Unit of Internal Medicine, Ospedale "Casa Sollievo della Sofferenza" IRCCS, San Giovanni Rotondo, FG, Italy.
J Endocrinol Invest. 2012 Oct;35(9):853-8. doi: 10.3275/8236. Epub 2012 Jan 30.
We investigated inpatients with and without Type 2 diabetes mellitus, aged over 60 yr, to compare their vitamin D status and calcium homeostatic parameters.
We studied 140 patients consecutively admitted to our Internal Medicine Unit during the year 2010 (61 from November to April, 79 from May to October). The sample encompassed 70 patients with and 70 without diabetes. At admission we measured serum calcium (Ca), phosphate (P), sodium (Na), potassium (K), creatinine (Cr), alkaline phosphatase total activity (AP), albumin adjusted serum calcium (Caalb adj), 25 hydroxy-vitamin D (25OHD), PTH, and 24-h urinary Na/Cr (uNa/Cr), K/Cr (uK/Cr), Ca/Cr (uCa/Cr), P/Cr (uP/Cr) ratios, and calcium excretion (Ca ex).
25OHD levels of patients with and without diabetes did not significantly differ. In patients without diabetes recruited from November to April, 25OHD levels were significantly lower than those from May to October, whilst patients with diabetes did not show a significant seasonal variation. PTH had opposite non-significant seasonal variations, and negatively correlated with 25OHD in both groups of patients. This correlation was lost after adjusting for age and body mass index in patients with diabetes. These inpatients had higher serum P and lower uP/Cr, according to lower PTH. Their serum glucose negatively correlated with uCa/Cr and Ca ex, contrary to inpatients with other diseases. Instead, uCa/Cr and Ca ex correlated with uNa/Cr only in patients without diabetes.
Inpatients with diabetes did differ from those with other disorders for vitamin D status and calcium-phosphate homeostatic mechanism.
我们比较了年龄＞60 岁的伴或不伴 2 型糖尿病的住院患者的维生素 D 状态和钙稳态参数。
我们连续研究了 2010 年入住我院内科的 140 例患者（11-4 月 61 例，5-10 月 79 例）。样本包括 70 例伴糖尿病和 70 例不伴糖尿病的患者。入院时我们检测了血清钙（Ca）、磷（P）、钠（Na）、钾（K）、肌酐（Cr）、总碱性磷酸酶（AP）、白蛋白校正的血清钙（Caalb adj）、25 羟维生素 D（25OHD）、甲状旁腺素（PTH）、24 小时尿钠/肌酐（uNa/Cr）、尿钾/肌酐（uK/Cr）、尿钙/肌酐（uCa/Cr）、尿磷/肌酐（uP/Cr）比值和钙排泄（Ca ex）。
伴或不伴糖尿病的患者的 25OHD 水平无显著差异。11-4 月入院的不伴糖尿病患者的 25OHD 水平显著低于 5-10 月入院的患者，而糖尿病患者无显著的季节性变化。PTH 有相反的非显著季节性变化，与两组患者的 25OHD 呈负相关。在调整了糖尿病患者的年龄和体重指数后，这种相关性丢失了。这些住院患者的血清 P 更高，uP/Cr 更低，提示 PTH 降低。他们的血清葡萄糖与 uCa/Cr 和 Ca ex 呈负相关，与其他疾病患者相反。相反，仅在不伴糖尿病的患者中，uCa/Cr 和 Ca ex 与 uNa/Cr 相关。
与其他疾病患者相比，糖尿病住院患者的维生素 D 状态和钙磷稳态机制存在差异。
