Ahmadieh Hala, Azar Sami T, Lakkis Najla, Arabi Asma
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.
ISRN Endocrinol. 2013 Oct 22;2013:641098. doi: 10.1155/2013/641098. eCollection 2013.
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.
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。
