广州市老年体检人群维生素D水平与代谢综合征的相关性

目的探讨老年体检人群维生素D(VD)水平与代谢综合征的关系。方法选择2011~2014年在该院体检中心进行健康体检的老年患者328例,年龄60~84岁,平均(66.1±5.5)岁。测定血清25-羟维生素D3〔25(OH)D3〕水平,收集身高、体重、年龄等资料,计算体重指数(BMI),检测空腹血糖(FPG)、血压、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)等代谢综合征相关指标,进行相关性分析。按照血清25(OH)D3水平分为VD充足组(≥75 nmol/L);VD不足组(50~75 nmol/L);VD缺乏组(50 nmol/L)。结果三组BMI、FPG、TG、平均年龄比较差异有统计学意义(F=6.565、3.081、4.069、7.336,P0.05)。进一步直线相关分析结果显示,VD水平与FPG、TG、BMI、平均年龄呈负相关(r=-0.153、-0.115、-0.122、-0.279,P0.05),与HDL-C、收缩压、舒张压无相关性(r=-0.059、0.024、-0.006,均P0.05)。多元线性回归分析显示,FPG、TG为VD不足的独立危险因素。结论老年人VD营养状况与BMI、FPG及TG等代谢相关指标呈负相关。随着年龄的增加,老年人群VD不足或缺乏的状况逐渐加重。     

血清25-羟维生素D3与2型糖尿病相关性分析

目的 探讨血清25-羟维生素D3 [25-（OH） D3]与2型糖尿病的关系.方法 选择2型糖尿病患者41例,同期健康体检者32例,比较两组间血糖、血脂、糖化血红蛋白（HbA1C）、空腹C-肽（FC-P）、血清25-（OH） D3等指标的差异,并对25-（OH）D3与上述指标进行相关性分析.结果 与对照组比较,2型糖尿病组患者空腹血糖（FPG）、餐后2小时血糖（2hPG）、HbA1C、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、HOMA模型胰岛素抵抗指数（HOMA-IR）均明显升高,血清25-（OH） D3水平、HOMA模型β细胞功能指数（HOMA-IS）明显降低,差异有统计学意义（P＜0.05）.两组FC-P、空腹胰岛素（FINS）、高密度脂蛋白胆固醇（HDL-C）比较,差异无统计学意义（P＞0.05）.血清25-（OH） D3与HbA1C呈负相关（r=-0.386,P＜0.05）,与TG呈负相关（r=-0.391,P＜0.05）,与HOMA-IS呈正相关（r=0.434,P＜0.05）.结论 血清25-（OH）D3可能通过直接或间接作用影响胰岛β细胞功能,并影响血脂代谢.     

老年代谢综合征患者血清25(OH)D3水平变化及临床价值

目的分析老年代谢综合征(MS)患者血清25-羟维生素D3〔25(OH)D3〕水平变化及其临床意义。方法老年MS患者80例为MS组,同时选取同期体检非MS患者80例作为对照组。对比两组的性别、年龄、体质指数(BMI)、血压、血脂、血糖、血钙和血磷等指标。对比两组血清25(OH)D3水平,对MS组血清25(OH)D3和各指标的相关性进行分析。采用多元线性逐步回归分析MS组25(OH)D3和各组分的关系。结果MS组BMI、收缩压、舒张压、甘油三酯、低密度脂蛋白、糖化血红蛋白、空腹血糖和餐后2 h血糖较对照组显著升高,MS组高密度脂蛋白较对照组显著降低(P0.05)。MS组血清25(OH)D3水平显著低于对照组(t=5.6667,P0.05)。MS组血清25(OH)D3和BMI、甘油三酯(TG)、糖化血红蛋白、空腹血糖和餐后2 h血糖呈负相关(P0.05)。在多元线性逐步回归分析中,低密度脂蛋白(LDL)、TG、高密度脂蛋白(HDL)、收缩压(SBP)和舒张压(DBP)与MS组25(0H)D3水平呈现较强的相关性(P0.05)。回归方程为:25(OH)D3=32.633-11.375LDL-0.124SBP-3.993TG+13.277HDL+0.091DBP,F=8.824,P0.05。结论老年MS患者的血清25(OH)D3水平显著低于正常人群,和血压、血脂、血糖具有一定的相关性。     

