Butler Alexandra E, Dargham Soha R, Latif Aishah, Mokhtar Haira R, Robay Amal, Chidiac Omar M, Jayyousi Amin, Al Suwaidi Jassim, Crystal Ronald G, Abi Khalil Charbel, Atkin Stephen L
Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar.
Weill Cornell Medicine-Qatar, Doha, Qatar.
Ther Adv Chronic Dis. 2020 Sep 26;11:2040622320924159. doi: 10.1177/2040622320924159. eCollection 2020.
Epidemiological studies have suggested that vitamin D deficiency is associated with the development of type 2 diabetes (T2DM) and is related to diabetes complications. This study was undertaken to determine the relationship between diabetes complications and cardiovascular risk factors with vitamin D and its metabolites: 1,25-dihydroxyvitamin D (1,25(OH)D), 25-hydroxyvitamin D (25(OH)D), 24,25-dihydroxyvitamin D (24,25(OH)D); and 25-hydroxy-3epi-vitamin D (3epi25(OH)D).
750 Qatari subjects, 460 (61.3%) with and 290 (38.7%) without T2DM, who were not taking vitamin D supplements, participated in this cross-sectional, observational study. Plasma concentrations of vitamin D and its metabolites were measured by liquid chromatography tandem mass spectrometry analysis.
T2DM subjects had lower concentrations of all vitamin D metabolites ( < 0.001) except 3epi25(OH)D ( < 0.071). Males had higher concentrations of all vitamin D metabolites ( < 0.001). In the T2DM subjects, lower 25(OH)D was associated with retinopathy ( < 0.03) and dyslipidemia ( < 0.04), but not neuropathy or vascular complications; lower 1,25(OH)D was associated with hypertension ( < 0.009), dyslipidemia ( < 0.003) and retinopathy ( < 0.006), and coronary artery disease ( < 0.012), but not neuropathy; lower 24,25(OH)D concentrations were associated with dyslipidemia alone ( < 0.019); 3epi25(OH)D associated with diabetic neuropathy alone ( < 0.029). In nondiabetics, 25(OH)D, 1,25(OH)D and 24,25(OH)D were associated with dyslipidemia ( < 0.001, < 0.001, < 0.015, respectively) and lower 1,25(OH)D was associated with hypertension ( < 0.001). Spearman's correlation showed 1,25(OH)D to be negatively correlated to age and diabetes duration.
Different diabetes complications were associated with differing vitamin D parameters, with diabetic retinopathy related to lower 25(OH)D and 1,25(OH)D levels, hypertension significantly associated with lower 1,25(OH)D, while dyslipidemia was associated with lower 25(OH)D, 1,25(OH)D and 24,25(OH)D While 25(OH)D metabolites were lower in females, there was not an exaggeration in complications.
流行病学研究表明，维生素D缺乏与2型糖尿病（T2DM）的发生有关，且与糖尿病并发症相关。本研究旨在确定糖尿病并发症及心血管危险因素与维生素D及其代谢产物：1,25 - 二羟维生素D（1,25(OH)D）、25 - 羟维生素D（25(OH)D）、24,25 - 二羟维生素D（24,25(OH)D）以及25 - 羟 - 3 - 表维生素D（3epi25(OH)D）之间的关系。
750名卡塔尔受试者参与了这项横断面观察性研究，其中460名（61.3%）患有T2DM，290名（38.7%）未患T2DM，且均未服用维生素D补充剂。采用液相色谱串联质谱分析法测定血浆中维生素D及其代谢产物的浓度。
除3epi25(OH)D外（P < 0.071），T2DM受试者所有维生素D代谢产物的浓度均较低（P < 0.001）。男性所有维生素D代谢产物的浓度较高（P < 0.001）。在T2DM受试者中，较低的25(OH)D与视网膜病变（P < 0.03）和血脂异常（P < 0.04）相关，但与神经病变或血管并发症无关；较低的1,2(OH)D与高血压（P < 0.009）、血脂异常（P < 0.003）、视网膜病变（P < 0.006）及冠状动脉疾病（P < 0.012）相关，但与神经病变无关；较低的24,25(OH)D浓度仅与血脂异常相关（P < 0.019）；3epi25(OH)D仅与糖尿病神经病变相关（P < 0.029）。在非糖尿病患者中，25(OH)D、1,25(OH)D和24,25(OH)D与血脂异常相关（分别为P < 0.001、P < 0.001、P < 0.015），且较低的1,25(OH)D与高血压相关（P < 0.001）。Spearman相关性分析显示，1,25(OH)D与年龄及糖尿病病程呈负相关。
不同的糖尿病并发症与不同的维生素D参数相关，糖尿病视网膜病变与较低的25(OH)D和1,25(OH)D水平相关，高血压与较低的1,25(OH)D显著相关，而血脂异常与较低的25(OH)D、1,25(OH)D和24,25(OH)D相关。虽然女性的25(OH)D代谢产物较低，但并发症并未加重。
