2型糖尿病合并颈动脉粥样硬化患者血清甲状旁腺激素及25羟维生素D与糖脂代谢的相关性

Correlations of serum parathyroid hormone and 25 hydroxyvitamin D with glycolipid metabolism in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis

目的 分析2型糖尿病合并颈动脉粥样硬化(CAS)患者血清甲状旁腺激素(PTH)、25羟维生素D[25-(OH)-D]与糖脂代谢的相关性。方法 收集2019年4月—2021年12月110例2型糖尿病患者的临床资料,入院后均常规行颈动脉超声、糖脂代谢及PTH、25-(OH)-D检查。根据颈动脉内中膜厚度(CIMT)检查结果将患者分为单纯2型糖尿病组(n=51)与合并CAS组(n=59)。比较2组PTH、25-(OH)-D、血糖指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]及血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平,分析血清PTH、25-(OH)-D与血糖及血脂代谢的关系。结果 2组性别、年龄、体质量指数、病程比较,差异无统计学意义(P>0.05)。合并CAS组患者血清PTH水平高于单纯2型糖尿病组,25-(OH)-D水平低于单纯2型糖尿病组,差异有统计学意义(P<0.01);合并CAS组FBG、HbA1c水平均高于单纯2型糖尿病组,差异有统计学意义(P<0.05);合并CAS组患者TC、TG、LDL-C均高于单纯2型糖尿病组,HDL-C低于单纯2型糖尿病组,差异有统计学意义(P<0.05)。双变量Pearson直线相关检验结果显示,2型糖尿病合并CAS患者血清PTH与FBG、HbA1c、TC、TG呈正相关(P<0.05),与HDL-C呈负相关(P<0.05);25-(OH)-D与HbA1c、TC、TG呈负相关(P<0.01),与HDL-C呈正相关(P<0.05)。结论 2型糖尿病合并CAS患者血清PTH、25-(OH)-D水平与糖脂代谢密切相关。

Objective To analyze the correlations of serum parathyroid hormone(PTH) and 25 hydroxyvitamin D[25-(OH)-D]with glycolipid metabolism in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis(CAS).Methods The clinical materials of 110 patients with type 2 diabetes mellitus from April 2019 to December 2021 were collected,and carotid ultrasound,glucose and lipid metabolism examination,and PTH and 25-(OH)-D detections were routinely performed after hospital admission.They were divided into simple type 2 diabetes group(n=51) and CAS group(n=59) according to the results of carotid artery intima-media thickness(CIMT) examination.The levels of PTH,25-(OH)-D,blood glucose indexes [fasting blood glucose(FBG),glycated hemoglobin( Hb A1c) ]and blood lipids indexes [total cholesterol( TC),triglycerides( TG),low density lipoprotein cholesterol( LDL-C),high density lipoprotein cholesterol( HDL-C) ]were compared between the two groups,and the relationships of serum PTH and 25-( OH)-D with blood glucose and lipid metabolism were analyzed.Results There were no significant differences in gender,age,body mass index and course of disease between the two groups( P > 0.05);the level of serum PTH in the CAS group was significantly higher than that in the simple type 2 diabetes group,while the level of 25-( OH)-D was significantly lower than that in the simple type 2 diabetes group( P < 0.05);the levels of FBG and Hb A1c in the CAS group were significantly higher than those in the simple type 2 diabetes group( P < 0.05);levels of TC,TG and LDL-C in the CAS group were significantly higher than those in the simple type 2 diabetes group,while the HDL-C was significantly lower than that in the simple type 2 diabetes group( P < 0.05).The results of bivariate Pearson linear correlation test showed that serum PTH was positively correlated with FBG,Hb A1c,TC and TG( P < 0.05),and negatively correlated with HDL-C in patients with type 2 diabetes complicated with CAS( P < 0.05).25-( OH)-D was negatively correlated with Hb A1c,TC and TG( P < 0.01),and positively correlated with HDL-C( P < 0.05).Conclusion Serum PTH and 25-( OH)-D levels in type 2 diabetes mellitus patients with CAS are closely related to glucose and lipid metabolism.