2型糖尿病患者血清25-羟维生素D水平对糖尿病周围神经病变的影响

目的:探讨2型糖尿病患者血清中25-羟维生素D(25(OH)D)水平及其与周围神经病(diabetic peripheral neuropathy,DPN)的影响。方法:选取2型糖尿病患者367例,根据有无周围神经病变分为非周围神经病变组(NDPN,n=192)和糖尿病周围神经病组(DPN,n=175),分析两组生化指标水平。结果:DPN组年龄、糖化血红蛋白、糖尿病病程、HOMA-IR、水平较NDPN组明显升高(P<0.05);而血清25(OH)D水平、骨密度较NDPN组明显降低(P<0.05)。Pearson相关分析显示年龄、糖尿病病程、Hb A1C与DPN呈正相关,HOMA-IR、25(OH)D与DPN呈负相关(r=-0.302,P=0.000)。年龄、糖尿病病程、25(OH)D为影响2型糖尿病患者发生DPN的危险因素。结论:血清维生素D缺乏与糖尿病周围神经病变的发生密切相关,血清25(OH)D的缺乏可使糖尿病周围神经病变的发生风险增加,随年龄、病程、Hb A1C、HOMA-IR增加,2型糖尿病患者发生DNP风险增加。

Influence of serum 25-hydroxy vitamin D level on diabetic peripheral neuropathy in patients with type 2 diabetes mellitus

Objective:To explore the level of serum 25-hydroxy vitamin D (25 (OH)D) in patients with type 2 diabetes mellitus (T2DM) and its influence on diabetic peripheral neuropathy (DPN).Methods:A total of 367 patients with T2DM were selected and divided into non-DPN group (NDPN group,n =192) and DPN group (n =175) based on the presence of DPN.General data and biochemical index levels were analyzed between two groups.Results:DPN group was evidently higher in patients' age,glycosylated hemoglobin (HbA 1 c) level,diabetic course,and homeostatic model assessment-insulin resistance (HOMA-IR) (P ＜ 0.05),but was notably lower in serum level of 25 (OH)D and bone density than NDPN group (P ＜ 0.05).Pearson correlation analysis showed age,diabetic course and HbA1c level were in positive association with DPN while HOMA-IR and 25 (OH) D in negative association(r =-0.302,P =0.000).Age,diabetic course and 25(OH) D level were influencing risk factors for the occurrence of DPN in patients with T2DM.Conclusion:Serum 25 (OH) D deficiency is closely associated with the occurrence of DPN as it can increase the morbidity of DPN.And the risk of DPN is increased in patients with T2DM with the increases of age,disease course,HbA1C and HOMA-IR.