2型糖尿病患者血清25-羟维生素D水平与颈动脉内膜中层厚度的相关性研究

Correlation between serum 25-hydroxyvitamin D level and carotid artery intima-media thickness in type 2 diabetic patients

摘要:

目的：探讨2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清25-羟维生素D[serum 25-hydroxy vitamin D，25（OH）D]水平与颈动脉内膜中层厚度（intimal-medial thickness，IMT）的相关性。方法：选取T2DM患者132例，根据血清25（OH）D浓度的四分位数分为4组（Q1～Q4）；又根据颈动脉IMT分为正常组和动脉粥样硬化组。测量血压、身高、体质量，并检测生化指标。采用电化学发光法测定血清25（OH）D浓度，彩色多谱勒超声测定颈动脉IMT、颈动脉收缩期最大流速（peak systolic velocity，PSV）、舒张末期血流速度（end diastolic velocity，EDV）。结果：Q1组颈动脉IMT高于Q3组（P=0.027）。Q1、Q2组颈动脉IMT高于Q4组（P=0.000、P=0.002）。Q1组的颈动脉斑块发生率明显高于Q2、Q3、Q4组（P=0.004、P=0.002、P=0.000）。Q1组颈总动脉PSV低于Q3组（P=0.031）。Q1组颈总动脉EDV低于Q2、Q3、Q4组（P=0.003、P=0.002、P=0.038）。动脉粥样硬化组的血清25（OH）D浓度低于正常组（P=0.000）。Pearson相关分析颈动脉IMT与血清25-（OH）D成负相关（r=-0.348，P=0.000）。多元回归分析显示颈动脉IMT与血清25-（OH）D 独立负相关（B=-0.012，P=0.000）。结论：在T2DM患者中，血清25（OH）D浓度与颈动脉IMT成负相关，低浓度血清25（OH）D可能为颈动脉粥样硬化的危险因素。

Abstract:

Objective：To evaluate the correlation between serum 25-hydroxy vitamin D（25（OH）D） level and carotid artery intimal-medial thickness（IMT）in type 2 diabetic（T2DM） patients. Methods：Totally 132 T2DM patients were divided into four quartile groups（Q1-Q4） according to the level of serum 25（OH）D and were divided into normal group and atherosclerotic group according to their IMT. Their blood pressure，body weight，body height，and biochemical indexes were measured. Their serum 25（OH） D level was mea－sured by ECL. Their carotid IMT，peak systolic velocity，（PSV），end diastolic velocity（EDV） were measured by ultrasongraphy. Results：Carotid IMT in Q1 group was significantly higher than that in Q3 group（P=0.027）. Carotid IMT in Q1 and Q2 groups were signifi－cantly higher than that in Q4 group（P=0.000；P=0.002）. Prevalence of carotid atherosclerotic plaque in Q1 group was significantly higher than that in Q2，Q3 and Q4 groups（P=0.004；P=0.002；P=0.000）. The carotid PSV was significantly lower in Q1 group than that in Q3 group（P=0.031）. Similarly，the carotid EDV was significantly lower in Q1 group than that in Q2，Q3 and Q4 groups（P=0.003；P=0.002；P=0.038）.The serum 25（OH）D concentration was significantly lower in atherosclerotic group than that in normal group（P=0.000）. Pearson correlation analysis showed that carotid IMT was negatively related with the 25（OH）D（r=-0.348，P=0.000）. Multivari－ate regression analysis revealed that 25（OH）D concentration was an independent predictor of carotid IMT in this cohort（B=-0.012，P=0.000）. Conclusion：Serum 25（OH）D concentration is nega－tively correlated with carotid IMT and low 25（OH）D concentra－tion may be a risk factor for carotid atherosclerosis in T2DM pa－tients.