Liu Jin-xia, Xiang Jie, Bu Rui-fang, Wu Wen-jun, Shen Hong, Wang Xia-juan
Department of Endocrinology, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Feb;40(2):115-9.
To evaluate the relationship between 25-hydroxy vitamin D [25(OH)D] and carotid artery intimal medial thickness (IMT) in type 2 diabetic (T2DM) patients.
Serum 25(OH)D and carotid IMT were measured in 300 T2DM patients. Patients were divided into four quartile groups according to the serum 25(OH)D levels (Q1: < 26.17 nmol/L, 74 cases; Q2: 26.17 - 32.75 nmol/L, 76 cases; Q3: 32.75 - 42.93 nmol/L, 78 cases; Q4 > 42.93 nmol/L, 72 cases).
Carotid IMT, carotid artery plaque prevalence, duration of diabetes, HbA1c, CRP and PTH were significantly higher in subjects with low 25(OH)D compared subjects with high 25(OH)D (P < 0.05). Carotid artery IMT in Q1 and Q2 groups were significantly higher than that in Q4 group (1.03 ± 0.21 vs. 0.90 ± 0.20, 1.01 ± 0.26 vs. 0.90 ± 0.20, P < 0.05), was similar among Q1 and Q2 and Q3 groups. Prevalence of carotid atherosclerotic plaque in Q1 group (50.0%) was also significantly higher than in Q3 (29.5%, P < 0.05) and Q4 (16.7%, P < 0.05). Similarly, 25(OH)D concentration was significantly lower in patients with carotid plaque compared patients without carotid plaque [(28.31 ± 4.91) nmol/L vs. (36.31 ± 4.31) nmol/L, P < 0.01]. Pearson correlation analysis showed that carotid IMT was positively correlated with age, smoking, BMI, HbA1c, CRP, LDL-C, PTH/25(OH)D ratio (P < 0.05), and was negatively correlated with 25 (OH) D (r = -0.51, P < 0.01). Multivariate regression analysis showed that 25(OH)D concentration was an independent predictor of carotid IMT in this cohort (β = -0.39, P < 0.01).
Serum 25(OH)D concentration is negatively correlated with carotid IMT and low 25 (OH) D level is a risk factor for preclinical atherosclerosis in T2DM patients.
评估2型糖尿病（T2DM）患者中25-羟维生素D [25(OH)D]与颈动脉内膜中层厚度（IMT）之间的关系。
对300例T2DM患者测量血清25(OH)D和颈动脉IMT。根据血清25(OH)D水平将患者分为四个四分位数组（Q1：< 26.17 nmol/L，74例；Q2：26.17 - 32.75 nmol/L，76例；Q3：32.75 - 42.93 nmol/L，78例；Q4 > 42.93 nmol/L，72例）。
与25(OH)D水平高的受试者相比，25(OH)D水平低的受试者的颈动脉IMT、颈动脉斑块患病率、糖尿病病程、糖化血红蛋白、C反应蛋白和甲状旁腺激素显著更高（P < 0.05）。Q1组和Q2组的颈动脉IMT显著高于Q4组（1.03±0.21 vs. 0.90±0.20，1.01±0.26 vs. 0.90±0.20，P < 0.05），Q1组、Q2组和Q3组之间相似。Q1组的颈动脉粥样硬化斑块患病率（50.0%）也显著高于Q3组（29.5%，P < 0.05）和Q4组（16.7%，P < 0.05）。同样，与无颈动脉斑块的患者相比，有颈动脉斑块的患者25(OH)D浓度显著更低[（28.31±4.91）nmol/L vs.（36.31±4.31）nmol/L，P < 0.01]。Pearson相关性分析显示，颈动脉IMT与年龄、吸烟、体重指数、糖化血红蛋白、C反应蛋白、低密度脂蛋白胆固醇、甲状旁腺激素/25(OH)D比值呈正相关（P < 0.05），与25(OH)D呈负相关（r = -0.51，P < 0.01）。多变量回归分析显示，在该队列中25(OH)D浓度是颈动脉IMT的独立预测因子（β = -0.39，P < 0.01）。
血清25(OH)D浓度与颈动脉IMT呈负相关，低25(OH)D水平是T2DM患者临床前期动脉粥样硬化的危险因素。
