基线25(OH)D水平与2型糖尿病发病风险无相关性:基于5044例人群的前瞻性队列研究

目的 探讨甘肃兰州城关区中老年人群基线血清25（OH）D水平与2型糖尿病（T2DM）发病和血糖控制的相关性。方法 选取2011年开展的“REACTION”研究兰州地区40~75岁居民的资料并于2014年开始随访，对2次调查资料完整的5044例对象进行研究。根据25（OH）D四分位水平将基线人群分为Q1、Q2、Q3、Q4组，比较不同糖代谢状态下各组的糖尿病发病情况和血糖控制情况及其相关性。结果（1）基线25（OH）D水平与空腹血糖（FPG）、OGTT-2h后血糖（2hPG）、糖化血红蛋白（HbA1c）无相关性（P>0.05）；（2）平均随访3.4±0.6年后发现，无论在正常糖耐量人群中还是在糖调节受损患者中，与Q1组相比，Q2、Q3、Q4组的糖尿病前期亦或糖尿病的发病风险均未见显著降低（P>0.05）；（3）T2DM患者随访后血糖控制达标率高于随访前（63.4% vs 60.6%），且随访后的HbA1c、FPG、2h-PG水平较随访前明显下降，但与Q1组比较，无论是血糖控制达标率还是HbA1c、FPG、 2h-PG水平，Q2、Q3、Q4组随访前后的差异均无统计学意义（P>0.05）。结论 本研究尚未发现基线25（OH）D水平的高低与糖尿病的发病风险及T2DM患者的血糖控制情况有关。

Correlation of baseline serum 25-hydroxyvitamin D level with the risk of type 2 diabetes mellitus: a prospective cohort study

Objective To investigate the correlation of baseline serum 25(OH) D level with the risk of type 2 diabetes mellitus (T2DM) and blood glucose control in diabetic patients among the middle-aged and elderly individuals in Chengguan District of Lanzhou, Gansu Province. Methods Residents aged 40 to 75 years in Lanzhou were selected from the "REACTION" study conducted in 2011 and had been followed up since 2014. A total of 5044 subjects with complete data from the two surveys were analyzed. Participants were divided into Q1, Q2, Q3, and Q4 subgroups based on quartiles of serum 25(OH)D level for comparison of the incidence of T2DM and blood glucose control. Results Baseline 25(OH)D level was not found to correlate with FPG, 2h-PG or HbA1c levels among the residents (P>0.05). The participants were followed up for a mean of 3.4±0.6 years, and compared with those in Q1 group, the participants in Q2, Q3 and Q4 groups did not show significantly lowered risk of prediabetes or diabetes regardless of glucose tolerance status. Among the patients with T2DM, the compliance rate of glycemic control after the follow-up was significantly higher than that before the follow-up (63.4% vs 60.6%), and the levels of HbA1c, FPG, and 2h-PG decreased obviously after the follow-up. But compared with Q1 group, Q2, Q3 and Q4 groups showed no significant changes in glycemic control compliance rate or levels of HbA1c, FPG and 2h-PG after the follow-up (P>0.05). Conclusion There is no evidence that baseline 25(OH)D levels are associated with the risk of diabetes and blood glucose control in patients with T2DM.