青年2型糖尿病患者血清25-羟维生素D3水平与糖尿病周围神经病变的关系

Relationship between serum 25-hydroxyvitamin D3 level and diabetic peripheral neuropathy in young patients with type 2 diabetes mellitus

目的探讨青年2型糖尿病(T2DM)患者血清25-羟维生素D3[25-(OH)D3]水平与糖尿病周围神经病变(DPN)的关系。方法将24~44岁的178例T2DM患者,根据是否发生糖尿病周围神经病变分为DPN组107例和非DPN组71例,另选取同期进行体检的50例健康人群作为对照组。比较三组空腹血糖、糖化血红蛋白(HbA1c)、总胆固醇、三酰甘油、HDL-C、LDL-C、25-(OH)D3水平以及血清25-(OH)D3缺乏情况,分析血清25-(OH)D3水平与年龄、病程及生化代谢指标的相关性。结果相较于对照组,DPN组和非DPN组的空腹血糖、HbA1c明显升高,血清25-(OH)D3降低;DPN组的血清25-(OH)D3水平较非DPN组低(均P<0.05)。25-(OH)D3缺乏率DPN组>非DPN组>对照组(均P<0.05)。血清25-(OH)D3水平与病程、HbA1c呈负性相关,与HDL-C、空腹血糖呈正性相关(均P<0.05)。结论发生DPN的青年T2DM患者血清25-(OH)D3水平降低,血清25-(OH)D3可能与DPN的发生相关,补充25-(OH)D3或可有助于预防和延缓DPN的发生和发展。

Objective To explore the relationship between serum 25-hydroxyvitamin D3[25-(OH)D3] level and diabetic peripheral neuropathy(DPN) in the young patients with type 2 diabetes mellitus(T2 DM).Methods A total of 178 T2 DM patients aged from 24 to 44 years were divided into DPN group(107 cases) and non-DPN group(71 cases) according to the occurrence or non-occurrence of DPN,and 50 healthy individuals undergoing physical examination during the same period were selected as control group.The fasting blood glucose,hemoglobin A1 c(HbA1 c),total cholesterol,triglyceride,HDL-C,LDL-C,25-(OH)D3 levels and deficiency of serum 25-(OH)D3 were compared between the three groups;besides,the correlation of serum 25-(OH)D3 level with age,course of disease,biochemical and metabolic indexes was analyzed.Results Compared with the control group,the DPN group and non-DPN group obtained significantly increased fasting blood glucose and HbA1 c levels,and decreased serum 25-(OH)D3;the 25-(OH)D3 level of the DPN group was lower than that of the non-DPN group(all P<0.05).The rate of 25-(OH)D3 deficiency decreased in the order of the DPN group,the non-DPN group and the control group(all P<0.05).The serum 25-(OH)D3 level was negatively correlated with course of disease and HbA1 c,but positively correlated with HDL-C and fasting blood glucose(all P<0.05).Conclusion The serum 25-(OH)D3 level decreases in the young T2 DM patients suffering from DNP,and serum 25-(OH)D3 may be correlated with the occurrence of DPN,therefore 25-(OH)D3 supplementation may be conducive to preventing and slowing the occurrence and development of DPN.