慢阻肺并发勃起功能障碍与25羟维生素D的相关性研究

Correlation between erectile dysfunction and 25 hydroxyvitamin D in patients with chronic obstructive pulmonary disease

目的 探讨血清25羟维生素D[25 hydroxy vitamin D,25(OH)D]与慢性阻塞性肺疾病患者(chronic obstructive pulmonary diseases,COPD)并发有勃起功能障碍(erectile dysfunction,ED)的相关性。方法 选取在安徽医科大学附属安庆第一人民医院就诊的120例COPD患者,分为COPD并ED组60例、COPD组60例。收集两组患者一般临床资料,对血清学指标检测,6 min步行实验(6 mintute walking test,6MWD)测定。分析COPD并发ED的影响因素。ROC曲线分析患者25(OH)D对COPD并发ED的预测价值。结果 COPD并ED组与COPD组相比,两组患者的年龄、血压以及体重指数,既往有无吸烟和饮酒史、动脉粥样硬化史差异均无统计学意义(P>0.05);病程比较,差异具有统计学意义(P<0.05),COPD并ED组病程大于COPD组。两组患者血清的血红蛋白以及血清肌酐水平相比较,差异无统计学意义(P>0.05);两组患者血清甘油三酯以及血清总胆固醇水平相比较,差异无统计学意义(P>0.05);两组糖化血红蛋白(glycated hemoglobin A1c,HbA1c)、25(OH)D水平比较,差异有统计学意义(P<0.05),COPD并ED组HbA1c大于COPD组,25(OH)D小于COPD组。两组6MWD相比较,差异没有统计学意义(P>0.05)。利用Logistic回归分析,病程、HbA1c、25(OH)D是COPD患者合并ED的独立影响因素(P<0.05)。ROC曲线示,25(OH)D预测COPD患者并发ED的曲线下面积为0.808,敏感度70.0%,特异度83.3%,最佳截断值为15.7 ng/mL。结论 COPD患者并发ED血清25(OH)D降低,25(OH)D是COPD患者并发ED的独立影响因素,血清25(OH)D值对COPD患者并发ED有一定预测意义。

Objective To investigate the relationship between serum 25 hydroxy vitamin D ~([25(OH)D]) and chronic obstructive pulmonary diseases(COPD) complicated with erectile dysfunction(ED).Methods 120 patients with COPD in Anqing First People's Hospital affiliated to Anhui Medical University were selected and divided into the COPD combined with ED group(60 cases) and the COPD group(60 cases).Their general clinical data of the two groups were collected,serological indexes were detected,and 6-minute walking test(6MWD) was performed.The influencing factors of COPD complicated with ED were analyzed.Predictive value of 25(OH)D in COPD complicated with ED was analyzed by ROC curve.Results There was no significant difference in age,blood pressure,body mass index,history of smoking and drinking,and history of atherosclerosis between the COPD and ED group and the COPD group(P>0.05).The course of disease showed significant difference(P<0.05),and the course of disease in the COPD and ED group was longer than that in the COPD group.There was no significant difference in serum hemoglobin and serum creatinine,serum triglyceride and serum total cholesterol between the two groups(P>0.05).There were significant differences in glycated hemoglobin A1c(HbA1c),and 25(OH) D between the two groups(P<0.05),that was HbA1c was higher in the COPD and ED group than in the COPD group and 25(OH) D was lower in the COPD and ED group than in the COPD group.There was no significant difference in 6MWD between the two groups(P>0.05).Logistic regression analysis showed that disease duration,HbA1c and 25( OH) D were independent factors for COPD patients with ED( P < 0.05).ROC curve showed that 25( OH) D predicted ED in COPD patients with area under the curve was 0.808,with 70% of sensitivity,83.3% of specificity,and 0.825 ~ 0.965 of 95% CI,the optimal cut-off value was 15.7 ng/m L.Conclusion Serum 25( OH) D decreases in COPD patients complicated with ED,and 25( OH) D is an independent factor of COPD patients complicated with ED,which has a certain predictive significance for COPD patients with ED.