2型糖尿病肾脏病变患者血清25羟维生素 D水平与肾功能不全的相关性研究

摘要

Objective It is to investigate the relationship of serum 25-hydroxy-vitamin D [25(OH)D] and renal insuf-ficiency in hospitalized patients with type 2 diabetic kidney disease(T2DKD).Methods 133 patients with T2DKD were select-ed and divided in renal insufficiency ( RI) group and non-renal insufficiency ( non-RI) group according to Glomerular filtra-tion rate (eGFR).Serum 25(OH)D were detected by chemiluminescence method of liason .Clinical data were recorded and biochemical indexes were also detected .Statistical analysis was performed .Results The level of serum 25(OH)D was(13.07 ± 6.62)nmol/L in 133 patients with T2DKD, in which there were 78 cases (58.65%)of RI and 55 cases (41.35%)of non-RI;The level of serum 25(OH)D in RI group was significantly lower than that in the non -RI group(P<0.01);25(OH)D deficiency/insufficiency in RI group was significantly higher than that in non -RI group(P<0.01); Multiple linear regression analysis demonstrated that 25(OH)D deficiency/insufficiency(OR=2.383, P=0.013)and serum uric acid level(OR=8. 338,P<0.001) were positively correlated with RI , age(OR=0.674,P=0.02),hemoglobin Alc(HbA1c)level(OR=0.493, P=0.027),tiglyceride (TG)level(OR=0.355,P=0.048)were negatively correlated with RI.Conclusion 25(OH)D deficien-cy/insufficiency was with high prevalence in T2DKD patients;25(OH)D deficiency /insufficiency may be the independent risk factor of renal insufficiency in T2DKD patients.%目的：分析住院2型糖尿病肾脏疾病（T2DKD）患者血清25羟维生素D[25（OH） D]水平与肾功能不全的相关性。方法根据估算肾小球滤过率（ eGFR ）将133例T2DKD患者分为肾功能不全组及肾功能正常组，采用liason 化学发光法测定2组血清25（ OH）D水平，收集患者临床指标和生化结果并进行统计学分析。结果133例T2DKD患者血清25（OH）D水平为（130．7±6．62）nmol／L，其中肾功能不全78例（58．65％），肾功能正常55例（41．35％）。肾功能不全组血清25（OH）D水平明显低于肾功能正常组（P＜0．05）；肾功能不全组25（OH）D缺乏／不足发生率及缺乏发生率均明显高于肾功能正常组（P均＜0．05）；多因素线性回归分析提示25（OH）D缺乏／不足（OR＝2．383，P＝0．013）及血尿酸（OR＝8．338，P＜0．001）与肾功能不全呈正相关，年龄（OR＝0．674，P＝0．02）、HbA1c（OR＝0．493，P＝0．027）、TG（OR＝0．355，P＝0．048）与肾功能不全呈负相关。结论 T2DKD患者中25（OH）D缺乏／不足发生率高，25（OH）D缺乏／不足可能是T2DKD患者发生肾功能不全的易患因素。