25-羟维生素D3与2型糖尿病视网膜病变相关性分析

Analysis of the correlation between 25 hydroxyvitamin D3 and type 2 diabetes retinopathy,Qingdao Chengyang District People's Hospital

目的 回顾性分析25-羟维生素D3与糖尿病视网膜病变(DR)的相关性。方法 回顾性分析2020年9月-2022年8月就诊于青岛市城阳区人民医院的2型糖尿病(T2DM)患者868例,先按照眼底检测情况,研究对象分为无糖尿病视网膜病变(NDR)组、非增殖性糖尿病视网膜病变(NPDR)组和增殖性糖尿病视网膜病变(PDR)组,比较三组患者临床资料;研究对象根据检测血清25-羟维生素D3,分为缺乏(25-羟维生素D3<20ng/mL)Q1组、不足(25-羟维生素D3 20-30ng/ml)Q2、正常(25-羟维生素D3>30ng/mL)Q3组,分析其与DR发生的相关性。结果 3组间糖尿病病程、年龄、DBP、FBG、HbA1c、SUA和UACR水平比较差异有统计学意义(P<0.05)。3组间血清25-羟维生素D3水平比较NPDR低于NDR和PDR,差异有统计学意义(P<0.05);3组间糖尿病病程、TG、HDL-C、FBG、HbA1c、NPDR检查比率和UACR比较差异有统计学意义(P<0.05)。DR发生危险因素logistic回归分析,与第一组25-羟维生素D3水平缺乏相比,第三组25-羟维生素D3水平充足发生NPDR的风险降低,与第二组25-羟维生素D3水平缺乏相比,第三组25-羟维生素D3水平充足发生NPDR的风险降低,差异均有统计学意义(P<0.05)。结论 NPDR患者25-羟维生素D3水平明显降低,25-羟维生素D3不足或缺乏是增加NPDR发生风险,适当补充25-羟维生素D3可能对于防治NPDR有一定临床指导意义。

Objective To retrospectively analyze the correlation between 25 hydroxyvitamin D3 and diabetic retinopathy(DR).Methods 868 patients with type 2 diabetes mellitus(T2DM)who visited Qingdao Chengyang District People's Hospital from september 2020 to August 2022 were analyzed retrospectively.According to the fundus examination,the subjects were divided into non diabetic retinopathy(NDR)group,non proliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group,and the clinical data of the three groups were compared;According to the detection of serum 25 hydroxyvitamin D3,the subjects were divided into three groups:deficient(25 hydroxyvitamin D3<20ng/mL)Q1 group,insufficient(25 hydroxyvitamin D320-30ng/mL)Q2 group,and normal(25 hydroxyvitamin D3>30ng/mL)Q3 group.The correlation between them and DR was analyzed.Results There were significant differences in the course of diabetes,age,DBP,FBG,HbA1c,SUA and UACR levels among the three groups(P<0.05).Compared with NDR and PDR,the levels of serum 25 hydroxyvita-min D3 in the three groups were lower in NPDR(P<0.05);There were statistically significant differences among the three groups in the course of diabetes,TG,HDL-C,FBG,HbA1c,NPDR examination rate and UACR(P<0.05).In the logistic regression analysis of risk factors for DR,compared with the lack of 25 hydroxyvitamin D3 in the first group,the risk of NPDR caused by adequate 25 hydroxyvitamin D3 in the third group was reduced,Compared with the lack of 25 hydroxyvitamin D3 in the second group,the risk of NPDR caused by adequate 25 hydroxyvitamin D3 in the third group was reduced,with statistically significant differences(P<0.05).Conclu-sion The level of 25 hydroxyvitamin D3 in NPDR patients was significantly reduced.Insufficient or lack of 25 hydroxyvitamin D3 increased the risk of NPDR.Appropriate supplementation of 25 hydroxyvitamin D3 may have some clinical significance for the prevention and treatment of NPDR.