豫西城乡社区糖尿病患者维生素D营养状况调查

目的 了解豫西农村与城市社区糖尿病患者维生素D(vitamin D, VitD)营养状况，为采取有效干预措施，提高糖尿病患者生存质量提供参考依据。方法 从豫西灵宝市和洛阳市吉利区随机选取4个乡镇和4个街道分别作为农村和城市调查社区。从每个调查社区基本公共卫生服务登记管理的糖尿病患者中随机抽取病人进行调查。采用高效液相色谱-串联质谱法检测空腹静脉血清25(OH)D含量。结果 在所调查的877例糖尿病患者中，血清25(OH)D含量平均为18.3ng/ml,男性(19.8ng/ml)高于女性(16.9ng/ml;t=7.85,P<0.001)，50岁以下年龄组(17.3ng/ml)低于50~64岁(18.6ng/ml)与≥65岁年龄组(18.5ng/ml;F=3.74,P<0.05)；VitD缺乏患病率为61.2%，女性(72.0%)高于男性(49.9%;〖XC小五号.EPS;P〗=45.15，P<0.001)，各年龄组间VitD缺乏率不同(〖XC小五号.EPS;P〗=6.10，P<0.05)，以小于50岁年龄组为最高。≥65岁年龄组VitD缺乏患病率农村社区为64.0%，高于城市社区(51.3%；〖XC小五号.EPS;P〗=3.85,P<0.05)。多因素方差分析和logistic回归分析结果均显示糖尿病患者VitD营养状况与性别、年龄相关；在校正性别、病程后，≥65岁年龄组的VitD营养状况农村社区比城市社区差。结论 所调查农村与城市社区糖尿病患者VitD营养水平均较低，VitD缺乏患病率较高，尤其是农村社区女性、小于50岁糖尿患者VitD营养状况值得关注。

Vitamin D status among diabetics in urban and rural communities in the western of Henan,China: a cross-sectional survey

Objective To learn vitamin D status among diabetics in urban and rural communities in the western of Henan, and to providing evidence of intervention to improve life quality of diabetics. Methods After four rural communities and four urban communities were randomly selected from one county and one city in Lingbao City in West Henan and Jili District in Luoyang City, 120 diabetics were selected in random from the cases registered and managed for basic service of public health in each selected community. In total, 877 diabetics were interviewed and had their serum 25-hydroxy vitamin D concentration(SHVDD) tested finally with HPLC-MS method. Results Of the 877 studied diabetics, mean of SHVDD was 18.3 ng/ml, and mean of SHVDD in males was significantly higher than that in females(19.8 ng/ml vs. 16.9 ng/ml; t=7.85, P<0.001); Mean of SHVDD for group aged <50 years was 17.3 ng/ml, significantly lower than those aged 50-64 years(18.6 ng/ml) and ≥65 years(18.5 ng/ml; F=3.74, P<0.05). Overall prevalence rate of vitamin D deficiency(VDD) was 61.2%. Prevalence rate of VDD in females was significantly higher than that of males(72.0% vs. 49.9%; ■=45.15, P<0.001); Prevalence rates of VDD across the three age groups were significantly different(■=6.10, P<0.05), and group aged < 50 years had the highest prevalence rate of VDD across all age groups. Prevalence rate of VDD in the group aged ≥65 years in rural communities was significantly higher than that in urban communities(64.0% vs. 51.3%; ■=3.85, P<0.05). Results with multifactor analysis of variance and logistic regression both showed status of vitamin D among diabetics was associated with sex and age, and the diabetics aged ≥65 years living in rural communities had a lower status of vitamin D than those in urban communities after adjusted with sex and disease duration. Conclusion The studied cases of DM living in rural and urban communities both had a low level of vitamin D and a high prevalence rate of VDD, especially cases in females and group aged < 50 years living in rural communities.