Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.
Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.
PLoS One. 2019 Apr 24;14(4):e0214728. doi: 10.1371/journal.pone.0214728. eCollection 2019.
The objective was to assess the association between 25-hydroxyvitamin D (25OHD) level and diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes.
Data pertaining to 351 in-patients with type 2 diabetes were collected. Subjects were classified into three groups based on the level of urinary albumin-to-creatinine ratio (UACR). UACR < 30 mg/g was defined as normoalbuminuria, while UACR levels of 30-300 mg/g and ≥ 300 mg/g were defined as microalbuminuria and macroalbuminuria, respectively. Serum 25OHD and other clinical characteristics among various UACR groups were compared. The relationship between albuminuiria and 25OHD was analyzed.
The prevalence of 25OHD insufficiency in the microalbuminuria group was significantly higher than that in the normoalbuminuria group (25.1% vs. 19.6%; P < 0.05); patients with macroalbuminuria had the highest prevalence of 25OHD deficiency (37.8%; P < 0.01 versus normoalbuminuria). Logistic regression analyses demonstrated that low 25OHD levels were associated with DKD [odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.16-1.97). The association was more robust after adjusting for sex, hypertension, increased systolic blood pressure, glycemic status, and hyperuricemia (OR = 1.62, 95% CI 1.19-2.20).
The prevalence of vitamin D insufficiency/deficiency in patients with albuminuria was overtly higher than that in patients without albuminuria among Chinese adults with type 2 diabetes. Vitamin D insufficiency/deficiency was independently associated with DKD in type 2 diabetes.
评估中国 2 型糖尿病患者 25-羟维生素 D（25OHD）水平与糖尿病肾脏疾病（DKD）的相关性。
收集了 351 例 2 型糖尿病住院患者的数据。根据尿白蛋白与肌酐比值（UACR）的水平将受试者分为三组。UACR＜30mg/g 定义为正常白蛋白尿，UACR 水平为 30-300mg/g 和≥300mg/g 分别定义为微量白蛋白尿和大量白蛋白尿。比较不同 UACR 组的血清 25OHD 和其他临床特征。分析蛋白尿与 25OHD 的关系。
微量白蛋白尿组的 25OHD 不足发生率明显高于正常白蛋白尿组（25.1%比 19.6%；P＜0.05）；大量白蛋白尿组的 25OHD 缺乏发生率最高（37.8%；P＜0.01比正常白蛋白尿）。Logistic 回归分析表明，低 25OHD 水平与 DKD 相关[比值比（OR）=1.51，95%置信区间（CI）1.16-1.97]。调整性别、高血压、收缩压升高、血糖状态和高尿酸血症后，该关联更为稳健（OR=1.62，95%CI 1.19-2.20）。
在患有 2 型糖尿病的中国成年人中，蛋白尿患者的维生素 D 不足/缺乏发生率明显高于无蛋白尿患者。维生素 D 不足/缺乏与 2 型糖尿病 DKD 独立相关。
