Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, PR China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, PR China.
Department of Clinical Laboratory, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, PR China.
Diabetes Res Clin Pract. 2024 Mar;209:111585. doi: 10.1016/j.diabres.2024.111585. Epub 2024 Feb 15.
This study explores the link between Vitamin D deficiency (VDD) and diabetic peripheral neuropathy (DPN) in elderly type 2 diabetes mellitus (T2DM) patients.
Involving 257 elderly T2DM patients, the study utilized propensity score matching to balance age, sex, and diabetes duration. VDD was defined as serum 25-hydroxyvitamin D [25(OH)D] levels below 20 ng/ml. Large nerve fiber lesions were evaluated by electromyogram, while small nerve fiber lesions were assessed by measuring skin conductance.
DPN patients had notably lower serum 25(OH)D levels than non-DPN patients [15.05 vs. 18.4 ng/ml, P = 0.018]. VDD was identified as an independent risk factor for DPN (odds ratio = 2.488, P = 0.008) in multivariate logistic regression analysis. Spearman's correlation showed negative correlations between serum 25(OH)D levels and specific nerve latencies, and positive correlations with specific nerve velocities and amplitudes. The VDD group exhibited longer median sensory nerve latencies and motor evoked potential latencies compared to the vitamin D-sufficient group. Further, VDD is associated with the prolongation of the median motor nerve latency (odds ratio = 1.362, P = 0.038).
VDD is independently associated with a higher risk of DPN. VDD may promote the development of DPN by affecting large nerve fibers.
本研究旨在探讨老年 2 型糖尿病患者维生素 D 缺乏（VDD）与糖尿病周围神经病变（DPN）之间的关系。
本研究纳入了 257 例老年 2 型糖尿病患者，采用倾向评分匹配法平衡年龄、性别和糖尿病病程。VDD 定义为血清 25-羟维生素 D [25(OH)D] 水平低于 20ng/ml。大纤维神经病变通过肌电图评估，小纤维神经病变通过皮肤电导率测量评估。
DPN 患者的血清 25(OH)D 水平明显低于非 DPN 患者[15.05 比 18.4ng/ml，P=0.018]。多因素 logistic 回归分析显示，VDD 是 DPN 的独立危险因素（比值比=2.488，P=0.008）。Spearman 相关分析显示，血清 25(OH)D 水平与特定神经潜伏期呈负相关，与特定神经速度和幅度呈正相关。VDD 组的正中感觉神经潜伏期和运动诱发电位潜伏期中位数均长于维生素 D 充足组。此外，VDD 与正中运动神经潜伏期延长相关（比值比=1.362，P=0.038）。
VDD 与 DPN 的风险增加独立相关。VDD 可能通过影响大纤维神经而促进 DPN 的发生。
