摘要
目的探讨2型糖尿病合并肿瘤患者的血清维生素D水平及发生肿瘤的危险因素。方法采用病例对照研究设计,收集2016年7月1日至2018年12月31日于天津市人民医院内分泌科住院的2型糖尿病合并肿瘤患者205例作为肿瘤组,并选择同期住院不合并肿瘤的2型糖尿病患者205例作为非肿瘤组,对两组患者血清25羟维生素D3[25(OH)D3]、白蛋白、总胆固醇、钙、磷、体重指数、吸烟、饮酒、尿微量白蛋白、尿蛋白定量、肌酐、尿酸、总胆红素、谷氨酰转肽酶、碱性磷酸酶、谷草转氨酶、谷丙转氨酶、甘油三酯进行比较。应用多因素logistic回归分析,筛选2型糖尿病合并肿瘤的独立危险因素,评价危险因素对2型糖尿病合并肿瘤的预测价值。结果与非肿瘤组相比,肿瘤组25(OH)D3水平较低(Z=-5.061,P<0.001),年龄较大(Z=-7.201,P<0.001),糖化血红蛋白较高(Z=-3.434,P=0.001),男性比例较低(χ^2=6.103,P=0.013),糖尿病病程较长(Z=-2.138,P=0.033),血清白蛋白(Z=-3.448,P=0.001)、总胆固醇(Z=-2.845,P=0.004)、钙(Z=-2.007,P=0.045)、磷(Z=-2.287,P=0.022)降低,两组体重指数、吸烟、饮酒、尿微量白蛋白、尿蛋白定量、血清肌酐、尿酸、总胆红素、谷氨酰转肽酶、碱性磷酸酶、谷草转氨酶、谷丙转氨酶、甘油三酯差异无统计学意义(P均>0.05)。多因素logistic回归分析显示,25(OH)D3(OR=0.931,95%CI:0.890~0.972)、HbA1c(OR=1.178,95%CI:1.040~1.335)、年龄(OR=1.087,95%CI:1.054~1.121)、性别(OR=1.766,95%CI:1.020~3.056)是2型糖尿病患者发生肿瘤的独立危险因素,ROC曲线下面积为0.783,95%CI:0.734~0.832(P<0.001)。结论2型糖尿病合并肿瘤患者血清25(OH)D3水平降低,且低血清25(OH)D3、高龄、女性、高糖化血红蛋白与2型糖尿病患者肿瘤发生风险增加独立相关。
Objective To investigate the level of serum vitamin D and the risk factors of patients with type 2 diabetes mellitus complicated with tumor.Methods A case-control study was designed to collect 205 patients with type 2 diabetes complicated with tumor who were admitted to the Department of Endocrinology in Tianjin People's Hospital from July 1,2016 to December 31,2018 as the tumor group,at the same time 205 patients with type 2 diabetes mellitus who were not complicated with tumor were selected as non-tumor group.Serum 25-hydroxyvitamin D3[25(OH)D3],albumin,total cholesterol,calcium,phosphorus,body mass index,smoking,drinking,urinary microalbumin,urinary protein quantity,creatine,uric acid,total bilirubin,glutamine transpeptidase,alkaline phosphatase,aspertate aminotransferase,alanine aminotransferase and triglyceride were compared between groups.Multivariate logistic regression analysis was used to screen the independent risk factors of type 2 diabetes mellitus complicated with tumor,and the predictive value of risk factors for type 2 diabetes mellitus complicated with tumor was evaluated.Results Compared with the non-tumor group,patients in the tumor group had lower levels of 25(OH)D3(Z=-5.061,P<0.001),older age(Z=-7.201,P<0.001),higher glycosylated hemoglobin(Z=-3.434,P=0.001),lower male proportion(χ^2=6.103,P=0.013),longer course of diabetes mellitus(Z=-2.138,P=0.033),lower levels of serum albumin(Z=-3.448,P=0.001),total cholesterol(Z=-2.845,P=0.004),calcium(Z=-2.007,P=0.045)and phosphorus(Z=-2.287,P=0.022).There was no significant difference in body mass index,smoking,drinking,urinary microalbumin,urinary protein quantity,serum creatine,uric acid,total bilirubin,glutamine transpeptidase,alkaline phosphatase,aspertate aminotransferase,alanine aminotransferase and triglyceride between both groups(all P>0.05).Multivariate logistic regression showed that 25(OH)D3(OR=0.931,95%CI:0.890-0.972),glycosylated hemoglobin(OR=1.178,95%CI:1.040-1.335),age(OR=1.087,95%CI:1.054-1.121)and sex(OR=1.766,95%CI:1.020-3.056)were i
作者
刘东玲
赵崇强
李春君
陈丽琴
邱慧娜
林静娜
Liu Dongling;Zhao Chongqiang;Li Chunjun;Chen Liqin;Qiu Huina;Lin Jingna(Department of Endocrinology,Dagang Hospital of Binhai New Area of Tianjin,Tianjin 300270,China;Department of Cardiovasology,Tianjin First Central Hospital,Tianjin 300192,China;Department of Endocrinology,Tianjin People's Hospital,Tianjin 300012,China)
出处
《国际内分泌代谢杂志》
2020年第4期217-222,共6页
International Journal of Endocrinology and Metabolism