贵阳市社区中老年人血压和血清25-羟维生素D水平的相关性研究

目的探讨贵阳市社区中老年人血清25-羟维生素D水平对血压的影响。方法采用整群抽样方法调查贵阳市社区年龄≥46岁的常住居民706人。根据年龄分为:中年组499例(46～64岁),老年组207例(年龄≥65岁),进行问卷调查及体格检查,并采集清晨空腹静脉血分离血清,美国DiaSorin公司的放射免疫试剂盒测定25-羟维生素D浓度。结果老年组收缩压水平明显高于中年组,老年组女性25-羟维生素D水平明显低于男性及中年组,差异有统计学意义(P<0.05)。logistic回归分析,年龄、体重指数与收缩压呈正相关(OR=1.072,95%CI:1.048～1.096;OR=1.147,95%CI:1.084～1.213,P<0.01),体重指数与舒张压呈正相关(OR=1.172,95%CI:1.108～1.240,P<0.01),25-羟维生素D水平与舒张压及收缩压不相关。结论贵阳市中老年人血压与25-羟维生素D水平无显著关联。     

老年糖尿病患者血清25-羟维生素D水平与代谢综合征、糖代谢、骨量的关系

目的探讨老年糖尿病患者血清25-羟维生素D[25(OH)D]水平与代谢综合征(MS)、糖代谢、骨量的关系。方法 100例年龄≥60岁的糖尿病患者为研究对象,以酶联免疫法测定其血清25(OH)D水平,并对糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FINS)]水平及骨量指标[甲状旁腺激素(PTH)、骨密度、碱性磷酸酶(ALP)]水平进行测量,并通过体重指数(BMI)、血糖、血压、血脂等综合评价MS,观察25(OH)D与MS、糖代谢、骨量的关系。结果依据25(OH)D结果,25(OH)D缺乏组MS患者明显多于非25(OH)D缺乏组(P0.05);25(OH)D缺乏组FPG、HbA1c、FINS、PTH水平明显高于非25(OH)D缺乏组,骨密度明显低于非25(OH)D缺乏组(P0.05);两组2 h PG、ALP水平比较无显著差异(P0.05);Pearson相关性分析显示25(OH)D与MS、FPG、HbA1c、PTH及骨密度密切相关(P0.05)。结论老年糖尿病患者25(OH)D水平与MS、糖代谢异常及骨量流失之间有密切关联。     

中老年人维生素D的营养状况

目的分析中老年体检者血清25-羟维生素D[25(OH)D]水平,了解维生素D营养状况。方法宁夏银川地区的中老年体检者931例采用电化学发光法测定血清25(OH)D水平,统计分析各年龄组和1年的25(OH)D分布状况。结果 25(OH)D平均水平为(14.57±8.20)ng/ml,维生素D缺乏和不足者占81.03%,其中男性占78.42%,女性占82.95%,性别差异无统计学意义(t=0.71,P>0.05)。根据血清25(OH)D的水平分为营养缺乏症,不足组,正常组和良好组,各组所占比例分别为42.32%,38.67%,14.50%和4.51%。各年龄段维生素D营养状况分布不同,进一步直线相关分析提示25(OH)D水平与年龄呈负相关(r=-0.15,P<0.01)。25(OH)D水平呈现季节性变化(F=7.21,P<0.01),夏秋季25(OH)D水平较高,而冬春季相对较低。结论宁夏银川地区中老年人群普遍缺乏血清维生素D,冬节较为严重,且随着年龄的增大有下降的趋势。提示应关注中老年人维生素D营养状况,及时补充维生素D。     

老年男性患者骨代谢生化指标与25羟维生素D的变化

目的探讨老年男性骨代谢生化指标及25羟维生素D(25-OHD)的变化。方法收集156例老年男性患者,依据骨密度检查,分为骨量正常组(A组)80例,骨量减少组(B组)54例,骨质疏松组(C组)22例;均检测血钙、血磷、碱性磷酸酶(ALP)、甲状旁腺素(PTH)、25-OHD、Ⅰ型前胶原氨基末端前肽(PⅠNP)、骨钙素N端中分子片段(N-MIDBGP)及β-胶原降解产物(β-CTX)。结果 1C组BMI低于A组及B组(P0.01及P0.01);C组ALP明显高于A组及B组(P0.05及P0.01);2C组及B组PTH和PINP明显高于A组(P0.01及P0.05);C组β-CTX明显高于A及B组(P0.01及P0.05);C组及B组N-MIDBGP明显高于A组(P0.05);C组及B组25-OHD明显低于A组(P0.01及P0.05);血钙、磷三组组间无显著差异(P0.05)。3以是否伴骨质疏松为因变量,多因素非条件Logistic回归分析,结果 PTH、PINP、N-MIDBGP为正相关因素(OR值分别为1.015、1.066和1.014)。4对于老年男性患者,维生素D不足组与维生素D正常组相比,骨质疏松及骨量减少组人数增多(P0.05)。结论骨代谢生化指标变化有助于老年男性骨质疏松的早期评估。     

