血清25羟维生素D与2型糖尿病周围神经病变的相关性

Correlation between Serum 25-hydroxyvitamin D and Peripheral Neuropathy in Type 2 Diabetes

目的探讨25(OH)D水平与DPN发生是否存在相关性。方法选取138例2型糖尿病(T2DM)患者作为研究对象,根据临床症状和神经电图检查结果分为SDM组47例及DPN组91例,DPN组根据临床症状分为无临床症状组(DPN1组)54例及有临床症状组(DPN2组)37例。收集所有患者的性别、年龄、就诊季节、糖尿病(DM)病程、吸烟史、SBP、DBP、BMI、25(OH)D、FPG、2 hPG、HbA1c、FC、TC、TG等指标,比较以上指标的组间差异。并对DPN发生的危险因素行二元Logistic回归分析。结果(1)住院T2DM患者中血清25(OH)D浓度平均为16.25(12.88,19.90)ng/mL,97.10%患者存在25(OH)D缺乏(76.09%)和不足(21.01%)。SDM组、DPN1组、DPN2组血清25(OH)D缺乏比例分别为68.09%、77.78%、83.78%,不足比例分别为25.53%、20.37%、16.22%,充足比例分别为6.38%、1.85%、0.00%,组间差异无统计学意义(P>0.05);(2)二元Logistic回归分析显示:25(OH)D是DPN发生的保护因素(OR=0.238,95%CI 0.074~0.764,P<0.05)。结论(1)住院T2DM患者中普遍存在25(OH)D不足和缺乏;(2)25(OH)D可能是DPN发生的保护因素。

Objective To investigate the correlation between 25(OH)D level and the occurrence of DPN.Methods A total of 138 patients with type 2 diabetes mellitus(T2DM)were selected as the study subjects.According to the clinical symptoms and neurogram results,there were 47 patients in the SDM group.And 91 patients in the DPN group were divided into 54 patients in the non-clinical group(DPN1 group)and 37 patients in the clinically symptomatic group(DPN2 group).The gender,age,treatment season,diabetes mellitus(DM)course,smoking history,SBP,DBP,BMI,25(OH)D,Ca,P,FPG,2 hPG,HbA1c,FC,TC,TG,HDL-C,LDL-C and other indicators of all patients were collected.The group differences of the above indicators were compared,and the correlation between serum 25(OH)D and the above indicators was analyzed.The occurrence risk factors of DPN were analyzed by binary Logistic regression.Results(1)The median serum 25(OH)D in hospitalized T2DM patients was 16.25(12.88,19.90)ng/ml,and 97.10%of the patients were deficient(76.09%)and inadequate(21.01%)in 25(OH)D.The proportion of serum 25(OH)D deficiency in SDM group,DPN1 group and DPN2 group was 68.09%,77.78%and 83.78%,25(OH)D inadequacy was 25.53%,20.37%and 16.22%,and 25(OH)D adequacy was 6.38%,1.85%,and 0.00%,respectively.The difference between the groups was not statistically significant(P>0.05).(2)Binary Logistic regression analysis showed that 25(OH)D was a protective factor in the occurrence of DPN(OR=0.238,95%CI 0.074-0.764,P<0.05).Conclusions(1)25(OH)D deficiency and inadequacy are common in hospitalized T2DM patients.(2)Serum 25(OH)D may be a protective factor for the occurrence of DPN.