血清25羟维生素D水平与老年2型糖尿病患者糖尿病足溃疡的相关性

Correlation between serum 25 hydroxyvitamin D level and diabetic foot ulcer in elderly patients with type 2 diabetes mellitus

目的 探讨老年2型糖尿病(T2DM)患者血清25羟维生素D[25(OH)D]水平与糖尿病足溃疡(DFU)发病的相关性。方法 选取2019年1月至2021年1月安徽医科大学第一附属医院内分泌科收治住院的86例老年T2DM合并DFU患者为病例组(DFU组),选择同期住院治疗的60例新诊断老年T2DM患者作为对照组(T2DM组),无DFU,无糖尿病下肢动脉疾病或周围神经病变。采用化学发光法测定血清25(OH)D水平。使用多因素logistic回归分析了解血清25(OH)D与老年T2DM患者DFU发病的关系。结果 DFU组中糖尿病病程、空腹血糖、糖化血红蛋白、甘油三酯、C反应蛋白、白细胞计数、红细胞沉降率高于T2DM组(P<0.05);而平均每天日照时间、高密度脂蛋白胆固醇、血清白蛋白、血红蛋白、估算肾小球滤过率、经皮氧分压、踝肱指数以及血清25(OH)D水平低于T2DM组(P<0.05)。多因素logistic回归分析发现高水平血清25(OH)D为DFU的独立保护因素(OR=0.54,95%CI:0.35~0.83,P=0.022)。结论 老年T2DM患者中血清25(OH)D水平与DFU发病之间存在密切相关关系,高水平血清25(OH)D为DFU的独立保护因素。

Objective To investigate the correlation between serum 25 hydroxyvitamin D [25(OH)D] level and diabetic foot ulcer(DFU) in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 86 elderly T2DM patients with DFU admitted to the Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from January2019 to January 2021 were selected as the DFU group,and 60 newly diagnosed elderly T2DM patients who were hospitalized during the same period were selected as the T2DM group,without DFU,diabetic lower extremity arterial disease or diabetic peripheral neuropathy.Serum 25(OH)D level was measured by chemiluminescence method.Multivariate logistic regression analysis was used to investigate the relationship between serum 25(OH)D and DFU of T2DM patients.Results In DFU group,the course of diabetes,fasting blood glucose,glycosylated hemoglobin,triglyceride,C-reactive protein,white blood cell count,and erythrocyte sedimentation rate were higher than those in T2DM group(P <0.05);however,the average sunshine time,high-density lipoprotein cholesterol,serum albumin,hemoglobin,estimated glomerular filtration rate,percutaneous partial pressure of oxygen,ankle brachial index,and serum 25(OH)D levels in the T2DM group were lower than those in the T2DM group(P<0.05).Multivariate logistic regression analysis showed that low serum 25(OH)D was an independent protective factor for DFU(OR=0.54,95%CI:0.35-0.83,P=0.022).Conclusion There is a close correlation between serum 25(OH)D levels and the onset of DFU in elderly T2DM patients,and high levels of serum 25(OH)D are independent protective factors for DFU.