中老年人不同季节血25羟维生素D水平变化及其与骨代谢关系的研究

目的探讨中老年人不同季节血25羟维生素D[25(OH)D]水平变化及其与骨代谢指标的关系。方法对2017-08～2018-08在内分泌代谢科就诊的117例绝经后女性及老年男性患者进行血清25(OH)D、电解质、甲状旁腺激素(PTH)、β胶原降解产物(β-CTX)及1型胶原氨基端延长肽(P1NP)检测。按照检测时间分为春组36例(3～5月份)、夏组32例(6～8月份)、秋组23例(9～11月份)、冬组26例(12～2月份),分析不同季节组血25(OH)D水平变化。同时,将患者按照25(OH)D水平分为维生素D缺乏组34例,25(OH)D50 nmol/L;维生素D不足组53例,50 nmol/L≤25(OH)D≤75 nmol/L;维生素D充足组30例,25(OH)D 75 nmol/L。分析各组电解质、PTH及骨转换指标的差异。结果春组与夏组、春组与秋组、夏组与冬组、秋组与冬组之间比较,25(OH)D差异有统计学意义(P0.01)。按维生素D水平分组的三组患者之间年龄、转氨酶、血肌酐、PTH、β-CTX差异均无统计学意义(P 0.05)。维生素D缺乏组与维生素D充足组比较,血钙(P0.01)、ln P1NP(P0.05)差异有统计学意义。各组25(OH)D水平与年龄呈负相关(P0.01)。结论中老年人夏季血25(OH)D水平高,冬季最低。在绝经后女性和老年男性患者中,25(OH)D与年龄呈负相关,25(OH)D缺乏的患者血钙水平下降,骨形成减少。     

血清25-羟维生素D3与糖尿病大血管并发症的相关性分析

目的 分析血清25-羟维生素D3[25-hydroxy vitamin D3,25-(OH)D₃]在糖尿病(diabetes mellitus, DM)中的变化,及其与糖尿病大血管并发症(macro-vascular complications, MVC)的相关性。方法 选取2018年2月—2019年6月宁德师范学院附属宁德市医院收治的120例DM患者作为研究对象。以血清25-(OH)D₃水平分为缺乏组、不足组及正常组,分析血清25-(OH)D₃水平与DM一般资料的相关性,并以是否发生MVC为依据,分析血清25-(OH)D₃的预测价值。结果 25-(OH)D₃不同浓度的HbA1c、TG、TC、FPG、hs-CRP水平及MVC发生率比较,差异有统计学意义(P<0.05)。HbA1c、TG、TC、FPG及hs-CRP与25-(OH)D₃均呈相关性(P<0.05)。发生MVC患者血清25-(OH)D₃水平为(18.36±9.69...     

中老年人血清丙氨酸氨基转移酶水平与代谢综合征的相关性研究

目的 研究中老年人血清丙氨酸氨基转移酶(ALT)水平与代谢综合征的相关性.方法 对上海市宝山区友谊街道1 664名40岁以上居民进行问卷调查、体格检查以及空腹采血检测肝肾功能、血糖及血脂等生化指标.代谢综合征采用按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATP Ⅲ)诊断标准.结果 研究对象各主要代谢指标均随着ALT水平的升高而逐渐趋向恶化.代谢综合征的患病率从第一个ALT四分位至第四个ALT四分位分别为29.2%、38.0%、44.9%和62.9%(组间趋势P<0.01).血清ALT水平与代谢综合征及其多个组分的患病风险之间存在显著的剂量一反应关系.相比ALT水平在第一个四分位的研究对象,ALT水平在第四个四分位的研究对象代谢综合征患病风险增加146%,中心性肥胖风险增加204%,高血压风险增加35%,高甘油三酯风险增加133%,高血糖风险增加72%.另外,随着代谢综合征组分个数的增加,ALT水平显著上升(组间趋势P<0.01).结论 中老年人血清ALT水平升高增加代谢综合征的患病风险.     

