Xing Yuling, Cheng Tiantian, Zhou Fei, Ma Huijuan
Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People's Republic of China.
Graduate School of Hebei Medical University, Shijiazhuang, 050017, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Feb 2;15:269-280. doi: 10.2147/DMSO.S348870. eCollection 2022.
To investigate the association between vitamin D deficiency and NAFLD risk in patients with type 2 diabetes mellitus (T2DM).
Overall, 434 patients with T2DM admitted to Hebei General Hospital from January 2019 to December 2019 were selected as the study subjects. According to abdominal ultrasound findings, patients were divided into the NAFLD group and the non-NAFLD group. Participants were divided into two study groups according to the 25-hydroxyvitamin D [25(OH)D] level. 25(OH)D deficiency was defined if 25(OH)D vitamin levels were <20 ng/mL. Chi-square test and one-way analysis of variance were used to compare groups. The relationship between 25(OH)D and NAFLD risk was analyzed using correlation and regression analyses. Furthermore, subgroup analyses were performed to verify the robustness of the results.
The 25(OH)D level in patients with T2DM complicated by NAFLD was significantly lower than in patients with T2DM only. Vitamin D deficiency was highly prevalent among T2DM patients with NAFLD. This study suggested that vitamin D deficiency was an independent factor for developing NAFLD in patients with T2DM. T2DM patients with vitamin D deficiency had 2.045 times higher risk of developing NAFLD than those without vitamin D deficiency. Vitamin D deficiency was associated with high NAFLD preference in T2DM patients with BMI >23kg/m, but not those with BMI ≤23kg/m. The significant correlation between vitamin D deficiency and NAFLD was found in participants with BMI >23kg/m, age ≤65 years, without hypertension, TG <1.7mmol/l, HDL ≥1 mmol/l in men, ≥1.3 mmol/l in women, HBA1C ≤7%, or females.
This study suggests that T2DM people with BMI >23kg/m were more susceptible to NAFLD by vitamin D deficiency and that it is necessary to maintain optimal serum vitamin D levels in this population.
探讨2型糖尿病（T2DM）患者维生素D缺乏与非酒精性脂肪性肝病（NAFLD）风险之间的关联。
选取2019年1月至2019年12月在河北医科大学第一医院住院的434例T2DM患者作为研究对象。根据腹部超声检查结果，将患者分为NAFLD组和非NAFLD组。根据25-羟基维生素D[25(OH)D]水平将参与者分为两个研究组。若25(OH)D维生素水平<20 ng/mL，则定义为25(OH)D缺乏。采用卡方检验和单因素方差分析比较各组。采用相关性和回归分析分析25(OH)D与NAFLD风险之间的关系。此外，进行亚组分析以验证结果的稳健性。
合并NAFLD的T2DM患者的25(OH)D水平显著低于单纯T2DM患者。维生素D缺乏在合并NAFLD的T2DM患者中非常普遍。本研究表明，维生素D缺乏是T2DM患者发生NAFLD的独立因素。维生素D缺乏的T2DM患者发生NAFLD的风险是无维生素D缺乏患者的2.045倍。维生素D缺乏与BMI>23kg/m的T2DM患者发生NAFLD的高偏好相关，但与BMI≤23kg/m的患者无关。在BMI>23kg/m、年龄≤65岁、无高血压、TG<1.7mmol/l、男性HDL≥1 mmol/l、女性≥1.3 mmol/l、HBA1C≤7%的参与者或女性中，发现维生素D缺乏与NAFLD之间存在显著相关性。
本研究表明，BMI>23kg/m的T2DM患者更容易因维生素D缺乏而患NAFLD，因此有必要维持该人群的血清维生素D水平在最佳状态。
