>0.05).There was significant difference in 25(OH)D levels(P<0.05),while there were no significant differences in Vit A and Vit E levels among three groups(P>0.05).The level of 25(OH)D in diabetic patients was positively correlated with TP,ALB and HDL(P<0.05),and negatively correlated with TC,TG,LDL and FPG(P<0.05).Conclusion Vit D level is closely related to diabetic vascular complications in patients with T2DM.