成渝地区中老年人群代谢综合征流行病学特征及其相关因素

目的探讨成渝地区中老年人群代谢综合征流行病学特征及其相关危险因素。方法于2013年采用分层整群抽样的方法,调查成渝城乡地区40~79岁中老年人7807例,进行身高、体重、血压、血脂及口服葡萄糖耐量试验(OGTT)等检测。用统一设计的调查表对研究对象进行面对面的问卷调查。代谢综合征诊断标准采用中华医学会糖尿病学分会标准。结果成渝地区中老年人群代谢综合征患病率为13.8%。男性患病率为13.3%,女性患病率为14.1%,两性患病率无统计学差异。城区患病率为14.6%,农村患病率为10.6%,城市患病率高于农村。40~69岁研究人群代谢综合征患病率逐渐升高。年龄、腹型肥胖、缺乏体育锻炼是成渝地区中老年男性代谢综合征主要的危险因素;年龄、一级亲属高血压病史、腹型肥胖是成渝地区中老年女性代谢综合征主要的危险因素。结论成渝地区中老年人群代谢综合征患病率较高。控制合理的腰围,对于人群代谢综合征的预防、干预以及阻止心血管疾病的发生发展可能有重要意义。     

Association of 25-hydroxyvitamin D levels and metabolic syndrome in Thai postmenopausal women

Background and aimsLow serum 25-hydroxyvitamin D [25(OH)D] levels have been reported to be associated with metabolic syndrome (MetS). In this study, we aimed to investigate the association between serum 25(OH)D levels and MetS in Thai postmenopausal women.MethodsA total of 340 postmenopausal women were enrolled in the study. The concentration of 25(OH)D, lipid profiles, fasting blood glucose (FBG) levels, blood pressure, and demographic and anthropometric parameters were measured. Subjects were divided into the hypovitaminosis D and vitamin D sufficiency groups. The association of serum 25(OH)D levels with MetS in postmenopausal women was analyzed using multivariate regression analysis.ResultsWaist circumference, total cholesterol levels, and triglyceride levels were significantly higher in hypovitaminosis D than in vitamin D sufficiency (p < 0.05). The prevalence of MetS, central obesity, and hypertriglyceridemia in hypovitaminosis D was significantly higher than in vitamin D sufficiency (p < 0.05). In the multivariable logistic regression model, hypovitaminosis D was associated with MetS (OR 1.85; 95% CI 1.12–3.04, p = 0.015), central obesity (OR 2.41; 95% CI 1.20–4.85, p = 0.014), and hypertriglyceridemia (OR 1.91; 95% CI 1.12–3.26, p = 0.018) compared with vitamin D sufficiency after adjusting for covariates. Serum vitamin D concentrations were significantly lower in the MetS group than in the non-MetS group (p = 0.016) and decreased with an increasing number of MetS components (p for trend = 0.034).ConclusionsHypovitaminosis D was associated with an increased risk of MetS, central obesity, and hypertriglyceridemia in Thai postmenopausal women.     

Serum uric acid to creatinine ratio and metabolic syndrome in middle-aged and elderly population: Based on the 2015 CHARLS

Background and aimsSerum uric acid to creatinine ratio (SUA/Cr) may be associated with metabolic syndrome (MS). Here, we investigated the correlation between SUA/Cr and MS in Chinese residents aged ≥ 45 years.Methods and resultsData were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) database. MS was diagnosed using the Chinese Diabetes Society 2017 criteria. We grouped the population according to SUA/Cr quartiles and compared the index differences between groups. We used spearman correlation analysis and binary logistic regression. The possible dose-response association of SUA/Cr with MS were analyzed using restricted cubic spline model. Of 12,946 included participants, 3370 (26.0%) had MS, and 1900 (56.4%) were female. After adjusting for multiple confounders, binary logistic regression analysis showed that compared with Quartile 1, the odds ratio (95% confidence interval) of the MS risk was 1.29 (1.09–1.52), 1.47 (1.25–1.74), and 1.80 (1.53–2.12) in Quartiles 2, 3, and 4, respectively. The restricted cubic spline model indicated a significant nonlinear dose-response association (P_overall < 0.001, P_{non-linearity} = 0.029) between SUA/Cr and strength of MS prevalence association; MS risk began increasing when SUA/Cr > 6.22.ConclusionsA significant positive correlation existed between SUA/Cr and MS risk in Chinese individuals aged ≥ 45 years, which may be a new predictive marker for MS risk.     

