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2型糖尿病患者维生素D缺乏:与疾病控制及并发症的关系

Hypovitaminosis d in patients with type 2 diabetes mellitus: a relation to disease control and complications.

作者信息

Ahmadieh Hala, Azar Sami T, Lakkis Najla, Arabi Asma

机构信息

Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon.

出版信息

ISRN Endocrinol. 2013 Oct 22;2013:641098. doi: 10.1155/2013/641098. eCollection 2013.

Abstract

Aims. This study aims at assessing the relationship between 25 (OH) vitamin D (25-OHD) levels and microvascular complications in patients with type 2 diabetes mellitus (DM2). Methods. 136 patients (59 ± 11 years) with DM2 (disease duration 8.6 ± 7 years) participated in this cross-sectional study. Anthropometric data, HbA1c, 25-OHD levels, serum creatinine, and urine microalbumin/creatinine ratio were collected. Dilated retinal exam was performed, and diabetic neuropathy was assessed using the United Kingdom Screening Score. Results. Serum 25-OHD correlated negatively with HbA1c (r = -0.20,  P = 0.049). Mean 25-OHD levels were lower in subjects with diabetic retinopathy compared to those without retinopathy (12.3 ± 5.5 versus 21.8 ± 13.7, P < 0.001) and lower in subjects with diabetic neuropathy compared to those without neuropathy (16.4 ± 10.4 versus 23.5 ± 14.5, P = 0.004). After adjustment for BMI, diabetes duration, and smoking, 25-OHD was an independent predictor of HbA1c ( β   -0.14; P = 0.03). After adjustment for HbA1c, age, smoking, BMI and disease duration, 25-OHD were independent predictors for diabetic retinopathy: OR 2.8 [95% CI 2.1-8.0] and neuropathy: OR 4.5 [95% CI 1.6-12] for vitamin D < 20 versus vitamin D ≥ 20 ng/mL. Conclusion. Low serum 25-OHD level was an independent predictor of HbA1c, diabetic neuropathy, and diabetic retinopathy in patients with DM2.

摘要

目的。本研究旨在评估2型糖尿病(DM2)患者的25(OH)维生素D(25-OHD)水平与微血管并发症之间的关系。方法。136例DM2患者(年龄59±11岁,病程8.6±7年)参与了这项横断面研究。收集了人体测量数据、糖化血红蛋白(HbA1c)、25-OHD水平、血清肌酐以及尿微量白蛋白/肌酐比值。进行了散瞳眼底检查,并使用英国筛查评分评估糖尿病神经病变。结果。血清25-OHD与HbA1c呈负相关(r = -0.20,P = 0.049)。与无糖尿病视网膜病变的患者相比,患有糖尿病视网膜病变的患者平均25-OHD水平较低(12.3±5.5 vs 21.8±13.7,P < 0.001);与无神经病变的患者相比,患有糖尿病神经病变的患者平均25-OHD水平较低(16.4±10.4 vs 23.5±14.5,P = 0.004)。在调整了体重指数(BMI)、糖尿病病程和吸烟因素后,25-OHD是HbA1c的独立预测因素(β -0.14;P = 0.03)。在调整了HbA1c、年龄、吸烟、BMI和病程后,25-OHD是糖尿病视网膜病变的独立预测因素:维生素D < 20 ng/mL与维生素D≥20 ng/mL相比,比值比(OR)为2.8 [95%可信区间(CI)2.1 - 8.0];也是糖尿病神经病变的独立预测因素:OR为4.5 [95% CI 1.6 - 12]。结论。低血清25-OHD水平是DM2患者HbA1c、糖尿病神经病变和糖尿病视网膜病变的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d164/3819758/5744f21b9340/ISRN.ENDOCRINOLOGY2013-641098.001.jpg

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