老年2型糖尿病患者血清25-羟维生素D3水平与颈动脉粥样硬化斑块的关系探讨

目的：探讨老年2型糖尿病患者血清25-羟维生素D325-（OH）D3]水平与颈动脉粥样硬化斑块的关系。方法选择308例老年2型糖尿病患者，测定颈动脉内膜的斑块，根据斑块大小、性质分为：中大斑块组、小斑块组、无斑块组。检测各组血压、BMI、空腹血糖（ FPG）、糖化血红蛋白（ HbAlc）、血脂、CRP及25-（ OH） D3等指标，分析颈动脉粥样硬化斑块的危险因素，探讨25-（ OH） D3与颈动脉粥样硬化斑块的关系。结果颈动脉中大斑块组患者年龄大于小斑块组和无斑块组（P＜0．05）；血清CRP水平（4．21±1．61）mg/L，高于小斑块组的（3．41±1．92）mg/L和无斑块组的（2．52±1．18）mg/L（t＝1．96、3．14，均P＜0．05）；血清25-（OH）D3水平（15．28±5．86）nmol/L，显著低于小斑块组的（24．30±7．60）nmol/L和无斑块组的（32．74±8．13）nmol/L（t＝4．67、3．41，均P＜0．01）。小斑块组血清25-（OH）D3浓度低于无斑块组（t ＝2．51，P＜0.05）。相关分析显示颈动脉粥样硬化斑块与年龄、BMI、HbAlc、CRP、LDL-C呈正相关（ r＝0．45、0．38、0．53、0.47，均P＜0．05），与25-（OH）D3浓度呈负相关（r＝-0．62，P＜0．05）；Logstic回归分析显示年龄、BMI、HbAlc、CRP、LDL-C及25-（ OH） D3水平是颈动脉粥样硬化斑块形成的独立危险因素。结论老年2型糖尿病患者颈动脉粥样硬化斑块的危险因素为年龄、BMI、HbAlc、CRP、LDL-C及25-（ OH） D3，血清25-（ OH） D3浓度可能是颈动脉粥样硬化斑块的预测指标。

Relationship between serum 25-hydroxy vitamin D3 level and carotid atherosclerosis plaque in elderly patients with type 2 diabetes

Objective To explore the relationship between serum 25-hydroxy vitamin D 3 level and carotid atherosclerosis plaque in elderly patients with type 2 diabetes .Methods 308 elderly patients with type 2 diabetes were selected .The carotid artery intimal plaque was measured .According to the characteristics and size of plaque ,they were divided into the medium/big group,small plaque group and no plaque group .Blood pressure,body mass index （BMI）,fasting plasma glucose（FPG）,glycosylated hemoglobin（HbA1c）,blood lipids,c-reactive protein（CRP）and the concentration of serum 25-hydroxy vitamin D 3 were detected .The risk factors forcarotid atherosclerosis plaque were analyzed,exploring the the relationship between serum 25-hydroxy vitamin D3 level and carotid atherosclerosis plaque . Results Age,CRP（4.21 ±1.61） mg/L in the medium/big group was significantly higher than those of the small plaque group（3.41 ±1.92）mg/L and the no plaque group（2.52 ±1.18）mg/L（t=1.96,3.14,all P＆lt;0.05）.The level of serum 25-hydroxy vitamin D3 in the medium/big group（15.28 ±5.86）nmol/L was significantly less than that of the small plaque group（24.30 ±7.60）nmol/L and the no plaque group（32.74 ±8.13）nmol/L（t=4.67,3.41,all P＆lt;0.01）.The level of serum 25-hydroxy vitamin D3 in the small plaque group was significantly less than that of the no plaque group（t=2.51,P＆lt;0.05）.There was positive correlation between carotid atherosclerotic plaques and age , BMI,HbA1c,CRP and LDL-C（ r=0.45,0.38,0.53,0.47,all P＆lt;0.05）.There was negtive correlation between carotid atherosclerotic plaques and 25-hydroxy vitamin D3（r=-0.62,P＆lt;0.05）.Logstic regression analysis showed that age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 were independent risk factors for the development of carotid atherosclerotic plaque .Conclusion The risk factors for carotid atherosclerotic plaques in elderly patients with type 2 diabetes are age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 concentration.25-hydr