Bener Abdulbari, Al-Hamaq Abdulla O A A, Kurtulus Eda Merve, Abdullatef Waleed K, Zirie Mahmoud
Department of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.
Qatar Diabetic Associations and Qatar Foundation, Doha, Qatar.
Diabetes Metab Syndr. 2016 Oct-Dec;10(4):198-204. doi: 10.1016/j.dsx.2016.06.007. Epub 2016 Jun 8.
The aims of this study were to determine the role of vitamin D, obesity and physical exercise in the regulation of glycemia in Type 2 Diabetes Mellitus patients in a highly consanguineous population.
Case and control study.
The survey was carried out at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar.
The study was conducted from November 2012 to June 2014 among subjects above 30 years of age. Of the 2224 registered with diagnosed diabetes and free diseases attending Hamad General Hospital and PHC centers agreed and gave their consent to study.
Questionnaire included socio-demographic variables, body mass index (BMI), consanguinity, lifestyle habits, family history of diabetes, blood pressure and development of diabetes complications such as retinopathy, nephropathy, and neuropathy were collected at regular intervals throughout the follow-up. Univariate and multivariate statistical analysis were performed.
There were statistically significant difference between patients with diabetic and control in terms of ethnicity (p=0.012), level of education (p=0.002), occupation (p<0.001), monthly income (p<0.001), BMI(p=0.024), sport activity (p=0.018), cigarette smoking (p<0.001), consanguinity (p=0.029) and family history of Diabetes Mellitus (p<0.001) and co-morbidity hypertension (p=0.041). Further, the biochemistry values in the studied subjects with T2DM compared to healthy controls and the study revealed that serum Vitamin D, BMI, fasting glucose level, calcium, HbA1c, total cholesterol HDL, LDL, bilirubin, triglycerides, uric acid and blood pressure systolic and diastolic were higher in T2DM compared to their counterparts. Multivariate logistic regression showed that vitamin D deficiency ng/mL, Family History of T2DM, BMI (kg/m) hypertension, consanguinity, income, mother occupation, ethnicity, educational level and Lack of physical exercise variables were significant predictors of diabetes. In the group of Diabetes Mellitus Type 2 patients, 39.3% as opposed to 51.2% in the control group had vitamin D deficiency, 25(OH) D3 levels≤10ng/ml (p<0.001). In the group of Diabetes Mellitus Type 2 patients, 34.6% as opposed to 37.9% in the control group had vitamin D insufficiency, 25(OH)D3 levels <20ng/ml (p < 0.001). In the group of Diabetes Mellitus Type 2 patients, 22.8% as opposed to 14.2% in the control group had vitamin D sufficiency, 25(OH)D3 levels >30 10ng/ml (p < 0.001).
Vitamin D, family history of diabetes, consanguinity marriages' and hereditary gene-environment interactions and physical exercise may also contribute to the current diabetes epidemic in Qatari's Arab populations.
本研究旨在确定维生素D、肥胖和体育锻炼在高度近亲通婚人群的2型糖尿病患者血糖调节中的作用。
病例对照研究。
该调查在卡塔尔国的哈马德总医院和初级卫生保健（PHC）中心进行。
该研究于2012年11月至2014年6月在30岁以上的人群中开展。在哈马德总医院和PHC中心登记诊断为糖尿病且无其他疾病的2224名患者同意并自愿参与研究。
问卷涵盖社会人口统计学变量、体重指数（BMI）、近亲通婚情况、生活方式习惯、糖尿病家族史、血压以及糖尿病并发症如视网膜病变、肾病和神经病变的发生情况，在整个随访过程中定期收集。进行单变量和多变量统计分析。
糖尿病患者与对照组在种族（p = 0.012）、教育程度（p = 0.002）、职业（p < 0.001）、月收入（p < 0.001）、BMI（p = 0.024）、体育活动（p = 0.018）、吸烟（p < 0.001）、近亲通婚（p = 0.029）、糖尿病家族史（p < 0.001）和合并高血压（p = 0.041）方面存在统计学显著差异。此外，与健康对照组相比，研究中2型糖尿病患者的生化值显示，2型糖尿病患者的血清维生素D、BMI、空腹血糖水平、钙、糖化血红蛋白、总胆固醇、高密度脂蛋白、低密度脂蛋白、胆红素、甘油三酯、尿酸以及收缩压和舒张压均高于对照组。多变量逻辑回归显示，维生素D缺乏（ng/mL）、2型糖尿病家族史、BMI（kg/m）、高血压、近亲通婚、收入、母亲职业、种族、教育程度和缺乏体育锻炼变量是糖尿病的重要预测因素。在2型糖尿病患者组中，39.3%的患者存在维生素D缺乏，即25(OH)D3水平≤10ng/ml，而对照组为51.2%（p < 0.001）。在2型糖尿病患者组中，34.6% 的患者存在维生素D不足，即25(OH)D3水平<20ng/ml，而对照组为37.9%（p < 0.001）。在2型糖尿病患者组中，22.8%的患者维生素D充足，即25(OH)D3水平>30ng/ml，而对照组为14.2%（p < 0.001）。
维生素D、糖尿病家族史、近亲通婚以及遗传基因 - 环境相互作用和体育锻炼也可能是导致卡塔尔阿拉伯人群当前糖尿病流行的原因。
