维生素D缺乏与糖尿病周围神经病变的相关性研究

The relationship between vitamin D deficiency and diabetic peripheral neuropathy

目的 研究2型糖尿病患者维生素D缺乏与糖尿病周围神经病变(DPN)的相关性.方法 选取2型糖尿病患者200例和正常对照者100名,其中2型糖尿病患者分为DPN组(109例)和无糖尿病周围神经病变(NDPN)组(91例).通过ELISA法测定25 (OH) D3水平,常规测定肝、肾功能,HbA1c,血脂,血钙、磷,β2微球蛋白,尿微量白蛋白等指标.25 (OH) D3与各指标之间进行相关性分析.结果 与正常对照组相比,NDPN组和DPN组25 (OH) D3水平降低,DPN组降低更加明显(F=202.265,P＜0.01),且DPN组维生素D缺乏患者比例(76.1％)明显高于NDPN组(47.3％)(x2=17.763,P＜0.01).维生素D水平与DPN、病程、年龄、性别、空腹血糖、HbA1c、总胆固醇、低密度脂蛋白-胆固醇、24 h尿微量白蛋白、β2微球蛋白均呈显著负相关(r=-0.315～-0.144,P均＜0.05),而与血钙呈正相关(r=0.193,P=0.006).二元Logistic回归分析显示,维生素D缺乏是DPN的独立危险因素(OR=3.564,95％ CI:1.950 ～6.511,P＜0.001).结论 维生素D缺乏是DPN的独立危险因子,并可能在2型糖尿病及DPN的发生、发展中发挥作用.

Objective To study the association of vitamin D deficiency with diabetic peripheral neuropathy (DPN) in type 2 diabetic patients.Methods A total of 200 type 2 diabetic patients and 100 healthy normal people were included in this study.Patients with type 2 diabetes were divided into DPN group (n =109)and non-DPN group (NDPN group,n =91).ELISA was used to measure the level of 25 (OH) D3,and conventional methods were used to determine the functions of liver and renal,glycosylated hemoglobin,blood lipid,serum calcium,phosphorus,beta 2 microglobulin,urinary microalbumin and other indicators.Correlation analysis between 25 (OH) 3 and other indicators were performed.Results Compared with normal control group,levels of 25 (OH)D3 in NDPN group and DPN group were lower,especially in DPN group (F =202.265,P ＜ 0.01).Moreover,the percentage of vitamin D deficiency in DPN group (76.1％) was much higher than that of NDPN group (47.3％,x2 =17.763,P ＜ 0.001).Level of vuitamin D was negatively related to DPN,diabetic duration,age,gender,fasting blood glucose,HbA1 c,total cholesterol,low density lipoprotein cholesterol,24 h urinary microalbumin,beta 2 microglobulin (r =-0.315 to-0.144,all P ＜ 0.05),and positively related to blood calcium (r =0.193,P =0.006).Binary Logistic regression analysis showed that vitamin D deficiency was an independent risk factor for DPN (OR =3.564,95％ CI:1.950-6.511,P ＜ 0.001).Conclusion Vitamin D deficiency is an independent risk factor for DPN,and may play a role in the occurrence and development of type 2 diabetes and DPN.