[1]郝帅,郭丽婷,高志红.2型糖尿病患者维生素D缺乏的调查分析[J].国际内分泌代谢杂志,2014,(03):153-157.[doi:10.3760/cma.j.issn.1673-4157.2014.03.003]
　Hao Shuai,Guo Liting,Gao Zhihong..Ａnalysis of vitamin D deficiency in patients with type 2 diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2014,(03):153-157.[doi:10.3760/cma.j.issn.1673-4157.2014.03.003]
点击复制

2型糖尿病患者维生素D缺乏的调查分析()
分享到：

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2014年03期
页码:
153-157
栏目:
论著
出版日期:
2014-06-30

文章信息/Info

Title:
Ａnalysis of vitamin D deficiency in patients with type 2 diabetes mellitus
作者:
郝帅; 郭丽婷; 高志红
300052　天津医科大学总医院内分泌科
Author(s):
Hao Shuai; Guo Liting; Gao Zhihong.
Department of Endocrinology,The General Hospital of Tianjin Medical University,Tianjin 300052,China Corresponding author : Gao Zhihong, Email: zhg2931@163.com
关键词:
25羟维生素D3; 维生素D缺乏; 维生素D不足; 糖尿病
Keywords:
25-Hydroxy vitamin D3; Vitamin D deficiency; Vitamin D insufficiency; Diabetes mellitus
DOI:
10.3760/cma.j.issn.1673-4157.2014.03.003
摘要:
目的　调查分析2型糖尿病患者血清25羟维生素D3[25（OH）D3]的水平和缺乏程度,初步了解维生素D缺乏与糖尿病病程和糖化血红蛋白（HbA1c）的关系。方法　选择天津医科大学总医院2型糖尿病患者140例,其中男60例,女80例,年龄21～89岁,平均（58.25±13.76）岁。分析不同年龄组即＜50岁、≥50且＜70岁、≥70岁者,不同检测季节组即冬春季和夏秋季两组,不同糖尿病病程组即＜10年、≥10且＜20年、≥20年,及不同HbA1c水平组即＜7%、≥7%且＜10%、≥10%的血清25（OH）D3水平。结果　 （1）140例患者血清25（OH）D3水平均明显降低[（40.07±16.12）nmol/L ],维生素D严重缺乏者占13.57%, 缺乏者占67.86%,充足者仅占4.29%,不同性别患者维生素D水平和缺乏程度的差异均无统计学意义（t =0.803,?字2 =0.189,P均＞0.05）。（2）男性≥50且＜70岁组25（OH）D3水平较＜50岁组明显降低（F =2.362,P ＜0.05）；女性≥50岁的两组患者25（OH）D3水平均较＜50岁组明显降低（F =3.928,P＜0.05）,维生素D缺乏者的比例均较＜50岁组显著增多（?字2=10.036,P ＜0.01）。（3）冬春季组25（OH）D3水平显著低于夏秋季组（t =-4.681, P ＜0.01）,严重缺乏者和缺乏者的比例也明显增加（?字2=18.202,P ＜0.01）。（4）病程≥10年的两组患者25（OH）D3水平均较＜10年组明显下降（F =5.489, P ＜0.05）,≥20年组严重缺乏者的比例也多于＜10年组（?字2=7.284,P ＜0.05）。（5）HbA1c≥7%的两组患者25（OH）D3水平均较＜7%组明显下降（F =3.963,P 均＜0.01）,其严重缺乏者和缺乏者的比例也较＜7%组明显增加（?字2=6.712, P ＜0.05）。结论　2型糖尿病患者普遍存在维生素D缺乏,尤其是病程长和持续血糖控制不佳者,特别需加强冬季维生素D的检测和补充。
Abstract:
Objective　To analyze the serum level of 25-hydroxy vitamin D3 and the degree of vitamin D deficiency in the patients with type 2 diabetes mellitus,and the relationships between the degree of vitamin D deficiency,durations of diabetes and glycosylated hemoglobin A1c（HbA1c） levels were also investigated. Methods　140 patients with type 2 diabetes mellitus （60 male and 80 female） were selected from the Department of Endocrinology of The General Hospital of Tianjin Medical University,aged 21 to 89,with an average age of （58.25±13.76） years old. Serum 25-hydroxy vitamin D3 levels between different age groups（＜50,≥50 and ＜70,≥70 years old group） and tested season groups（winter and spring,summer and autumn group） ,different duration of diabetes groups（＜10,≥10 and＜20,≥20 years group） and different HbA1c level groups（＜7%,≥7% and＜10%,≥10%） were compared. Results　（1）The serum 25（OH）D3 levels of these 140 patients were all below normal range,and the average levels was（40.07±16.12） nmol/L.The prevalence of severe vitamin D deficiency,deficiency and sufficiency were 13.57%,67.86% and 4.29%,respectively.But there was no significant difference between male and female both in the serum 25（OH）D3 levels and the degree of vitamin D deficiency（t =0.803,?字2=0.189,both P ＞0.05）. （2） The serum 25（OH）D3 levels of patients aged ≥50 and＜70 were lower than that of the subjects aged ＜50 in male（F =2.362,P ＜0.05）. In female,the serum 25（OH）D3 levels of patients aged ≥50 were lower than that of the subjects aged ＜50 （F =3.928,P ＜0.05）, and the percentages of vitamin D deficiency were also greater than that in patients younger than 50 years （?字2=10.036,P ＜0.01）. （3）The serum 25（OH）D3 levels in winter and spring were lower than that in summer and autumn（t =-4.681, P ＜0.01）, and the percentage of severe vitamin D deficiency and deficiency were increased as well（?字2=18.202,P ＜0.01）. （4）The serum 25（OH）D3 levels in patients whose durations of diabetes were more than 10 years were lower than that of patients with diabetic duration less than 10 years （F =5.489,P ＜0.05,P ＜0.01）, and the percentage of severe vitamin D deficiency in patients whose durations were more than 20 years was higher than that of patients with diabetic duration less than 10 years（?字2=7.284,P ＜0.05）. （5）The serum 25（OH）D3 levels in patients whose HbA1c were more than 7% were lower than those with HbA1c lower than 7%（F =3.963,P ＜0.01）, and the percentages of severe vitamin D deficiency and deficiency were higher than that of patients with HbAlc lower than 7% as well（?字2=6.712, P ＜0.05）. Conclusion　Vitamin D deficiency is common in patients with type 2 diabetes,especially in patient with long durations and continuously poor blood glucose control. The assessment and supplement of vitamin D should be strengthened in patients with diabetes especially in winter.

