男性2型糖尿病伴代谢综合征患者血清维生素D水平的研究

The study of serum vitamin D levels in male patients with type 2 diabetes mellitus patients and metabolic syndrome

目的观察男性2型糖尿病(T2DM)患者血清25-羟维生素D[25(OH)D]水平与代谢综合征(MS)及其组分的关系。方法收集2018年3月至2019年6月在遵义医科大学附属医院内分泌科住院的男性T2DM患者203例及同期健康男性对照组(NC组)42例,糖尿病患者中根据有无MS分为T2DM+MS组(122例)、T2DM+非MS组(81例),另根据符合MS诊断标准数目分为T2DM组(单纯糖尿病组)、T2DM+1组(除血糖异常外另加一个组分)、T2DM+2组(除血糖异常外另加两个组分)、T2DM+3组(除血糖异常外另加三个组分)、T2DM+4组(具备MS的所有组分),分析WC、BMI、SBP、DBP、FBG、HbAlc、HOMA-IR、TG、TC、LDL-C、HDL-C和25(OH)D水平。结果T2DM+MS组及T2DM+非MS组血清25(OH)D水平均较NC组显著降低(P<0.05),T2DM+MS组血清25(OH)D水平较T2DM+非MS组显著降低(P<0.05)。NC组、T2DM组、T2DM+1组、T2DM+2组、T2DM+3组、T2DM+4组血清25(OH)D水平逐渐降低,差异有统计学意义(P<0.05)。Pearson相关分析显示血清25(OH)D水平与WC、BMI、SBP、DBP、HOMA-IR、FBG、TG、TC、LDL-C呈负相关(P<0.05),与HDL-C呈正相关(P<0.05)。多元线性回归提示HOMA-IR是血清25(OH)D水平的独立影响因素(P<0.05)。二元Logistic回归分析显示血清25(OH)D是T2DM伴MS患者的独立保护因素(P<0.05)。结论血清维生素D水平在男性T2DM患者代谢综合征的发生发展中可能起着一定作用。低水平维生素D与MS组分数目增加存在一定相关性。

Objective To analyze the relationship between serum 25-hydroxyvitamin D(25(OH)D)levels and metabolic syndrome(MS)and its components in male patients with type 2 diabetes mellitus(T2DM).Methods 203 male T2DM patients admitted to the department of endocrinology,affiliated hospital of zunyi medical university from March 2018 to June 2019 and 42 healthy male control group(NC group)in the same period were collected.The diabetic patients were divided into T2DM+MS group(n=122)and T2DM+non-MS group(n=81)according to whether MS was present or not.Another according to the number of MS diagnosis standard divided into T2DM group(simple diabetes group),T2DM+1 group(except abnormal blood glucose plus a component),T2DM+2 group(except abnormal blood glucose plus two components),T2DM+3 group(except abnormal blood glucose plus three components),T2DM+4 group(has all the components of the MS).WC,BMI,SBP,DBP,FBG,HbAlc,HOMA-IR,TG,TC,LDL-C,HDL-C and 25(OH)D levels were analyzed.Results Compared with the NC group,the serum levels of 25(OH)D in the T2DM+MS group and the T2DM+non-MS group was significantly decreased(P<0.05).Serum 25(OH)D levels in the T2DM+MS group decreased significantly(P<0.05).Serum 25(OH)D levels in NC group,T2DM group,T2DM+1 group,T2DM+2 group,T2DM+3 group,and T2DM+4 group decreased gradually,with statistically significant differences(P<0.05).The levels of serum 25(OH)D were negatively correlated with WC,BMI,SBP,DBP,HOMA-IR,FBG,TG,TC and LDL-C,and positively correlated with HDL-C(P<0.05).Conclusion Serum vitamin D levels may play a role in the development of metabolic syndrome in male T2DM patients.Low levels of vitamin D were associated with an increase in the number of MS components.