老年2型糖尿病患者血清25-羟维生素D3水平与足背动脉粥样硬化的关系

摘要

Objective:To explore the relationship between serum 25-hydroxy vitamin D3 level and dorsal artery of foot atheroscle-rosis plaque in elderly patients with type 2 diabetes. Methods:108 elderly patients with type 2 diabetes were selected.The luminal stenosis of dorsal artery of foot was measured.According to the percentage of luminal stenosis of dorsal artery,they were divided into the more than 50% group,less than 50% group and no plaque group,Blood pressure,body mass index(BMI),fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1C),blood lipids and the concentration of serum 25-hydroxy vitamin D3 were detected.The risk factors forcarotid atherosclerosis were analyzed ,exploring the relation ship between serum 25-hydroxy vitamin D3 level and dorsal ar-tery of foot. Results:Age ,the more than 50%group was significantly higher than those of the less than 50%group(3.41±1.92)mg/L and the no plaque group(2.52 ± 1.18)mg/L(t=1.96,3.14,all P<0.05).The level of serum 25-hydroxy vitamin D3 in the more than 50% group(15.28 ± 5.86)nmol/L was significantly less than that of the less than 50% group(24.30 ± 7.60)nmol/L and the no plaque group (32.74±8.13)nmol/L(t=4.67,3.41,all P<0.01).The level of serum 25-hydroxy vitamin D3 in the less than 50%group was significantly less than that of the no plaque group(t=2.51,P<0.05).There was positive correlation between artery stenosis of foot. And age,BMI,HbA1c and LDL-C(r=0.45,0.38.0.53.0.47.all P<0.05) There was negative correlation between artery stenosis of foot and 25-hydroxy vitamin D3(r=-0.62,P<0.05).Logstic regression analysis showed that age,BMI,HbA1c,LDL-C and 25-hydroxy vitamin D3 were independent risk factors for the development of artery stenosis of foot. Conclusion:The risk factors for artery stenosis of foot in elderly patients with type 2 diabetes are age,BMI, HbA1c,LDL-C and 25-hydroxy vitamin D3 concertration. 25-hydroxy vitamin D3 may be a predictor of artery stenosis of foot%目的：探讨老年男性2型糖尿病患者血清25-羟维生素D3[25-(OH)D3]水平与足背动脉粥样硬化斑块的关系。方法：选择108例老年男性2型糖尿病患者，测定足背动脉管腔狭窄率，分为狭窄率≥50%；狭窄率<50%；动脉内膜无变化组。检测各组血压、BMI、空腹血糖（FPG）、糖化血红蛋白（HbA1C）、血脂及25-(OH)D3等指标，分析足背动脉粥样硬化的危险因素，探讨25-(OH)D3与足背动脉粥样硬化的关系。结果：足背动脉中狭窄率≥50%组患者年龄大于狭窄率<50%组和动脉内膜无变化组（P＜0.05）；血清25-(OH)D3水平（14.28±5.46）nmol/L，显著低于狭窄率<50%组的（24.14±7.61）nmol/L和动脉内膜无变化组的（30.54±7.13）nmol/L（t＝4.67、3.41，均P＜0.01）。动脉内膜无变化组血清25-(OH)D3浓度低于动脉内膜无变化组（t＝2.51，P＜0.05）。相关分析显示足背动脉狭窄与年龄、BMI、空腹血糖（FPG）、糖化血红蛋白（HbA1C）、LDL-C呈正相关（r＝0.45、0.38、0.53、0.74，均P＜0.05），与25-(OH)D3浓度呈负相关（r＝-0.62，P＜0.05）；Logstic回归分析显示年龄、BMI、糖化血红蛋白（HbA1C）、LDL-C及25-(OH)D3水平是足背动脉形成的独立危险因素。结论：老年2型糖尿病患者足背动脉的危险因素为年龄、BMI、糖化血红蛋白（HbA1C）、LDL-C及25-(OH)D3，血清25-(OH)D3浓度可能是足背动脉的预测指标，降糖同时补充25-(OH)D3可延缓足背动脉狭窄甚至闭塞的发生。