Wang Yujie, Hu Chenggang, Li Ying, Liu Qi, Gao Lichao, Zhang Dongmei, Cao Ling
Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China.
Front Med (Lausanne). 2024 Aug 9;11:1445487. doi: 10.3389/fmed.2024.1445487. eCollection 2024.
This investigation explored the potential correlation between serum vitamin D concentration and diabetic kidney disease (DKD) among patients with type 2 diabetes mellitus (T2DM).
This cross-sectional study assessed 4,570 patients with T2DM drawn from the National Health and Nutrition Examination Survey (NHANES) dataset. Restricted cubic splines were utilized to examine the dose-response relationship between serum vitamin D levels and the risk of DKD in patients with T2DM. Serum vitamin D concentrations were divided into quartiles for multivariable logistic regression analysis to evaluate the association between varying serum vitamin D levels and DKD risk in patients with T2DM. Additionally, sex-stratified analyses were conducted to determine consistency of the results. The influence of vitamin D concentrations on mortality risk was assessed using a Cox regression model.
Of the patients with T2DM, 33% were diagnosed with DKD. Restricted cubic spline plots revealed a U-shaped relationship between vitamin D levels and DKD risk, with a protective effect noted in the mid-range, indicating optimal serum vitamin D concentrations between 59.6 nmol/L and 84.3 nmol/L. The multivariate Cox regression analysis suggested that higher VID levels were associated with a reduced mortality risk, particularly in male patients.
The regulation and monitoring of serum vitamin D levels within an optimal range may play a pivotal role in the prevention of DKD in patients with T2DM. Public health strategies should emphasize the regular monitoring of vitamin D levels, especially among populations at elevated risk, to mitigate the progression of DKD and decrease the associated mortality rates.
本研究探讨2型糖尿病（T2DM）患者血清维生素D浓度与糖尿病肾病（DKD）之间的潜在相关性。
这项横断面研究评估了从美国国家健康与营养检查调查（NHANES）数据集中抽取的4570例T2DM患者。采用受限立方样条来检验T2DM患者血清维生素D水平与DKD风险之间的剂量反应关系。血清维生素D浓度被分为四分位数进行多变量逻辑回归分析，以评估不同血清维生素D水平与T2DM患者DKD风险之间的关联。此外，还进行了性别分层分析以确定结果的一致性。使用Cox回归模型评估维生素D浓度对死亡风险的影响。
在T2DM患者中，33%被诊断为DKD。受限立方样条图显示维生素D水平与DKD风险之间呈U形关系，在中等范围内具有保护作用，表明最佳血清维生素D浓度在59.6 nmol/L至84.3 nmol/L之间。多变量Cox回归分析表明，较高的维生素D水平与降低的死亡风险相关，尤其是在男性患者中。
将血清维生素D水平调节和监测在最佳范围内可能在预防T2DM患者的DKD中起关键作用。公共卫生策略应强调定期监测维生素D水平，特别是在高风险人群中，以减轻DKD的进展并降低相关死亡率。
