1型和2型糖尿病患者维生素D缺乏与并发症的发生：一项队列研究。

Vitamin D deficiency and development of complications in individuals with type 1 and type 2 diabetes: A cohort study.

作者信息

Tougaard Ninna Hahn, Hansen Tine Willum, Rossing Peter

机构信息

Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark.

出版信息

J Diabetes Complications. 2023 Oct;37(10):108611. doi: 10.1016/j.jdiacomp.2023.108611. Epub 2023 Sep 6.

DOI:10.1016/j.jdiacomp.2023.108611

PMID:37716257

Abstract

AIMS

To investigate vitamin D deficiency as a risk marker for complications in individuals with type 1 and type 2 diabetes.

METHODS

A cohort study including 1448 adults with type 1 and 770 with type 2 diabetes. Individuals in the decile with lowest vitamin D level were classified as vitamin D deficient. Outcomes based on medical records and registers included mortality, major adverse cardiovascular event (MACE), heart failure, a composite kidney endpoint, albuminuria progression and sight-threatening eye disease. Risk in individuals with vitamin D deficiency was compared to the remaining using adjusted Cox proportional hazards models.

RESULTS

Vitamin D deficiency was associated with higher risk of MACE (adjusted hazard ratio (HR): 2.6; 95 % confidence interval (CI): 1.3-5.2) in type 1, but not in type 2 diabetes. Risk of heart failure was higher in individuals with vitamin D deficiency in both cohorts (HR (95%CI): 16 (4.8-50) in type 1 and 2.4 (1.1-5.5) in type 2 diabetes). Vitamin D deficiency was not associated with development of microvascular complications or mortality.

CONCLUSIONS

Vitamin D deficiency was a risk marker for MACE and heart failure in type 1 and for heart failure in type 2 diabetes, but not for microvascular complications or all-cause mortality.

摘要

目的

研究维生素D缺乏作为1型和2型糖尿病患者并发症风险标志物的情况。

方法

一项队列研究，纳入1448例1型糖尿病成人患者和770例2型糖尿病成人患者。维生素D水平处于最低十分位数的个体被归类为维生素D缺乏。基于病历和登记信息的结局包括死亡率、主要不良心血管事件（MACE）、心力衰竭、复合肾脏终点、蛋白尿进展和威胁视力的眼部疾病。使用校正后的Cox比例风险模型比较维生素D缺乏个体与其余个体的风险。

结果

在1型糖尿病中，维生素D缺乏与MACE风险较高相关（校正风险比（HR）：2.6；95%置信区间（CI）：1.3 - 5.2），但在2型糖尿病中并非如此。两个队列中维生素D缺乏个体的心力衰竭风险均较高（1型糖尿病的HR（95%CI）：16（4.8 - 50），2型糖尿病的HR（95%CI）：2.4（1.1 - 5.5））。维生素D缺乏与微血管并发症的发生或死亡率无关。