Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Endocrinol Metab (Seoul). 2021 Feb;36(1):106-113. doi: 10.3803/EnM.2020.826. Epub 2021 Feb 24.
Low 25-hydroxyvitamin D (25OHD) levels are associated with the incidence of type 2 diabetes mellitus (T2DM). However, the association between 25OHD and metabolic health status or diabetic complications is inconclusive. We evaluated this relationship between vitamin D status and metabolic parameters and complications of T2DM.
This study included 1,392 patients with T2DM who visited Eulji and Ewha Diabetes Center between January 2011 and August 2016. Anthropometric parameters and laboratory tests including glycated hemoglobin (HbA1c), lipid profile, liver and kidney function, and urinary albumin-to-creatinine ratio (UACR) were evaluated. Diabetic macro- and microvascular complications were determined through a medical record review. Serum 25OHD concentrations were measured by chemiluminescent immunoassay.
The mean 25OHD level was 16.8±9.6 ng/mL. Vitamin D deficiency (<20 ng/mL) and severe deficiency (<10 ng/mL) were observed in 990 (71.1%) and 351 (25.2%) participants, respectively. 25OHD level was positively correlated with age and highdensity lipoprotein cholesterol (HDL-C) level and negatively correlated with HbA1c, triglyceride level, and UACR. HDL-C and UACR were significantly associated with 25OHD after adjusting for other variables. Vitamin D deficiency was independently related to nephropathy after adjusting for confounding variables.
Vitamin D deficiency was common among Korean T2DM patients; it was independently associated with microalbuminuria and HDL level, and positively related to diabetic nephropathy.
低 25-羟维生素 D（25OHD）水平与 2 型糖尿病（T2DM）的发病率有关。然而，25OHD 与代谢健康状况或糖尿病并发症之间的关系尚无定论。我们评估了维生素 D 状态与 T2DM 代谢参数和并发症之间的关系。
本研究纳入了 2011 年 1 月至 2016 年 8 月期间在欧亚糖尿病中心就诊的 1392 例 T2DM 患者。评估了人体测量参数和实验室检查结果，包括糖化血红蛋白（HbA1c）、血脂谱、肝肾功能和尿白蛋白与肌酐比值（UACR）。通过病历回顾确定糖尿病大血管和微血管并发症。采用化学发光免疫分析法测定血清 25OHD 浓度。
平均 25OHD 水平为 16.8±9.6ng/mL。990 名（71.1%）和 351 名（25.2%）患者分别存在维生素 D 缺乏症（<20ng/mL）和严重缺乏症（<10ng/mL）。25OHD 水平与年龄和高密度脂蛋白胆固醇（HDL-C）水平呈正相关，与 HbA1c、甘油三酯水平和 UACR 呈负相关。在调整其他变量后，HDL-C 和 UACR 与 25OHD 显著相关。在调整混杂因素后，维生素 D 缺乏与肾病独立相关。
韩国 T2DM 患者中维生素 D 缺乏较为常见；它与微量白蛋白尿和 HDL 水平独立相关，与糖尿病肾病呈正相关。
