Wang Yurong, Zhang Huijuan
Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
J Diabetes Res. 2017;2017:3510275. doi: 10.1155/2017/3510275. Epub 2017 Mar 28.
To investigate the relationship between serum 25-hydroxyvitamin D3 [25(OH)D3] levels and carotid intima-media thickness (IMT) as well as carotid atherosclerotic plaque in patients with type 2 diabetes mellitus (T2DM). 314 patients with T2DM were enrolled in this study. The clinical data and laboratory examinations of subjects were recorded, such as serum 25(OH)D3, hemoglobin A1c (HbA1c), serum lipids, fasting blood glucose (FBG), and other biochemical parameters. Color Doppler ultrasound was used to measure carotid IMT and carotid atherosclerotic plaques. Patients were divided into four quartile groups according to the serum 25(OH)D3 levels from low to high: group Q1group Q4. From group Q1 to group Q4, carotid IMT and the incidence of plaque were gradually reduced. Serum 25(OH)D3 levels were lower in the plaque group compared with the nonplaque group ( < 0.01). Serum 25(OH)D3 levels were negatively correlated with the carotid IMT ( = -0.4, < 0.01). Multiple linear stepwise regression analysis showed that serum 25(OH)D3 was independently associated with carotid IMT ( = -0.009, < 0.01). Logistic regression analysis showed that serum 25(OH)D3 levels were independently associated with the presence of carotid plaque in T2DM (OR = 0.95; 95%CI: 0.920.98, = 0.004). Low vitamin D status may contribute to the incidence of carotid atherosclerosis in type 2 diabetic patients.
探讨2型糖尿病（T2DM）患者血清25-羟维生素D3[25(OH)D3]水平与颈动脉内膜中层厚度（IMT）以及颈动脉粥样硬化斑块之间的关系。本研究纳入了314例T2DM患者。记录受试者的临床资料和实验室检查结果，如血清25(OH)D3、糖化血红蛋白（HbA1c）、血脂、空腹血糖（FBG）及其他生化参数。采用彩色多普勒超声测量颈动脉IMT和颈动脉粥样硬化斑块。根据血清25(OH)D3水平由低到高将患者分为四个四分位数组：Q1组Q4组。从Q1组到Q4组，颈动脉IMT和斑块发生率逐渐降低。斑块组血清25(OH)D3水平低于无斑块组（<0.01）。血清25(OH)D3水平与颈动脉IMT呈负相关（=-0.4，<0.01）。多元线性逐步回归分析显示，血清25(OH)D3与颈动脉IMT独立相关（=-0.009，<0.01）。Logistic回归分析显示，血清25(OH)D3水平与T2DM患者颈动脉斑块的存在独立相关（OR = 0.95；95%CI：0.920.98，= 0.004）。低维生素D状态可能导致2型糖尿病患者颈动脉粥样硬化的发生。
