老年2型糖尿病患者血清25羟维生素D与血浆致动脉硬化指数的相关性研究

Relationship between serum 25-hydroxyvitamin D and plasma atherogenic index in elderly patients with type 2 diabetes mellitus

目的:观察老年2型糖尿病患者血清25羟维生素D[25(OH)D]与血浆致动脉硬化指数(AIP)的相关性。方法:纳入2020年1月至2022年12月在中南大学湘雅二医院老年医学科住院的848例老年2型糖尿病患者,检测血清25(OH)D、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),计算AIP=log[TG/HDL-C]。以AIP=0.06为切分点分为致动脉硬化表型组(病例组AIP≥0.06,523例)和非致动脉硬化表型组(对照组AIP<0.06,325例),收集两组患者的一般资料并进行比较,采用Pearson相关分析和多因素Logistic回归分析探讨致动脉粥样硬化表型的影响因素。结果:病例组体质指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿酸、TC、TG、LDL-C均高于对照组(均P<0.01),而HDL-C及25(OH)D则显著低于对照组(均P<0.01)。AIP与25(OH)D(r=-0.271、P<0.001)呈负相关关系。多因素Logistic回归分析结果显示,在排除了其他干扰因素后,维生素D缺乏是AIP的危险因素(OR=2.294、95%CI:1.419~3.708、P=0.001)。结论:老年2型糖尿病患者血清25(OH)D水平与AIP相关,维生素D缺乏是老年2型糖尿病患者AIP的独立危险因素。

Objective To investigate the relationship between serum 25-hydroxyvitamin D[25(OH)D]levels and the plasma atherogenic index(AIP)in elderly patients with type 2 diabetes mellitus(T2DM).Methods In our study,we recruited 848 elderly in patients with T2DM who were admitted to the Department of Geriatrics at the Second Xiangya Hospital of Central South University in Changsha,China,between January 2020 and December 2022.We measured serum levels of 25(OH)D,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),and calculated the atherogenic index of plasma(AIP)as log[TG/HDL-C].The patients were then categorized into two groups based on their AIP values:the atherogenic phenotype group(case group,AIP≥0.06,523 cases)and the non-atherogenic phenotype group(control group,AIP<0.06,325 cases),using an AIP value of 0.06 as the cut-off point.We collected and compared clinical data from both groups,and conducted Pearson correlation analysis and multivariate Logistic regression analysis.Results In the case group,body mass index(BMI),fasting blood glucose(FBG),glycated hemoglobin A1c(HbA1c),uric acid,TC,TG,and LDL-C levels were significantly higher than those in the control group(all P<0.01),while HDL-C and 25(OH)D levels were significantly lower(all P<0.01).AIP showed a negative correlation with 25(OH)D(r=-0.271,P<0.001).Multivariate Logistic regression analysis revealed that excluding other factors,vitamin D deficiency posed a risk for AIP(OR=2.294,95%CI:1.419-3.708,P=0.001).Conclusions The level of serum 25(OH)D in elderly patients with T2DM is correlated with AIP,and vitamin D deficiency serves as an independent risk factor for AIP in this population.