血清VDR、VDBP水平与糖尿病并发甲状腺功能减退症的相关性研究

Study on the correlation between the serum levels of VDR and VDBP and diabetes mellitus complicated with hypothyroidism

目的 探讨血清维生素D受体(VDR)、维生素D结合蛋白(VDBP)与2型糖尿病(T2DM)患者并发甲状腺功能减退症(简称甲减)的相关性。方法 选择2018年1月至2021年5月该院收治的117例T2DM并发甲减患者作为观察组,另选取同期120例单纯T2DM患者作为对照组。收集所有患者一般资料。采用酶联免疫吸附试验检测患者血清VDR、VDBP水平,采用全自动生化分析仪检测甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平,采用化学发光法检测血清空腹胰岛素、餐后2 h胰岛素、空腹C肽、餐后2 h C肽、三碘甲腺原氨酸(T)、甲状腺素(T)、促甲状腺激素(TSH)、游离T(FT)、游离T(FT)、糖化血红蛋白(HbA1c),采用葡萄糖氧化酶法测定空腹血糖(FPG)、餐后2 h血糖水平,并计算胰岛素抵抗指数(IR)。采用Pearson相关分析观察组血清VDR、VDBP水平与其他指标的相关性,采用Logistic回归模型分析T2DM患者发生甲减的影响因素。结果 两组糖尿病病程、IR及FPG、HbA1c、TG、TC、HDL、LDL、T、T、FT、FT、TSH水平比较,差异均有统计学意义(P<0.05)。观察组血清VDR、VDBP水平明显低于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,观察组血清VDR、VDBP水平与糖尿病病程、IR、FPG、LDL呈负相关(r<0,P<0.05)。Logistic回归模型分析结果显示,VDR、VDBP水平降低,FPG水平、IR升高是T2DM患者并发甲减的独立危险因素(P<0.05)。结论 VDR、VDBP在T2DM并发甲减患者血清中的水平降低,是T2DM患者并发甲减的独立危险因素。

Objective To investigate the correlation between serum vitamin D receptor(VDR) and vitamin D-binding protein(VDBP) and type 2 diabetes mellitus(T2 DM) complicated with hypothyroidism.Methods From January 2018 to May 2021,117 patients with T2 DM complicated with hypothyroidism admitted to this hospital were selected as the observation group, and 120 patients with simple T2 DM in the same period were selected as the control group.General data of all patients were collected.Enzyme-linked immunosorbent assay was used to detect the serum levels of VDR and VDBP of patients.Automatic biochemical analyzer was used to detect the levels of triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL) and low density lipoprotein(LDL).Chemiluminescence method was used to detect the serum levels of fasting insulin, 2 h postprandial insulin, fasting C-peptide, 2 h postprandial C-peptide, triiodothyronine(T),thyroxine(T),thyroid stimulating hormone(TSH),free T(FT),free T(FT) and glycosylated hemoglobin(HbA1 c).Glucose oxidase method was used to measured the levels of fasting blood glucose(FPG) and 2 h postprandial blood glucose, and insulin resistance index(IR) was calculated.Pearson correlation was used to analyze the correlation between the serum levels of VDR and VDBP and other indicators in the observation group.Logistic regression model was used to analyze the influencing factors of hypothyroidism in T2 DM patients.Results There were statistically significant differences in the course of diabetes, IR and the levels of FPG,HbA1 c, TG, TC, HDL,LDL,T,T,FT,FTand TSH between the two groups(P<0.05).The serum levels of VDR and VDBP in the observation group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05).The results of Pearson correlation analysis showed that the serum levels of VDR and VDBP in the observation group were negatively correlated with the course of diabetes, IR, FPG and LDL(r<0,P<0.05).The results of Logistic regression model analysis showed that decreased levels of VDR and VDBP,increased levels of FPG and IR were independent risk factors for T2 DM patients complicated with hypothyroidism(P<0.05).Conclusion The decrease of levels of VDR and VDBP in the serum of patients with T2 DM complicated with hypothyroidism is an independent risk factors of patients with T2 DM complicated with hypothyroidism.