参考文献/References:

　[1]　Mithal A,Wahl DA,Bonjour JP,et al.Global vitamin D status and determinants of hypovitaminosis D[J].Osteoporos Int,2009, 20（11）：1807-1820. 　
[2]　Kayaniyil S,Retnakaran R,Harris SB,et al.Prospective associa-tions of vitamin D with beta-cell function and glycemia：the PROspective Metabolism and ISlet cell Evaluation （PROMISE） cohort study[J]．Diabetes,2011,60（11）：2947-2953. 　
[3]　Chiu KC,Chu A,Go VL,et al.Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction[J]. Am J Clin Nutr,2004,79（4）：820-825. 　
[4]　Harris SS. Does vitamin D deficiency contribute to increased rates of cardiovascular disease and type 2 diabetes in African Americans? [J]. Am J Clin Nutr,2011,93（5）：1175S-1178S． 　
[5]　Holick MF.Vitamin D deficiency[J]. N Engl J Med,2007,357（3）： 266-281. 　
[6]　朱丽颖,宁光. 维生素D 与2 型糖尿病研究进展[J].中国实用内科杂志,2012,32 （8）：635-637. 　
[7]　Chakhtoura M,Azar ST.The role of vitamin d deficiency in the incidence,progression,and complications of type 1 diabetes mellitus[J]. Int J Endocrinol,2013,2013：148673. 　
[8]　Chagas CE,Borges MC,Martini LA,et al.Focus on vitamin D, inflammation and type2 diabetes[J].Nutrients,2012,4（1）：52-67. 　
[9]　Kuhlmann A,Haas CS,Gross ML,et al．1,25-Dihydroxyvitamin D3 decreases podocyte loss and podocyte hypertrophy in the subtotally nephrectomized rat[J]．Am J Physiol Renal Physiol, 2004,286（3）：F526-F533．
[10]　Takiishi T,Gysemans C,Bouillon R,et al.Vitamin D and dia-betes[J]. Endocrinol Metab Clin North Am,2010,39（2）：419-446.
[11]　Daga RA,Laway BA,Shah ZA,et al. High prevalence of vitamin D deficiency among newly diagnosed youth-onset diabetes mellitus in north India[J].Arq Bras Endocrinol Metabol,2012, 56（7）：423-428.
[12]　Cannell JJ,Vieth R,Umhau JC,et al.Epidemic influenza and vitamin D[J]. Epidemiol Infect,2006,134（6）：1129-1140.
[13]　Ginde AA,Mansbach JM,CamargoCA Jr.Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey[J].Arch Intern Med,2009,169（4）：384-390.
[14]　Shehab D,Al-Jarallah K,Mojiminiyi OA,et al.Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes? [J]. Diabet Med,2012,29（1）：43-49.

相似文献/References:

[1]郭丽婷,郝帅,高志红.2型糖尿病患者骨代谢生化指标和钙调激素 与骨密度关系的研究[J].国际内分泌代谢杂志,2015,(02):88.[doi:10.3760/cma.j.issn.1673-4157.2015.02.005]
　Guo Liting,Hao Shuai,Gao Zhihong..Research on the relationship between bone mineral density and biochemical index of bone metabolism ,calmodulin hormone in type 2 diabetic patients[J].International Journal of Endocrinology and Metabolism,2015,(03):88.[doi:10.3760/cma.j.issn.1673-4157.2015.02.005]
[2]徐娜,胡咏新,刘超.2022中欧和东欧专家共识《维生素D缺乏的预防、诊断和治疗的临床实践》解读:凝聚共识,规范诊治[J].国际内分泌代谢杂志,2023,43(04):357.[doi:10.3760/cma.j.cn121383-20221105-11013]
　Xu Na,Hu Yongxin,Liu Chao.2022 Central and Eastern European Expert Consensus Interpretation of Clinical Practice on Prevention, Diagnosis and Treatment of Vitamin D Deficiency: build consensus and standardize diagnosis and treatment[J].International Journal of Endocrinology and Metabolism,2023,43(03):357.[doi:10.3760/cma.j.cn121383-20221105-11013]

备注/Memo

备注/Memo:
通信作者：高志红,Email: zhg2931@163.com
更新日期/Last Update: 2014-05-20