Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China.
Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China.
J Diabetes Res. 2022 May 9;2022:9632355. doi: 10.1155/2022/9632355. eCollection 2022.
Emerging evidence demonstrates that vitamin D status contributes to the incidence of diabetic kidney disease (DKD). However, the causal relationships between vitamin D and mortality among individuals with DKD are inconclusive. Our study is aimed at exploring the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentrations and mortality among adults with DKD. . Our study included 1,202 adult participants with DKD from the National Health and Nutrition Examination Survey (NHANES) 2001-2014. Cox and competing-risks regression were used to estimate hazard ratios (HRs) and 95% CIs for associations between 25(OH)D concentrations and survival.
The overall mean serum 25(OH)D concentration was 55.9 ± 26.3. Vitamin D deficiency (25(OH)D < 50 nmol/l), insufficiency group (50 ≤ 25(OH)D < 75 nmol/l), and sufficiency group (25(OH)D ≥ 75 nmol/l) were observed in 552 (45.9%), 409 (34.0%), and 241 (20.0%) participants, respectively. Higher levels of vitamin D were significantly associated with improved all-cause and nonaccident- and malignant neoplasm-cause mortality among individuals with DKD after adjusting for the potential confounding factors.
We observed widespread vitamin D deficiency or insufficiency in DKD patients. Higher 25(OH)D values were significantly correlated with lower risk of mortality after adjusting for confounding variables.
新出现的证据表明，维生素 D 状态与糖尿病肾病（DKD）的发生有关。然而，维生素 D 与 DKD 患者死亡率之间的因果关系尚无定论。我们的研究旨在探讨血清 25-羟维生素 D（25（OH）D）浓度与 DKD 成人死亡率之间的关系。
我们的研究纳入了 2001-2014 年国家健康和营养调查（NHANES）中 1202 名患有 DKD 的成年参与者。使用 Cox 和竞争风险回归估计 25（OH）D 浓度与生存之间的关联的风险比（HRs）和 95%置信区间（CIs）。
总体平均血清 25（OH）D 浓度为 55.9 ± 26.3。维生素 D 缺乏症（25（OH）D < 50 nmol/l）、不足组（50 ≤ 25（OH）D < 75 nmol/l）和充足组（25（OH）D ≥ 75 nmol/l）分别在 552（45.9%）、409（34.0%）和 241（20.0%）名参与者中观察到。在调整潜在混杂因素后，维生素 D 水平较高与 DKD 患者全因和非意外及恶性肿瘤原因死亡率降低显著相关。
我们观察到 DKD 患者普遍存在维生素 D 缺乏或不足。在调整混杂变量后，较高的 25（OH）D 值与较低的死亡率风险显著相关。
