摘要
目的探讨25-羟基维生素D(25-hydroxy vitamin D,25OHD)水平与初诊2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生糖尿病酮症(diabetic ketosis,DK)的相关性。方法回顾性分析2017年1月至2023年3月于清华大学附属垂杨柳医院住院治疗的186例初诊T2DM患者的临床资料,收集患者的年龄、性别、身高、体重、血压、血清25OHD水平、尿酮体、糖脂代谢指标以及胰岛功能等。根据尿酮体检测是否阳性将186例患者分为酮症组(119例)和非酮症组(67例)。根据25OHD水平对186例患者进行分组,25OHD<10ng/ml为25OHD严重缺乏组(38例),10ng/ml≤25OHD<20ng/ml为25OHD缺乏组(100例),20ng/ml≤25OHD<30ng/ml为25OHD不足组(41例),25OHD≥30ng/ml为25OHD充足组(7例)。采用二元logistic回归分析初诊T2DM患者发生DK的危险因素。结果酮症组患者血清25OHD水平为(14.53±6.37)ng/ml,显著低于非酮症组的(18.07±7.99)ng/ml,差异有显著性(P<0.05);酮症组25OHD缺乏率为81.51%,显著高于非酮症组的61.19%,差异有显著性(P<0.05)。不同25OHD水平分组中,酮症患者和非酮症患者的检出率差异均有显著性(P<0.05)。Logistic回归分析显示,血清25OHD及磷水平降低、餐后2h静脉血糖升高及年龄较低是初诊T2DM患者合并DK的独立危险因素(P<0.05)。结论初诊T2DM患者25OHD重度缺乏,以合并DK者更为明显;25OHD缺乏是初诊T2DM患者发生DK的独立危险因素。
Objective To explore the association between serum 25-hydroxy vitamin D(25OHD)level and the occurrence of ketosis in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Method From January 2017 to March 2023,a retrospective analysis was conducted on 186 cases(125 males,61 females)of preliminary diagnosed T2DM hospitalized in the department of endocrinology,Chuiyangliu Hospital affiliated to Tsinghua University.The serum 25OHD levels and related clinical indexes such as age,gender,height,weight,blood pressure,urinary ketones,glucose,lipid metabolism parameters and pancreatic function were collected.There were 119 patients in the ketosis group and 67 patients were allocated to a non-ketotic group.All the patients were divided into four groups in accordance with the levels of 25OHD.Severe deficiency group(n=38):25OHD<10ng/ml;deficiency group(n=100):10ng/ml≤25OHD<20ng/ml;insufficiency group(n=41):20ng/ml≤25OHD<30ng/ml;and sufficiency group(n=7):30ng/ml≤25OHD.Logistic regression analysis was used to analyze the risk factors for the newly diagnosed T2DM patients with ketosis.Result Among the 186 patients,The serum 25OHD levels in the ketosis group were significantly lower than those in the non-ketotic group[(14.53±6.37)ng/ml vs.(18.07±7.99)ng/ml,P<0.05].The rate of 25OHD deficiency was significantly higher in ketosis group compared to that in non-ketotic group(81.51%vs.61.19%,P<0.05).The prevalence of ketosis group and the non-ketosis group varied significantly in different 25OHD status groups(P<0.05).Logistic regression analysis suggested that low serum 25OHD,phosphorus levels,high postprandial plasma glucose and younger age were risk factors for ketosis in the newly diagnosed T2DM patients(P<0.05).Conclusion In the newly T2DM patients have a severe deficiency of vitamin D,which is more pronounced in diagnosed T2DM patients with concurrent ketosis.Low serum 25OHD level may be an independent risk factor for ketosis in the newly diagnosed T2DM patients.
作者
王潇颖
李彬
崔丽梅
Wang Xiaoying;Li Bin;Cui Limei(Department of Endocrinology,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100021,China)
出处
《中国医刊》
CAS
2023年第12期1313-1317,共5页
Chinese Journal of Medicine
基金
首都卫生发展基金重点攻关项目(2022-1G-2064)。
