2型糖尿病患者维生素D水平与血清CRP、自身免疫抗体及甲状腺功能的相关性

Correlation of Vitamin D Levels with Serum CRP,Autoimmune Antibodies and Thyroid Function in Patients with Type 2 Diabetes

目的研究2型糖尿病患者维生素D水平与血清C反应蛋白(CRP)、自身免疫抗体及甲状腺功能的相关性。方法选取2018年1月至2019年1月于信阳职业技术学院附属医院就诊的150例2型糖尿病患者为研究组,同期选取50例健康体检者作为对照组。检测血清CRP、血清25-羟维生素D[25(OH)D]、胰岛自身免疫抗体和甲状腺功能指标水平并比较两组差异;按血清25(OH)D水平将研究组分为正常组(34例)、不足组(37例)、缺乏组(39例)和严重缺乏组(40例)4个亚组,比较组间血清CRP、胰岛自身免疫抗体阳性率和甲状腺功能指标水平差异;对血清25(OH)D与CRP、胰岛自身免疫抗体阳性率及甲状腺功能指标水平的相关性进行Pearson和Spearman相关性分析;随访3 a,统计甲状腺功能障碍发生率,并绘制受试者工作特征(ROC)曲线分析2型糖尿病患者血清25(OH)D对甲状腺功能障碍的预测效能。结果与对照组比较,研究组血清25(OH)D、TSH水平较低,CRP水平和胰岛自身免疫抗体阳性率较高(P<0.05)。正常组、不足组、缺乏组和严重缺乏组的血清CRP、胰岛自身免疫抗体阳性率和TSH水平比较差异有统计学意义,其中血清CRP、TSH水平逐渐上升(P<0.05)。2型糖尿病患者血清25(OH)D水平与CRP(r=-0.714)、胰岛自身免疫抗体阳性率(r=-0.397)和TSH(r=-0.410)水平均呈负相关(P<0.001)。2型糖尿病患者甲状腺功能障碍发生率为25.33%(38/150),绘制ROC曲线分析血清25(OH)D预测甲状腺功能障碍发生的AUC为0.916。结论2型糖尿病患者血清维生素D与CRP、自身免疫抗体阳性率以及甲状腺功能指标水平存在负相关关系,且对甲状腺功能障碍的发生有一定预测价值。

Objective To investigate the correlation between vitamin D levels and serum C-reactive protein(CRP),autoimmune antibodies and thyroid function in patients with type 2 diabetes mellitus.Methods A total of 150 patients with type 2 diabetes treated in the Affiliated Hospital of Xinyang Vocational and Technical College from January 2018 to January 2019 were selected as the study group,and 50 healthy subjects were selected as the control group during the same period.Serum CRP,serum 25-hydroxy vitamin D[25(OH)D],islet autoimmune antibodies and thyroid function indexes were detected and the differences between the two groups were compared.According to the serum 25(OH)D level,the study group was divided into 4 subgroups:normal group(34 cases),insufficient group(37 cases),deficient group(39 cases)and severely deficient group(40 cases).The serum CRP,islet autoimmune antibody positive rate and thyroid function index levels were compared between the groups.The correlation between serum 25(OH)D and CRP,islet autoimmune antibody and thyroid function index was analyzed by Pearson and Spearman correlation analysis.After 3 years of follow-up,the incidence of thyroid dysfunction was analyzed,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of serum 25(OH)D in thyroid dysfunction in type 2 diabetes patients.Results Compared with the control group,the levels of serum 25(OH)D and TSH in the study group were lower,the levels of CRP and the positive rate of islet autoimmunity antibody were higher(P<0.05).The serum CRP,islet autoimmune antibody positive rates and TSH levels of normal group,deficiency group,deficiency group and severe deficiency group were significantly different,and the serum CRP and TSH levels were gradually increased(P<0.05).Serum 25(OH)D levels were negatively correlated with CRP(r=-0.714),islet autoimmune antibody positive rate(r=-0.397)and TSH(r=-0.410)levels in patients with type 2 diabetes(P<0.001).The incidence of thyroid dysfunction in type 2 diabetes patients was 25.33%(38/150),and the AUC of serum 25(OH)D predicted by ROC curve analysis was 0.916.Conclusion Serum vitamin D is negatively correlated with the positive rate of CRP,autoimmune antibody and thyroid function index in patients with type 2 diabetes,and has certain predictive value for the occurrence of thyroid dysfunction.