2型糖尿病视网膜病变患者血清25-羟维生素D水平及其发生和严重程度的影响因素分析

目的 探讨2型糖尿病视网膜病变(diabetic retinopathy,DR)患者血清25-羟维生素D[25-hy-droxy vitamin D,25-(OH)D]水平及其发生和严重程度的影响因素.方法 选取2型糖尿病(type 2 diabetes mellitus,T2DM)300例,根据疾病不同阶段分为无DR...

Analysis of Factors Influencing 25-Hydroxyvitamin D Level and Its Occurrence and Degree of Severity in Type 2 Diabetic Patients with Diabetic Retinopathy

Objective To investigate the level of 25-hydroxyvitamin D[25-(OH)D]in the serum of patients with Type 2 diabetes mellitus(T2DM)combined with diabetic retinopathy(DR)and the factors influencing its occurrence and the degree of severity.Methods Three hundred patients with T2DM were divided into non-DR diabetes group,background DR group and proliferative DR group according to different stages of the disease,with 100 cases in each group.In the meantime,100 healthy volunteers were selected as the control group.All subjects enrolled were compared for sex,age,course of diabetes,body mass index(BMI).The levels of 25-(OH)D and triacylglycerol(TG),high-density lipoprotein(HDL),total cholesterol(TC)and glycosylated hemoglobin A1c(HbA1c)were measured.Pearson's correlation coefficient was used to analyze the correlation of clinical and laboratory findings with DR in patients with T2DM,and multivariate Logistic regression analysis was used to analyze the factors influencing occurrence and the severity of DR in T2DM patients.Results There were statistically significant differences in the course of diabetes and the levels of 25-(OH)D and HbA1c between the four groups(P<0.01).With the progression of DR,the course of diabetes was prolonged in the four groups,the level of 25-(OH)D in serum was decreased and the level of HbA1c was increased gradually.There was a statistically significant difference between every two factors(P<0.01).Results of Pearson's correlation coefficient showed that the course of diabetes and the level of HbA1c were positively correlated with DR(P<0.01),and the level of 25-(OH)D was negatively correlated with DR(P<0.01).Results of multiple Logistic regression analysis showed that course of disease and HbA1c were the risk factors of DR in T2DM patients(P<0.05),serum 25-(OH)D was the protective factor of DR in T2DM patients(P<0.01),and serum 25-(OH)D was the protective factor of severity of DR in T2DM patients(P<0.01).Conclusion The decrease of 25-(OH)D level in T2DM patients may promote the occurrence and development of DR,and it is related to the severity of DR.