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糖尿病肾病患者的维生素D缺乏及相关危险因素

Vitamin D deficiency and related risk factors in patients with diabetic nephropathy.

作者信息

Xiao Xiaoyan, Wang Yajuan, Hou Yanlian, Han Feng, Ren Jianmin, Hu Zhao

机构信息

Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China.

Department of Endocrinology, Jinan Central Hospital, Jinan, China Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China.

出版信息

J Int Med Res. 2016 Jun;44(3):673-84. doi: 10.1177/0300060515593765. Epub 2016 Mar 4.

Abstract

OBJECTIVES

To investigate serum 25-hydroxyvitamin D (25[OH]D) levels in patients with diabetic nephropathy, analyse the relationship between 25(OH)D and clinical indexes, and identify risk factors for vitamin D deficiency in diabetic nephropathy.

METHODS

Patients with diabetic nephropathy were sequentially enrolled and grouped according to diabetic nephropathy stage. Serum 25(OH)D levels were measured. A control group of healthy subjects was used for comparison.

RESULTS

Out of 240 patients with diabetic nephropathy and 60 healthy controls, 25(OH)D levels were lower in diabetic nephropathy patients than in controls, and showed a gradually decreasing trend with diabetic nephropathy stage. Serum 25(OH)D levels were significantly correlated with age, sex, diabetes history, body mass index, systolic blood pressure, albumin excretion rate (AER), estimated glomerular filtration rate, fasting blood glucose, glycosylated haemoglobin (HbA1c), haemoglobin, serum albumin, creatinine clearance rate, blood urea nitrogen and complicated diabetic retinopathy. Moreover, age, body mass index, AER, haemoglobin, and HbA1c were independent risk factors of 25(OH)D deficiency in diabetic nephropathy.

CONCLUSIONS

Vitamin D deficiency is prevalent in patients with diabetic nephropathy and increases in severity with diabetic nephropathy progression. Age, obesity, glucose level and renal function largely affect 25(OH)D deficiency in diabetic nephropathy.

摘要

目的

探讨糖尿病肾病患者血清25-羟维生素D(25[OH]D)水平,分析25(OH)D与临床指标之间的关系,并确定糖尿病肾病患者维生素D缺乏的危险因素。

方法

连续纳入糖尿病肾病患者,并根据糖尿病肾病分期进行分组。检测血清25(OH)D水平。选取健康受试者作为对照组进行比较。

结果

在240例糖尿病肾病患者和60例健康对照中,糖尿病肾病患者的25(OH)D水平低于对照组,且随着糖尿病肾病分期呈逐渐下降趋势。血清25(OH)D水平与年龄、性别、糖尿病病史、体重指数、收缩压、白蛋白排泄率(AER)、估计肾小球滤过率、空腹血糖、糖化血红蛋白(HbA1c)、血红蛋白、血清白蛋白、肌酐清除率、血尿素氮及合并糖尿病视网膜病变显著相关。此外,年龄、体重指数、AER血红蛋白及HbA1c是糖尿病肾病患者25(OH)D缺乏的独立危险因素。

结论

糖尿病肾病患者普遍存在维生素D缺乏,且随着糖尿病肾病进展其严重程度增加。年龄、肥胖、血糖水平及肾功能在很大程度上影响糖尿病肾病患者的25(OH)D缺乏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b9a/5536722/08697ac7aedb/10.1177_0300060515593765-fig1.jpg

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