初诊2型糖尿病患者血清维生素D水平与尿微量白蛋白的关系

摘要

目的观察正常人群及初诊2型糖尿病(Type 2 diabetes mellitus,T2DM)患者血清中25羟维生素D[25-hydroxyvitamin D,25(OH)D]水平,并分析25(OH)D与尿微量白蛋白(24 hours urine micro albumin,24 h UALB)的关系。方法选取正常人群60例及初诊2型糖尿病患者207例,测定各组25(OH)D及空腹静脉血糖(Fasting plasma glucose,FPG)、甘油三酯(Triglyeride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白(High density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白(Low density lipoprotein-cholesterol,LDL-C)、肌酐(Creatinine,Cr)、尿微量白蛋白(24h UALB)、空腹胰岛素(Fasting insulin,FIns)、空腹c-肽(Fasting C-peptide,FCP)、糖化血红蛋白(Glycosylated hemoglobin,Hb A1c)水平并分析其相关性。结果初诊2型糖尿病患者血清25(OH)D水平[(10.42±5.47)ng/m L]较健康对照者明显降低[(18.42±5.47)ng/m L];微量白蛋白组25(OH)D、HDL-C水平较单纯T2DM组及正常对照组明显降低(P=0.016,0.032,0.029,0.033);微量白蛋白组FPG、Hb A1c、Cr水平较单纯T2DM组及正常对照组明显增高(P=0.025,0.032,0.019,0.040);单纯T2DM组、微量白蛋白组TG水平较正常对照组明显增高(P=0.028,0.030);单纯T2DM组FIns水平较正常对照组明显增高(P=0.040)。维生素D缺乏组24 h UALB、Hb A1c水平较正常组、不足组明显增高(P=0.027,0.036,0.025,0.030);维生素D缺乏组FIns水平较正常组、不足组明显降低(P=0.020,0.039);维生素D缺乏组FCP水平较正常组明显降低(P=0.041)。相关性分析显示25(OH)D与尿24 h UALB成负相关(r=-0.420,P=0.032)。结论初诊2型糖尿病患者易合并维生素D缺乏,且尿微量白蛋白增高者维生素D缺乏水平更严重。