2型糖尿病患者血清25-羟维生素D水平与视网膜病变发生及严重程度的相关分析
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摘要
目的分析2型糖尿病患者血清25-羟维生素D与视网膜并发症的发生及严重程度之间的关系。方法选取2016年6月—2018年1月于该院内分泌科病房诊断明确的2型糖尿病患者380例,分为单纯糖尿病组(NDR)、非增殖期视网膜病变组(NPDR)和增殖期视网膜病变组(PDR),收集各组患者一般资料(性别、年龄、病程、身高、体重、BMI、血压、腰臀比等),测量空腹血糖、血脂、肾功、胱抑素C、糖化血红蛋白、C肽水平、24 h尿白蛋白、尿微量白蛋白、ACR及25-羟血清维生素D等指标,通过SPSS17.0软件进行统计学分析。结果 NDR、NPDR、PDR三组间血清25-羟维生素D水平不同,随着糖尿病视网膜病变程度的加重,维生素D水平逐渐降低,维生素D水平与2型糖尿病视网膜病变程度呈负相关,排除年龄、性别等混杂因素的影响后得出,维生素D是2型糖尿病视网膜病变的保护因素。结论 25-羟维生素D对2型糖尿病性视网膜病变具有保护作用。
Objective To analyze the relationship between serum 25-hydroxyvitamin D and recurrence complications in patients with type 2 diabetes mellitus. Methods A total of 380 patients with type 2 diabetes diagnosed in the endocrinology ward of our hospital from June 2016 to January 2018 were enrolled. The patients were divided into simple diabetes group(NDR), non-proliferative retinopathy group(NPDR) and proliferative retinopathy group(PDR). Collect general data(gender,age, duration, height, weight, BMI, blood pressure, waist-to-hip ratio, etc.) of each group, and measure fasting blood glucose, blood lipids, renal function, cystatin C, glycosylated hemoglobin, C-peptide level, 24 Urinary albumin, urinary albumin, ACR and 25-hydroxy serum vitamin D were statistically analyzed by SPSS 17.0 software. Results Serum 25-hydroxyvitamin D levels were different among NDR, NPDR and PDR groups. As the degree of diabetic retinopathy worsened, vitamin D levels gradually decreased, and vitamin D levels were negatively correlated with the degree of type 2 diabetic retinopathy. After the influence of confounding factors such as gender, vitamin D is a protective factor for type 2 diabetic retinopathy. Conclusion 25-hydroxyvitamin D has a protective effect on type 2 diabetic retinopathy.
Objective To analyze the relationship between serum 25-hydroxyvitamin D and recurrence complications in patients with type 2 diabetes mellitus. Methods A total of 380 patients with type 2 diabetes diagnosed in the endocrinology ward of our hospital from June 2016 to January 2018 were enrolled. The patients were divided into simple diabetes group(NDR), non-proliferative retinopathy group(NPDR) and proliferative retinopathy group(PDR). Collect general data(gender,age, duration, height, weight, BMI, blood pressure, waist-to-hip ratio, etc.) of each group, and measure fasting blood glucose, blood lipids, renal function, cystatin C, glycosylated hemoglobin, C-peptide level, 24 Urinary albumin, urinary albumin, ACR and 25-hydroxy serum vitamin D were statistically analyzed by SPSS 17.0 software. Results Serum 25-hydroxyvitamin D levels were different among NDR, NPDR and PDR groups. As the degree of diabetic retinopathy worsened, vitamin D levels gradually decreased, and vitamin D levels were negatively correlated with the degree of type 2 diabetic retinopathy. After the influence of confounding factors such as gender, vitamin D is a protective factor for type 2 diabetic retinopathy. Conclusion 25-hydroxyvitamin D has a protective effect on type 2 diabetic retinopathy.
引文
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[11]Maestro B,Campion J,Davila,N et al.Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsivenessm for glucose transport in U-937 human promonocytic cells[J].Endocr,2000,47:383-391.
[12]Draznin B,Sussman K,Kao M,et al.The existence of an optimal range of cytosolic free calcium for insulin-stimulated glucose transport in rat adipocytes[J].Biol Chem,1987,262:14385-14388.
