新冠疫情期2型糖尿病住院患者维生素D状态调查及影响因素分析

An Investigation on the Status of Vitamin D in Hospitalized Patients with Type 2 Diabetes During COVID-19 Pandemic

目的调查新冠疫情前、疫情期及后疫情时期T2DM住院患者的25(OH)D水平及影响因素。方法回顾性分析2513例T2DM住院患者25(OH)D水平及缺乏患病率的逐月变化,比较新冠疫情前后时期不同就诊季节患者、性别间各人口学资料及实验室指标的差异;并建立Logistic回归模型分析25(OH)D水平及缺乏的影响因素。结果夏秋季就诊患者25(OH)D水平显著高于秋冬季,而冬季就诊患者HDL-C显著高于夏季(P<0.05);夏季就诊者BMI显著低于其余3个季节(P<0.05)。女性患者25(OH)D、BMI水平显著低于男性,而年龄、T-CHO、HDL-C、LDL-C均显著高于男性(P<0.05)。逐月分析显示,2型糖尿病患者25(OH)D水平及缺乏患病率呈季节性变化,2020年患者总体25(OH)D水平达到峰值较2019年推迟。疫情期25(OH)D显著低于疫情前及疫情后同期水平,而疫情期缺乏患病率显著高于疫情前及疫情后同期水平。二元Logistic回归分析显示,较低HDL-C水平、较小的年龄、女性、冬春季、体重过轻及肥胖、疫情因素是影响维生素D状态的不利因素。结论后疫情时期,尤其在冬春季,2型糖尿病患者更应保持足够的户外运动,维持适当的血脂及BMI水平。

Objective To investigate the level of 25(OH)D and its influence factors in inpatient with T2DM before,during and after COVID-19 pandemic.Methods The monthly changes of 25(OH)D level and deficiency prevalence in 2513 inpatients with T2DM were retrospectively analyzed.The differences in the patient demographic data and laboratory indexes among different seasons as well as between genders were then compared among stages of before,during and after the pandemic.Furthermore,we established binary logistic regression model to explore the influence factors of 25(OH)D deficiency.Results 25(OH)D level in hospitalized patient admitted in summer and autumn were significantly higher than that in winter and spring seasons,and there was higher inpatient’s HDL-C level in winter than in summer,however,lowest inpatient’s BMI level in summer among the four seasons was observed(P<0.05).25(OH)D and BMI levels in female were significantly lower than male’s,however,age,T-CHO,HDL-C,and LDL-C were the opposite(P<0.05).25(OH)D level and the prevalence of deficiency in T2DM inpatients showed a seasonal variation from month to month,and compared to 2019,the peak of 25(OH)D level in patients in 2020 was delayed.25(OH)D level during the pandemic period was significantly lower than that before and after the pandemic period,and prevalence of deficiency during the pandemic period was significantly higher than that before and after the pandemic period.Binary logistic regression analysis showed that low HDL-C level,low age,female,winter and summer,underweight and obesity,the impact of COVID-19 pandemic were the adverse factors for 25(OH)D deficiency.Conclusion In the post-pandemic period,patient with T2DM should maintain sufficient outdoor activities,appropriate lipid aspect and BMI level.