Ding Ya-Hui, Wei Tie-Ming, Qian Lin-Yan, Ma Yuan, Lao Di-Bo, Yao Bin, Pang Jie
Department of Cardiology, Zhejiang Provincial People's Hospital Department of Cardiology, Lishui Central Hospital, Lishui, Zhejiang Province Department of Geriatrics Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.
Medicine (Baltimore). 2017 Mar;96(13):e6445. doi: 10.1097/MD.0000000000006445.
In this study, we investigated the distribution of vitamin D and its association with carotid atherosclerotic plaque (CP) in Chinese type 2 diabetic (T2D) patients. We performed a cross-sectional study in 210 T2D and 94 age- and gender-matched nondiabetic patients during winter months, by determining serum 25-hydroxyvitamin D (25(OH)D) levels in both diabetic and nondiabetic controls. We carried out measurements of B-mode ultrasonography of carotid arteries in each T2D patient. The 25(OH)D concentration was 26.25 nmol/L among the T2D patients. About 93.3% T2D patients suffered from hypovitaminosis D. First, we found a clear inverse correlation between the 25(OH)D concentration and CP (P <0.001). Second, an association between 25(OH)D and macrovascular disease was significant (P = 0.005). In multivariate logistic regression analysis, decreasing 25(OH)D concentration was markedly associated with CP in T2D patients. Third, after adjusting for the confounding factors, we also observed a positive correlation between low levels of 25(OH)D in T2D patients with CP, when the following parameters were measured: old age (odds ratio [OR] = 2.533, P = 0.013); smoking (OR = 3.872, P = 0.001); and high level of low-density lipoprotein (LDL) cholesterol (OR = 2.776, P = 0.009). Thus, we concluded that high prevalence of hypovitaminosis D exists in Chinese T2D patients. Further, we found a significant association between low concentration of serum 25(OH)D and the existence of high body mass index, and high circulating LDL to be substantially positive predictors of patients with CP in T2D.
在本研究中,我们调查了中国2型糖尿病(T2D)患者维生素D的分布及其与颈动脉粥样硬化斑块(CP)的关联。在冬季,我们对210例T2D患者和94例年龄及性别匹配的非糖尿病患者进行了一项横断面研究,测定了糖尿病和非糖尿病对照组的血清25-羟基维生素D(25(OH)D)水平。我们对每位T2D患者进行了颈动脉B型超声检查。T2D患者的25(OH)D浓度为26.25纳摩尔/升。约93.3%的T2D患者患有维生素D缺乏症。首先,我们发现25(OH)D浓度与CP之间存在明显的负相关(P<0.001)。其次,25(OH)D与大血管疾病之间的关联具有显著性(P = 0.005)。在多因素逻辑回归分析中,25(OH)D浓度降低与T2D患者的CP显著相关。第三,在调整混杂因素后,当测量以下参数时,我们还观察到患有CP的T2D患者中低水平的25(OH)D之间存在正相关:老年(比值比[OR]=2.533,P = 0.013);吸烟(OR = 3.872,P = 0.001);以及高水平的低密度脂蛋白(LDL)胆固醇(OR = 2.776,P = 0.009)。因此,我们得出结论,中国T2D患者中维生素D缺乏症的患病率很高。此外,我们发现血清25(OH)D低浓度与高体重指数的存在之间存在显著关联,并且高循环LDL是T2D患者CP的重要阳性预测指标。