血清维生素D水平与2型糖尿病患者糖脂代谢指标的相关性
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摘要
目的探讨河南农村地区2型糖尿病(T2DM)患者糖脂代谢指标与血清维生素D水平的相关性。方法采用整群抽样法选取河南省郑州市二七区侯寨乡和焦作市武陟县农村地区居民为研究对象,其中T2DM患者为396例,纳入T2DM组,根据性别、年龄按照1∶1匹配396例非T2DM患者作为对照组。比较两组一般资料及相关实验室指标,分析T2DM组患者血清25(OH)D_3水平与糖脂代谢指标的相关性。结果 T2DM组患者维生素D缺乏水平、糖尿病家族史比例、全身性肥胖、向心性肥胖、腰臀比异常、腰身比异常、高血压比例均高于对照组,体力活动水平低于对照组,差异有统计学意义(均P<0.05)。T2DM组患者胰岛素和TG水平高于对照组,血清高密度脂蛋白胆固醇(HDL-C)水平、25(OH)D_3、1,25(OH)_2D_3水平低于对照组,差异有统计学意义(均P<0.05)。T2DM患者血清25(OH)D_3水平与血糖、甘油三酯(TG)呈负相关(均P<0.05),与HDL-C呈正相关(P<0.05)。结论河南农村地区T2DM患者血清维生素D水平与血糖和TG水平呈负相关,与HDL-C呈正相关。
Objective To investigate the relationship between glucose and lipid metabolism markers and serum vitamin D level in patients with type 2 diabetes mellitus(T2 DM) in rural areas of Henan Province.Methods The population sampling method was used to select residents from rural areas of Houzhai Township of Zhengzhou City and Wuyi County of Jiaozuo City in Henan Province. Among them, 396 patients were T2 DM patients, and were included in T2 DM group. According to gender and age, 369 non-T2 DM patients were matched as control group according to 1∶1. The general data and related laboratory indicators of two groups were compared. The correlation between serum 25(OH)D_3 level and glucose and lipid metabolism indicators in T2 DM patients was analyzed.Results The level of vitamin D deficiency, family history of diabetes, systemic obesity, central obesity, abnormal waist-to-hip ratio, waist-to-body ratio, and hypertension were higher in T2 DM group than in control group(all P<0.05). The physical activity level was lower than that in control group(P<0.05). The levels of insulin and serum TG in T2 DM group were higher than those in control group(both P<0.05). The levels of serum high-density lipoproteincholesterol(HDL-C), 25(OH)D_3, and 1,25(OH)_2D_3 were lower than those in control group(all P<0.05). In T2 DM patients, serum 25(OH)D_3 level was negatively correlated with blood glucose and triglyceride(TG)(both P<0.05), and positively correlated with HDL-C(P<0.05).Conclusion Serum vitamin D level in T2 DM patients in rural areas of Henan are negatively correlated with blood glucose and serum TG level, and positively correlated with serum HDL-C level.
Objective To investigate the relationship between glucose and lipid metabolism markers and serum vitamin D level in patients with type 2 diabetes mellitus(T2 DM) in rural areas of Henan Province.Methods The population sampling method was used to select residents from rural areas of Houzhai Township of Zhengzhou City and Wuyi County of Jiaozuo City in Henan Province. Among them, 396 patients were T2 DM patients, and were included in T2 DM group. According to gender and age, 369 non-T2 DM patients were matched as control group according to 1∶1. The general data and related laboratory indicators of two groups were compared. The correlation between serum 25(OH)D_3 level and glucose and lipid metabolism indicators in T2 DM patients was analyzed.Results The level of vitamin D deficiency, family history of diabetes, systemic obesity, central obesity, abnormal waist-to-hip ratio, waist-to-body ratio, and hypertension were higher in T2 DM group than in control group(all P<0.05). The physical activity level was lower than that in control group(P<0.05). The levels of insulin and serum TG in T2 DM group were higher than those in control group(both P<0.05). The levels of serum high-density lipoproteincholesterol(HDL-C), 25(OH)D_3, and 1,25(OH)_2D_3 were lower than those in control group(all P<0.05). In T2 DM patients, serum 25(OH)D_3 level was negatively correlated with blood glucose and triglyceride(TG)(both P<0.05), and positively correlated with HDL-C(P<0.05).Conclusion Serum vitamin D level in T2 DM patients in rural areas of Henan are negatively correlated with blood glucose and serum TG level, and positively correlated with serum HDL-C level.
引文
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[2] GE H,SUN H,WANG T,et al.The association between serum 25-hydroxyvitamin D3 concentration and serum lipids in the rural population of China[J].Lipids Health Dis,2017,16(1):215.
[3] 龙丽,向菲,梁英梅,等.妊娠妇女血清25-羟维生素D水平及其与血脂相关性研究[J].贵州医药,2015,39(1):7-9.
[4] World Health Organization.Definition,diagnosis and classification of diabetes mellitus and its complications[EB/OL].1999.https://www.paho.org/hq/dmdocuments/2012/WHO-Definition-Diagnoses-Classification-Diabetes-1999.
[5] HOD M,KAPUR A,SACKS D A,et al.The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus:a pragmatic guide for diagnosis,management,and care[J].Int J Gynaecol Obstet,2015,131(Suppl 3):S173-211.
[6] GULSETH H L,WIUM C,ANGEL K,et al.Effects of vitamin D supplementation on insulin sensitivity and insulin secretion in subjects with type 2 diabetes and vitamin D deficiency:a randomized controlled trial[J].Diabetes Care,2017,40(7):872-878.
[7] LI L H,YIN X Y,WU X H,et al.Serum 25(OH)D and vitamin D status in relation to VDR,GC and CYP2R1 variants in Chinese[J].Endocr J,2014,61(2):133-141.
[8] 谷宁.复脾汤对2型糖尿病大鼠糖脂代谢紊乱的影响[D].郑州:河南中医学院,2009.
[9] 《光明日报》.《中国居民营养与慢性病状况报告(2015年)》发布[J].上海医药,2015(13):79.
[10] JOHNSON M D,NADER N S,WEAVER A L,et al.Relationships between 25-hydroxyvitamin D levels and plasma glucose and lipid levels in pediatric outpatients[J].J Pediatr,2010,156(3):444-449.
[11] BORISSOVA A M,TANKOVA T,KIRILOV G,et al.The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients[J].Int J Clin Pract,2003,57(4):258-261.