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2 型糖尿病合并高血压患者血浆维生素 D 状态与生活方式模式及动态血压监测参数的相关性。

Association of plasma vitamin D status with lifestyle patterns and ambulatory blood pressure monitoring parameters in patients with type 2 diabetes and hypertension.

机构信息

Endocrine Division of Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Endocrine Division of Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Diabetes Res Clin Pract. 2018 May;139:139-146. doi: 10.1016/j.diabres.2018.02.038. Epub 2018 Mar 6.

DOI:10.1016/j.diabres.2018.02.038
PMID:29518487
Abstract

AIMS

To evaluate nutritional and metabolic parameters associated with vitamin D status and blood pressure (BP) in type 2 diabetes and hypertensive patients.

METHODS

BP evaluated by office and 24-h ambulatory BP monitoring (ABPM). Physical activity was evaluated by daily step count, body composition by DXA, and diet by a food frequency questionnaire.

RESULTS

116 patients were evaluated and median 25-hydroxyvitamin D level was 21 (16-27) ng/ml; 43% deficient (<20 ng/ml). Vitamin D deficiency was associated with higher systolic ABPM (136 ± 10 vs. 130 ± 13 mmHg; P = 0.01) and daytime ABPM (138 ± 11 vs. 133 ± 13 mmHg; P = 0.02), lower step counts (4400 [2700-6600] vs. 6400 [4700-8100] steps/day), lower urinary calcium (47 [32-141] vs. 89 [68-152] mEq), and higher fat mass (31 ± 8 vs. 27 ± 6.5 kg). Milk intake (37 vs. 64%; P = 0.009) and fish (31 vs. 69%; P < 0.001) were lower in deficients. On multivariate analysis, adjusted for fat mass and colder seasons, <5000 steps/day (OR = 3.30; 95%CI 1.34-8.12), no milk/fish intake (OR = 6.56; 95%CI 2.52-17.17), and both (OR = 7.24; 95%CI 2.19-23.90) remained associated with vitamin D deficiency.

CONCLUSIONS

Vitamin D deficiency was highly prevalent in patients with hypertension and type 2 diabetes and associated with higher systolic ABPM (daytime and 24-h), less physical activity, and no milk or fish intake.

摘要

目的

评估 2 型糖尿病和高血压患者的维生素 D 状态与血压(BP)相关的营养和代谢参数。

方法

通过诊室和 24 小时动态血压监测(ABPM)评估 BP。通过日常步数评估身体活动,通过 DXA 评估身体成分,通过食物频率问卷评估饮食。

结果

共评估了 116 例患者,中位 25-羟维生素 D 水平为 21(16-27)ng/ml;43%为不足(<20ng/ml)。维生素 D 缺乏与较高的收缩压 ABPM(136±10 与 130±13mmHg;P=0.01)和白天 ABPM(138±11 与 133±13mmHg;P=0.02)、较低的步数(4400[2700-6600]与 6400[4700-8100]步/天)、较低的尿钙(47[32-141]与 89[68-152]mEq)和更高的脂肪量(31±8 与 27±6.5kg)相关。缺乏维生素 D 的患者牛奶摄入量(37 与 64%;P=0.009)和鱼摄入量(31 与 69%;P<0.001)较低。多元分析调整脂肪量和寒冷季节后,每天步数<5000 步(OR=3.30;95%CI 1.34-8.12)、不摄入牛奶/鱼(OR=6.56;95%CI 2.52-17.17)以及两者兼而有之(OR=7.24;95%CI 2.19-23.90)与维生素 D 缺乏相关。

结论

高血压和 2 型糖尿病患者中维生素 D 缺乏非常普遍,与较高的收缩压 ABPM(白天和 24 小时)、较少的体力活动以及不摄入牛奶或鱼有关。

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