维生素D与糖尿病肾病早期：1型糖尿病患者的横断面研究
Vitamin D on Early Stages of Diabetic Kidney Disease: A Cross-sectional Study in Patients with Type 1 Diabetes Mellitus.
作者信息
Felício João Soares, Luz Rafael Mendonça, de Melo Franciane Trindade Cunha, de Souza Resende Fabricio, de Oliveira Alana Ferreira, Peixoto Amanda Soares, Abrahão Neto João Felício, Carvalho Carolina Tavares, da Silva Denisson Dias, Dos Santos Marcia Costa, de Queiroz Natércia Neves Marques, de Lemos Manuela Nascimento, Yamada Elizabeth Sumi, Felício Karem Miléo
机构信息
Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará , Belém, Pará , Brazil.
出版信息
Front Endocrinol (Lausanne). 2016 Dec 12;7:149. doi: 10.3389/fendo.2016.00149. eCollection 2016.
CONTEXT
Genetic and environmental factors are involved in the pathogenesis of type 1 diabetes mellitus (T1DM), and vitamin D (VD) deficiency appears as a candidate to risk factor for developing diabetic kidney disease (DKD).
OBJECTIVE
The purpose of study was to evaluate the existence of an association between low levels of VD and the presence and degree of DKD in T1DM.
PATIENTS AND METHODS
We performed a cross-sectional study, between November 2014 and December 2015. Levels of 25(OH)D and albuminuria were analyzed in 37 patients with T1DM and normal glomerular filtration rate. Thirty-six subjects were evaluated as a control group.
RESULTS
Patients with T1DM and hypovitaminosis D had higher levels of albuminuria compared to those with normal VD levels [albuminuria (log) = 1.92 vs. 1.44; < 0.05]. When we have separated the group of patients according to stage of DKD in patients with normo, micro, and macroalbuminuria, there are lower levels of 25(OH)D in the last when compared to the first two groups (26.7 ± 6.2, 24.8 ± 7.0, and 15.9 ± 7.6 ng/ml; < 0.05, respectively). In T1DM group, we have found correlations between VD levels and both albuminuria and DKD stages ( = -0.5; < 0.01 and = -0.4; < 0.05, respectively). A simple linear regression model, with albuminuria as the dependent variable and VD as an independent variable, showed = 0.2 and < 0.01.
CONCLUSION
Our data suggest an association between reduced levels of VD and the presence and severity of DKD.
背景
遗传和环境因素参与1型糖尿病（T1DM）的发病机制，维生素D（VD）缺乏似乎是发生糖尿病肾病（DKD）的一个危险因素。
目的
本研究旨在评估T1DM患者中低水平VD与DKD的存在及程度之间是否存在关联。
患者与方法
我们在2014年11月至2015年12月期间进行了一项横断面研究。分析了37例肾小球滤过率正常的T1DM患者的25(OH)D水平和蛋白尿情况。36名受试者作为对照组进行评估。
结果
与VD水平正常的T1DM患者相比，VD缺乏的T1DM患者蛋白尿水平更高[蛋白尿（对数）=1.92对1.44；P<0.05]。当我们根据DKD分期将患者分为正常蛋白尿、微量蛋白尿和大量蛋白尿组时，与前两组相比，最后一组的25(OH)D水平较低（分别为26.7±6.2、24.8±7.0和15.9±7.6 ng/ml；P均<0.05）。在T1DM组中，我们发现VD水平与蛋白尿及DKD分期之间存在相关性（分别为r=-0.5；P<0.01和r=-0.4；P<0.05）。以蛋白尿为因变量、VD为自变量的简单线性回归模型显示r²=0.2且P<0.01。
结论
我们的数据表明VD水平降低与DKD的存在及严重程度之间存在关联。
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