基线血清25-羟维生素D_(3)水平与代谢综合征发病风险的前瞻性队列研究

Baseline serum 25-hydroxyvitamin D_(3)levels and risk of metabolic syndrome:a prospective cohort study

目的:探讨兰州市中老年人基线血清25-羟维生素D_(3)[25-hydroxyvitamin D_(3),25-(OH)D_(3)]水平与代谢综合征(metabolic syndrome,MS)发病风险的相关性。方法:于2011年选取兰州市3个社区非MS人群2754人建立队列研究人群,于2014年进行了平均3.1年的随访,对2次调查资料完整的2309例对象进行研究。根据25-(OH)D_(3)四分位数水平将基线人群分为Quartile1(Q1)、Quartile2(Q2)、Quartile3(Q3)、Quartile4(Q4)组。比较不同25-(OH)D_(3)水平MS的发病情况,分析25-(OH)D_(3)与MS之间的相关性。结果:随着基线血清25-(OH)D_(3)水平升高,MS患病率降低(P<0.05);基线血清25-(OH)D_(3)水平与腰围(waist circumference,WC)、甘油三酯(triglyceride,TG)、空腹血糖(fasting plasma glucose,FPG)、OGTT-2 h后血糖(2 hpostprandial plasma glucose,2 h-PG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、收缩压(systolic blood pressure,SBP)呈负相关(P均<0.01);Logistic回归分析显示:基线血清25-(OH)D_(3)水平是WC、TG、FPG增加及MS发生的独立保护因素(P均<0.05)。平均随访3.1年后,共有341人发展为MS(14.8%);Cox回归分析显示:基线血清25-(OH)D_(3)水平与随访后发生异常高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及2 h-PG的风险相关(P<0.05)。结论:在甘肃兰州市中老年人群中,基线血清25-(OH)D_(3)水平是WC、TG、FPG增加及MS发生的独立保护因素,随访后发现较低的血清25-(OH)D_(3)水平与HDL-C水平降低的发生风险相关,尚未发现基线血清25-(OH)D_(3)水平的高低与MS及其他组分的发生风险相关。

AIM:To investigate the association between baseline serum 25-(OH)D_(3)level and the risk of metabolic syndrome in middle-aged and elderly people in Lanzhou.METHODS:A total of 2754 non-MS people were selected from three communities in Lanzhou in 2011 to establish a cohort study population,In 2014,2309 subjects with complete data from two surveys were followed up for an average of 3.1 years.According to the quartile level of 25-(OH)D_(3),the baseline population was divided into Q1,Q2,Q3 and Q4 groups.The incidence of MS at different levels of 25-(OH)D_(3)was compared,and the correlation between 25-(OH)D_(3)and MS was analyzed.RESULTS:With the increase of baseline serum 25-(OH)D_(3)level,the prevalence of MS decreased(P<0.05).Baseline serum 25-(OH)D_(3)level was negatively correlated with WC,TG,FPG,2h-PG,HbA1c and SBP(P<0.01).Logistic regression analysis showed that baseline serum 25-(OH)D_(3)level is an independent protective factor for the increase of WC,TG,FPG and MS(P<0.05).After an average follow-up of 3.1 years,a total of 341 patients developed MS(14.8%).Cox regression analysis showed that baseline serum 25-(OH)D_(3)level was correlated with the risk of abnormal HDL-C and 2 h-PG after follow-up(P<0.05).CONCLUSION:In the middleaged and elderly population in Lanzhou,Gansu Province,baseline serum 25-(OH)D_(3)level is an independent protective factor for the increase of WC,TG,FPG and MS,the lower serum 25-(OH)D_(3)level is associated with the risk of decreased HDL-C level after follow-up.It has not been found that the baseline serum 25-(OH)D_(3)level is associated with the risk of MS and other components.