成年人群血清25-羟维生素D3水平与糖尿病和血糖异常关联性分析

ASSOCIATIONS BETWEEN SERUM 25-HYDROXYVITAMIN D_3 LEVEL AND THE PREVALENCES OF DIABETES AND ABNORMAL BLOOD GLUCOSE IN A CHINESE ADULT POPULATION

目的探索成年人群血清维生素D(vitamin D,VD)水平与糖尿病/血糖异常患病风险的关系。方法采用多阶段抽样的方法纳入年龄大于18周岁符合条件的2072名调查对象,收集相关人口统计学、身体测量学指标,检测血清25(OH)D3水平和糖脂代谢指标,将血清25(OH)D3水平分为缺乏组和不缺乏组,统计分析各组相应指标,探索血清25(OH)D3水平与糖尿病/血糖异常的关联性。结果研究对象中糖尿病患病率为5.69%,血糖异常率为54.68%,而VD缺乏率为19.79%,其中糖尿病患者中VD缺乏率为28.81%,血糖异常人群中VD缺乏率为19.59%;VD缺乏的研究对象糖尿病患病率显著高于VD不缺乏者(8.25%vs 5.06%,P=0.012),而VD缺乏的研究对象血糖异常率与VD不缺乏者血糖异常率差异无统计学意义(20.83%vs 19.59%,P=0.716)。调整年龄、地区、锻炼情况、身体质量指数(BMI)、空腹血脂和血压等因素之后,血清25(OH)D3浓度降低与更高的糖尿病患病率相关(P=0.046),并且血清25(OH)D3水平每降低10ng/ml,糖尿病/血糖异常患病风险增加1.391(1.039~1.861)倍(P trend=0.026)。进一步将糖尿病患者分层后,与VD不缺乏组相比,进行多因素调整后VD缺乏组的糖尿病患病危险度为1.594(1.009~2.250)倍(P=0.046),血清VD水平每降低10 ng/ml,糖尿病的患病风险分别增加了1.391(1.039~1.861)倍(P trend=0.026)。结论血清VD缺乏可能是成年人群糖尿病高发的一个独立危险因素。

Objective To explore the associations between serum vitamin D(VD)level and the prevalences of diabetes/abnormal blood glucose in a Chinese population.Methods A total of 2072 eligible subjects over 18 years of age were included by the multi-stage sampling method.Serum 25 hydroxyvitamin D3(25(OH)D_3)level and lipid metabolism indexes were detected,and relevant demographic and physical information were collected.Multiple logistic regression analysis was used to examine the relationship between serum 25(OH)D_3 level and the prevalences of diabetes and abnormal blood glucose.Results The prevalence of diabetes was 5.69%,the rate of abnormal blood glucose was 54.68%,and the rate of vitamin D deficiency was 19.79%.The rate of vitamin D deficiency was 28.81%in diabetic subjects and 19.59%in abnormal blood glucose subjects.The prevalence of diabetes in subjects with vitamin D deficiency was significantly higher than that in subjects with vitamin D sufficiency(8.25%vs 5.06%,P=0.012),while there was no statistically significant difference in the rates of abnormal blood glucose between the subjects with vitamin D deficiency and vitamin D sufficiency(20.83%vs 19.59%,P=0.716).After adjusting for multiple factors such as age,region,exercise,BMI,fasting lipids,and blood pressure,the decrease of serum 25(OH)D_3 level was associated with a higher prevalence of diabetes(P=0.046),and the risk of diabetes/abnormal blood glucose was increased by 1.391(1.039-1.861)times for every 10 ng/ml decrease in serum 25(OH)D_3 level(P=0.026).After further stratification of the diabetic subjects,compared with the vitamin D adequate group,the risk of diabetes in the vitamin D deficiency group was 1.594(1.009-2.520,P=0.046)after multi-factor adjustment.The risk of diabetes was increased by 1.391(1.039-1.861)times for every 10 ng/ml decrease in serum vitamin D_3level(P=0.026).Conclusion Vitamin D deficiency may be an independent risk factor for high incidence of diabetes in Chinese adult population.