[13]Wei Y,Sowers JR,Clark SE,et al.Angiotensin II-induced skeletal muscle insulin resistance mediated by NF-kappaBactivation via NADPH oxidase[J].Am,2008,294:E345-E351.PMID:18073321.
[14]Molinari C,Uberti F,Grossini E,et al.1,25-Dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells[J].Cell Physiol Biochem,2011,27(6):661-668.
[15]Weng S,Felton SK,et al.1,25(OH)2 vitamin D inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus[J].Circulation,2009,120(8):687-698.
[16]Mathieu C,Gysemans C,Giulietti A,et al.Vitamin D and diabetes.Diabetologia,2005(48):1247-1257,1238.
[17]Lee JH,O’Keefe JH,Bell D,et al.Vitamin D deficiency an important,common,and easily treatable cardiovascular risk factor J Am Coll Cardiol,2008,52(24):1949-1956.
[18]Mora JR,Iwata M,von Andrian UH.Vitamin effects on the immune system:vitamins A and D take centre stage[J].Nat Rev Immunol,2008,8(9):685-698.
[2]Stram DA,Jiang X,Varma R,et al.Factors Associated with Prevalent Diabetic Retinopathy in Chinese Americans:The Chinese American Eye Study[J].Ophthalmol Retina 2018(2)96-105.
[3]Cantorna MT,Zhu Y,Froicu M,et al.Vitamin D status,1,25dihydroxyvitamin D3,and the immune system.[J].Am J ClinNutr 2014,80(6):1717S-1720S.
[4]Stadlmayr A,Aigner E,Huber-Sch?nauer U,et al.Relations of vitamin D status,gender and type 2 diabetes in middleaged Caucasians[J].Acta diabetologica,2015,52(1):39-46.
[5]Song Y,Wang L,Pittas AG,Liana C Del Gobo.Blood 25-hydroxy vitamin D levels and incident type 2 diabetes.Ameta-analysis of prospective studies[J].Diabetes Care,2013,36:1422-1428.
[6]中国2型糖尿病防治指南(2013年版)[J].中国医学前沿杂志:电子版,2015,7(3):26-89.
[7]Levey AS,Stevens LA,Schmid CH,et al.A new equation to estimate glomerular filtration rate[J].Annals of internal medicine,2009,150(9):604-612.
[8]Chagas CE,Borges MC,Martini LA,et al,Focus on vitamin D,inflammation and type 2 diabetes.Forum Nutr,2012(4)52-67.
[9]中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[10]Yi X,Sun J,Li L,et al.1,25-Dihydroxyvitamin D3 Deficiency is Involved in the Pathogenesis of Diabetic Retinopathy in the Uygur Population of China[J].IUBMB life,2016,68(6):445-451.
[11]Maestro B,Campion J,Davila,N et al.Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsivenessm for glucose transport in U-937 human promonocytic cells[J].Endocr,2000,47:383-391.
[12]Draznin B,Sussman K,Kao M,et al.The existence of an optimal range of cytosolic free calcium for insulin-stimulated glucose transport in rat adipocytes[J].Biol Chem,1987,262:14385-14388.
[13]Wei Y,Sowers JR,Clark SE,et al.Angiotensin II-induced skeletal muscle insulin resistance mediated by NF-kappaBactivation via NADPH oxidase[J].Am,2008,294:E345-E351.PMID:18073321.
[14]Molinari C,Uberti F,Grossini E,et al.1,25-Dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells[J].Cell Physiol Biochem,2011,27(6):661-668.
[15]Weng S,Felton SK,et al.1,25(OH)2 vitamin D inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus[J].Circulation,2009,120(8):687-698.
[16]Mathieu C,Gysemans C,Giulietti A,et al.Vitamin D and diabetes.Diabetologia,2005(48):1247-1257,1238.
[17]Lee JH,O’Keefe JH,Bell D,et al.Vitamin D deficiency an important,common,and easily treatable cardiovascular risk factor J Am Coll Cardiol,2008,52(24):1949-1956.
[18]Mora JR,Iwata M,von Andrian UH.Vitamin effects on the immune system:vitamins A and D take centre stage[J].Nat Rev Immunol,2008,8(9):685-698.
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