藏汉两族2型糖尿病患者维生素D水平影响因素分析

The influence factors of vitaminD status in Tibetan and Han patients with type 2 diabetes

目的探讨藏汉两族2型糖尿病患者维生素D水平的影响因素。方法收集2016年11月至2018年10月在西藏自治区人民政府驻成都办事处医院内分泌科住院治疗的藏汉两族患者176例,比较藏汉两族2型糖尿病患者腰围、体质量指数(bone mass index,BMI)及25羟维生素D[25(OH)D]、糖化血红蛋白(HbA1c)水平的差异,并对藏汉两族25羟维生素D水平相关因素进行多元线性回归分析。结果藏族2型糖尿病患者25(OH)D水平低于汉族(男性:12.08±5.28 vs 18.71±5.63,P<0.01;女性:11.62±4.78 vs 19.97±7.77,P<0.01),HbA1c水平高于汉族(男性:9.98±2.71 vs 8.17±1.77,P<0.01;9.97±2.72 vs 8.01±1.78,P<0.01);多元线性回归提示藏族2型糖尿病患者25(OH)D的主要影响因素是HbA1c(β=-0.718,P<0.05),汉族2型糖尿病患者25(OH)D的主要影响因素是HbA1c、BMI(β=-1.222,β=0.985,P<0.05)。结论藏族2型糖尿病患者维生素D水平明显低于汉族2型糖尿病患者,藏汉两族血糖控制欠佳的2型糖尿病患者维生素D缺乏风险高,临床医生控制2型糖尿病患者血糖的同时应注意补充患者维生素D水平。

Objective To investigate the influencing factors of vitaminD status in Tibetan and Han patients with type 2 diabetes(T2DM).Methods 176 patients who were hospitalized in the Department of Endocrinology from November 2016 to October 2018 were enrolled.Compared the differences of waist circumference,BMI,25(OH)D and HbA1c between Tibetan and Han patients with type 2 diabetes and Multivariate linear regression analysis was performed on the correlation factors of 25(OH)D levels.Results The level of 25(OH)D is lower in Tibetans with T2DM than that in Han nationality(male:12.08±5.28 vs 18.71±5.63,P<0.01;female:11.62±4.78 vs 19.97±7.77,P<0.01),HbA1c level was higher in Tibetans with T2DM than that of Han nationality(male:9.98±2.71 vs 8.17±1.77,P<0.01,female:9.97±2.72 vs 8.01±1.78,P<0.01).The mutiple linear regression analysis showed that HbA1c was correlated with 25(OH)D in Tibetan T2DM patients(β=-0.718,P<0.05),HbA1c and BMI was correlated with 25(OH)D in Han T2DM patients(β=-1.222,β=0.985,P<0.05).Conclusion The level of vitamin D in Tibetan T2DM patients was significantly lower than that in Han T2DM patients.The risk of vitamin D deficiency was high in Tibetan and Han T2DM patients with poorly control of blood glucose.Clinicians should pay attention to supplementing vitamin D levels while controlling blood glucose in patients with type 2 diabetes.