Department of Endocrinology Diabetes, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, China.
Acta Diabetol. 2024 Nov;61(11):1393-1402. doi: 10.1007/s00592-024-02292-3. Epub 2024 Jun 3.
Liver fibrosis (LF) is a common complication of diabetes mellitus (DM). Studies have found that vitamin D (VD), as a modifiable factor has been reported to be associated with LF. The relationship between serum VD concentration and LF in DM patients has rarely been reported. The aim of this study was to assess the association between serum VD concentration and LF in DM patients.
In this cross-sectional study, data of DM patients aged ≥ 45 years were extracted from the National Health and Nutrition Examination Survey (NHANES 2017-2018). Serum VD concentration was measured by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Vibration controlled transient elastography (VCTE) was used to measure liver stiffness. Covariates included sociodemographic information, lifestyles, laboratory data, diseases history were extracted from the database. The weighted univariable and multivariable logistic regression models were utilized to explore the association between serum VD concentration and LF in DM patients, and were described as odds ratio (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on BMI, liver steatosis, hypertension and dyslipidemia were further assessed the association.
A total of 799 patients were included, of which 188 (23.53%) had LF. Higher serum VD concentration was associated with the lower odds of LF (OR = 0.33, 95% CI 0.19-0.59) and advanced LF (OR = 0.31, 95% CI 0.17-0.55) in DM patients after adjustment for race, liver steatosis, BMI, smoking, drinking, AST, ALT and physical activity, especially in patients with liver steatosis (OR = 0.28, 95% CI 0.13-0.59) and dyslipidemia (OR = 0.31, 95% CI 0.14-0.66), respectively.
High serum VD concentration may have a potential benefit for maintain the liver health in DM patients.
肝纤维化（LF）是糖尿病（DM）的常见并发症。研究发现，维生素 D（VD）作为一种可调节因素，与 LF 有关。血清 VD 浓度与 DM 患者 LF 之间的关系鲜有报道。本研究旨在评估 DM 患者血清 VD 浓度与 LF 之间的关系。
本横断面研究从 2017-2018 年国家健康与营养调查（NHANES）中提取年龄≥45 岁的 DM 患者的数据。采用高效液相色谱-串联质谱法（HPLC-MS/MS）测定血清 VD 浓度。采用振动控制瞬态弹性成像（VCTE）测量肝硬度。从数据库中提取社会人口统计学信息、生活方式、实验室数据和疾病史等协变量。采用加权单变量和多变量逻辑回归模型探讨 DM 患者血清 VD 浓度与 LF 之间的关系，并以比值比（OR）和 95%置信区间（CI）表示。进一步根据 BMI、肝脂肪变性、高血压和血脂异常进行亚组分析，以评估两者之间的关联。
共纳入 799 例患者，其中 188 例（23.53%）存在 LF。校正种族、肝脂肪变性、BMI、吸烟、饮酒、AST、ALT 和体力活动后，血清 VD 浓度较高与 DM 患者 LF （OR=0.33，95%CI 0.19-0.59）和进展性 LF（OR=0.31，95%CI 0.17-0.55）的几率降低相关，尤其是在存在肝脂肪变性（OR=0.28，95%CI 0.13-0.59）和血脂异常（OR=0.31，95%CI 0.14-0.66）的患者中。
高血清 VD 浓度可能对 DM 患者的肝脏健康有益。
