中老年2型糖尿病患者血脂异常与血清维生素D水平相关性研究

THE RELATIONSHIP BETWEEN SERUM VITAMIN D CONCENTRATION AND RISK OF DYSLIPIDEMIA IN MIDDLE-AGED AND ELDERLY PATIENTS WITH TYPE 2 DIABETES MELLITUS

目的 探索中老年2型糖尿病患者血清维生素D(VD)水平与血脂异常发生风险的关系。方法 分层随机抽样纳入年龄大于50周岁的2型糖尿病确诊患者,检测血清25羟维生素D[25(OH)D]水平和糖脂代谢指标,收集相关人口统计学、身体测量学指标,将血清25(OH)D水平分为充足组和不足组,统计分析各组相应指标,探索血清25(OH)D水平与血脂异常的相关关系。结果 研究对象中血脂异常率为43.70%,而维生素D充足率为19.26%,其中血脂异常患者中VD充足率仅为13.56%;VD水平不足的中老年2型糖尿病患者血脂异常发生率显著高于VD充足患者(46.79%vs 30.77%,P=0.0364)。进行多因素调整BMI和臀围比率之后,血清25(OH)D浓度降低显著增加血脂异常的风险(OR=2.11;95%CI:1.01-4.43;P=0.0481),并且血清25(OH)D水平每降低10 ng/ml,血脂异常患病风险增加0.74倍(95%CI:0.51-1.00)。结论 血清VD水平下降可能是中老年2型糖尿病患者血脂异常高发的一个独立危险因素。[营养学报,2022,44(5):449-454]

Objective To explore the relationship between vitamin D insufficiency and risk of dyslipidemia in middle-aged and elderly patients with type 2 diabetes mellitus. Methods Using a stratified random sampling method,patients older than 50 years with diagnosed type 2 diabetes mellitus were included in the study. We measured serum 25-hydroxyvitamin D(25(OH)D) level and glycolipid metabolism indicators, and collected relevant demographic and anthropometric information. Serum 25(OH)D levels were ivided into sufficient and insufficient groups, and the results were statistically analyzed to explore the correlation between serum 25(OH)D level and dyslipidemia. Results The incidence of dyslipidemia in middle-aged and elderly patients with type 2 diabetes mellitus in insufficient vitamin D group was significantly higher than in sufficient vitamin D group(46.79% vs 30.77%, P = 0.0364). After adjusting for confounding factors, the adverse effect of insufficiency vitamin D on dyslipidemia was significant(OR: 2.11, 95% CI: 1.01,4.43;P =0.0481). The risk of dyslipidemia increased 0.74 times(95% CI: 0.51,1.00) when serum 25(OH)D concentration decreased by 10 ng/ml. Conclusion Decreased serum vitamin D concentration may be an independent risk factor for hyperlipidemia in middle-aged and elderly patients with type 2 diabetes mellitus. [ACTA NUTRIMENTA SINICA, 2022,44(5):449-454]