High prevalence of metabolic syndrome in a middle-aged and elderly population with prehypertension in Tianjin

Abstract

Background: Prehypertension has been reported as being correlated with future cardiovascular risk and end-organ damage in middle-aged and elderly persons, and also playing an important role in metabolic syndrome (MetS). The association between prehypertension and MetS has rarely been reported among urban adults in Tianjin, China. Methods: In this cross-sectional study, a total of 1176 participants aged 40–70 years (524 males and 652 females) were enrolled after excluding participants with hypertension or treated hypertension. Participants were divided into two groups [optimal blood pressure (BP) and prehypertension] based on the classification of BP from the JNC-7. The definition of MetS was as per the International Diabetes Federation standard. An adjusted logistic regression model was used to assess relationships between prehypertension and MetS. Results: The prehypertension group had a significantly higher odds ratio (OR) than the optimal BP group for abnormal waist circumference (WC), fasting plasma glucose (FPG) and triglycerides (TG). In addition, the prehypertension group had a higher OR (3.12; 95% confidence interval 2.34–4.18) for having MetS after adjusting for potential confounders. Conclusions: The risk of having MetS was significantly associated with prehypertension in middle-aged and elderly persons in Tianjin. Stricter control of BP in this age group is warranted.     

Association between alcohol consumption and metabolic syndrome in 19,215 middle-aged and elderly Chinese

Aims

To assess the association of alcohol consumption with metabolic syndrome (Mets) in a Chinese population.

Methods

A community-based cross-sectional study was performed in 19,215 participants aged 40 years or over in Shanghai of China during June 2008-April 2009. Information about the alcohol consumption including quantity and type of alcoholic beverage was obtained using a standard questionnaire. Physical examination was performed and fasting blood samples were obtained for the measurements of biochemical indicators.

Results

In male wine-only consumers, after adjusted for age, sex, BMI, education levels, exercise and smoking habit, severe alcohol consumption (≥50.0 g/d), compared with non-alcohol consumption, conferred 53% increased risk of having MetS. In women, alcohol consumption did not have relation to the prevalence of Mets. In the beer-only, liquor-only and mixed type consumers, no significant associations between MetS or its components and the quantity of alcohol consumption were detected.

Conclusions

Our findings suggest that excessive wine consumption (alcohol ≥50.0 g/d) is associated with higher prevalence of MetS in Chinese men.     

中老年人血尿酸水平与非酒精性脂肪性肝病的相关性研究

目的:研究中老年人群血尿酸水平与非酒精性脂肪性肝病(NAFLD)的相关性。方法 :采取整群抽样方法,对上海市嘉定社区2 519名40岁以上常住居民进行问卷调查、体格检查,同时采血进行血尿酸、血糖、血脂、肝功能、肾功能检测,以及上腹部彩色多普勒超声检查。NAFLD的诊断依据高分辨率超声扫描结果。按照血尿酸水平四分位数将研究人群分为Q1、Q2、Q3、Q4四组,并对其各项代谢指标进行分析。结果:NAFLD组的血尿酸水平显著高于非NAFLD组[(319.6±92.3)比(272.8±88.8)μmol/L,P<0.05)。结论:上海城镇中老年人群NAFLD患病风险随着血尿酸水平升高而增加。     

Association between vitamin D status and metabolic syndrome risk factors

Background

The concern with the incidence of chronic-degenerative diseases is increasing worldwide, and many studies have shown that insufficiency of vitamin D (VD) can be linked to several metabolic disorders.

Serum 25-hydroxyvitamin D concentration and arterial stiffness among type 2 diabetes

Aim

To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] and arterial stiffness in patients with type 2 diabetes.

Methods

Serum 25(OH)D was measured in a cross-sectional sample of 131 men and 174 women aged 30 years and over in Korea. Arterial stiffness was assessed by pulse wave velocity (PWV) obtained with a VP-2000 pulse wave unit. Fasting plasma glucose, insulin, lipid profile, HbA1c, calcium, phosphorous, and HS-CRP were measured.

Results

The prevalence of vitamin D deficiency was high (85.9%). Those with lower vitamin D levels had increased PWV. Using multivariate regression analysis, low 25(OH)D concentrations independently predicted PWV (p < 0.001) in people with type 2 diabetes after adjustment for other risk factors such as age, smoking, hypertension, HS-CRP, diabetes duration, hypertension duration, HbA1c, and BMI.

Conclusions

Vitamin D deficiency is common in type 2 diabetes, and a low 25(OH)D level is significantly associated with increased arterial stiffness in these patients. Vitamin D may influence the development of cardiovascular disease. Clinical intervention studies are needed to clarify whether treatment with vitamin D decreases the risk of cardiovascular disease in patients with type 2 diabetes.