老年糖尿病患者血清25羟维生素D水平与踝肱指数的相关研究

目的 探讨老年2型糖尿病(diabetes mellitus,T2DM)患者血清25羟维生素D25-hydroxyvitaminD,25(OH)D]水平与踝肱指数(ankle-brachial index,ABI)的关系.方法 老年T2DM患者(T2DM组)180例,根据ABI值将患者分为下肢血管病变(peripheral arterial disease,PAD)组(82例),非下肢血管病变(N-PAD)组(98例),设正常对照组(50例),记录所有受试者的临床资料及检测指标.结果 T2DM组患者血清25(OH)D水平低于对照组(t=-2.45,P=0.024),T2DM患者中PAD组25(OH)D水平低于N-PAD组(t=-2.19,P=0.038),差异有统计学意义.相关分析显示,ABI值与糖尿病病程(r=-0.396,P=0.004)、收缩压(r=-0.332,P=0.016)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)(r=-0.335,P=0.015)、血尿酸(r=-0.347,P=0.012)及尿白蛋白/尿肌酐比(urinary albumin/creatinine ratio,ACR)(r=-0.367,P=0.008)呈负相关,与25(OH)D呈正相关(r =0.535,P＜0.001).多因素Logistic回归分析显示,吸烟(OR=1.145,P=0.017)、高收缩压(OR=0.972,P=0.009)、高水平HbA1c(OR=0.636,P=0.038)、高水平血尿酸(OR=0.631,P=0.033),低水平25 (OH) D(OR=2.746,P=0.009)是老年T2DM患者ABI值低于正常范围的危险因素.结论 血清25(OH)D水平与老年T2DM患者PAD的发生相关.

Study on relationship between serum 25-hydroxyvitamin D concentration and ankle-brachial index in elder diabeticpatients

Objective To understand the relationship between serum 25-hydroxyvitamin D （25 （OH）D） and an- kle-braehial index （ABI） in elderly type 2 diabetes mellitus （T2DM） patients. Methods A total of 180 T2DM patients and 50 non-diabetic healthy controls were selected in this study. All the T2DM patients were divided into 2 groups accord- ing to ABI values ： peripheral arterial disease （PAD） group （ n = 82） and non-PAD group （ n = 98 ）. Clinical data were collected, and biochemical indice were determined. Results Serum 25 （OH） D levels decreased significantly in T2DM pa- tients（t = -2.45,P =0. 024）, specially in PAD group（t = -2. 19,P =0. 038）, with statistical differences from the con- trols. A negative and significant correlation was observed between the ABI and duration of diabetes （ r = - 0. 396, P = 0. 004 ） , systolic blood pressure （ r = - 0. 332, P = 0. 016 ） , glyeosylated hemoglobin A1 c （ HbA1 c ） （ r = - 0. 335, P = 0. 015 ） , serum uric acid （ r = - 0. 347, P = 0. 012 ） and urinary albumin/creatinine ratio （ r = - 0. 367, P = 0. 008 ）. Meanwhile, positive relationship was found between ABI and 25 （OH） D （ r = 0. 535, P 〈 0. 001 ）. Multivariate Logistic re- gression analysis showed that smoking（ OR = 1. 145, P = 0. 017 ） , systolic blood pressure （ OR = 0. 972, P = 0. 009 ）, in- creased levels of HbA1 e （ OR = 0. 636, P = 0. 038 ） , serum uric acid （ OR = 0. 631, P = 0. 033 ） and decreased levels of 25 （OH） D （ OR = 2. 746, P = 0. 009 ） were risk factors for lower ABI in elderly patients with T2DM. Conclusions Serum 25 （OH） D concentration was associated with PAD in elderly patients with T2DM.