Endocr Pract. 2019 Aug;25(8):809-816. doi: 10.4158/EP-2019-0015. Epub 2019 Apr 23.
The objective of this cross-sectional study was to investigate the association of serum 25-hydroxyvitamin D (25[OH]D) levels with estimated glomerular filtration rate (eGFR), albumin/creatinine ratio (ACR), and the prevalence of diabetic retinopathy (DR) in Chinese diabetic adults. A total of 4,767 diabetic participants were enrolled from seven communities in Shanghai, China, in 2018. Participants underwent several examinations, which included the measurement of anthropometric parameters, blood pressure, glucose, lipid profiles, 25(OH)D, and ACR. DR was detected based on high-quality fundus photographs and remotely read by ophthalmologists. Compared with the first 25(OH)D quartile, participants in the fourth quartile had a lower prevalence of high ACR (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.61 to 0.96) ( for trend <.01). No association was found between 25(OH)D levels and eGFR. For DR, the OR (95% CI) for DR ranging from 0 to 4 in ordinal logistic regression associated with 25(OH)D was 0.62 (0.47 to 0.82) for the fourth 25(OH)D quartile ( for trend <.01) compared with the first quartile. These associations were all fully adjusted for confounding factors. Lower serum 25(OH)D concentration is significantly associated with increased ACR and higher prevalence of DR in middle-aged and elderly diabetic adults. However, the possibility of a causal relationship between 25(OH)D deficiency and diabetic microvascular complications remains to be demonstrated. = 25-hydroxyvitamin D; = albumin/creatinine ratio; = body mass index; = confidence interval; = diabetic kidney disease; = diabetic retinopathy; = estimated glomerular filtration rate; = glycated hemoglobin; = high-density lipoprotein; = low-density lipoprotein; = odds ratio; = type 2 diabetes mellitus.
本横断面研究旨在探讨血清 25-羟维生素 D(25[OH]D)水平与估计肾小球滤过率(eGFR)、白蛋白/肌酐比值(ACR)以及中国糖尿病成人糖尿病视网膜病变(DR)患病率之间的关系。2018 年,共从中国上海的 7 个社区招募了 4767 名糖尿病患者。参与者接受了多项检查,包括测量人体测量参数、血压、血糖、血脂谱、25(OH)D 和 ACR。DR 通过高质量眼底照片检测,并由眼科医生远程读取。与第一四分位 25(OH)D 相比,第四四分位参与者的高 ACR 患病率较低(比值比 [OR],0.77;95%置信区间 [CI],0.61 至 0.96)(趋势检验<.01)。25(OH)D 水平与 eGFR 之间无关联。对于 DR,在有序逻辑回归中,25(OH)D 与 0 至 4 之间的 DR 呈连续分布,与第四四分位 25(OH)D 相比,第一四分位 25(OH)D 的 OR(95%CI)为 0.62(0.47 至 0.82)(趋势检验<.01)。这些关联均经过混杂因素的充分调整。血清 25(OH)D 浓度较低与中老年糖尿病患者的 ACR 升高和 DR 患病率增加显著相关。然而,25(OH)D 缺乏与糖尿病微血管并发症之间存在因果关系的可能性仍有待证明。25-羟维生素 D;白蛋白/肌酐比值;体质量指数;置信区间;糖尿病肾病;糖尿病视网膜病变;估计肾小球滤过率;糖化血红蛋白;高密度脂蛋白;低密度脂蛋白;比值比;2 型糖尿病。