青岛老年住院病人维生素D缺乏与糖尿病伴心血管病变关系的研究

发布时间：2018-04-21 22:28

  本文选题：维生素D + 2型糖尿病　； 参考：《青岛大学》2015年硕士论文

【摘要】：目的调查青岛地区老年住院患者的维生素D缺乏现状;探讨在老年2型糖尿病患者中,维生素D与心血管发病率及危险因素间的关系。方法收集2014年11月至2015年4月在青岛大学附属医院住院并检测血清25-羟维生素D(25(OH)D)的60岁以上老年患者1821例,通过查阅病历收集临床诊断、年龄、性别等基本资料,根据年龄、25(OH)D、临床诊断等指标将患者分组比较,利用SPSS19统计学软件分析各组间25(OH)D差异性;筛选上述患者中符合入组标准的2型糖尿病患者94例,收集一般情况、疾病史、实验室指标等。根据合并疾病状况、糖尿病病程及血清25(OH)D水平将患者分组。应用多元Logistic回归分析心血管病变与危险因素的关系,应用pearson分析25(OH)D与各危险因素的相关性。结果在1821例老年患者中,不同性别组间,男性组VD缺乏率为88.75%,女性组缺乏率为87.87%,血清25(OH)D含量男性组低于女性组,但差异无统计学意义(P=0.3670.05);不同年龄组间比较,高龄组(≥75岁)血清25(OH)D含量低于低龄组(60-74岁),其结果具有显著性差异(p=0.0060.01);不同疾病组间血清25(OH)D含量差异具有统计学意义(p=0.0440.05),其中肾病组25(OH)D最低(39.89±23.66nmol/L),高血压组25(OH)D最高(60.69±28.27nmol/L)。在上述94例糖尿病患者中,合并心血管疾病组较糖尿病组在25(OH)D、总胆固醇(TC)、血尿酸(UA)、血钙(Ca)水平上比较均有统计学差异(p0.05)。不同病程组间25(OH)D随病程逐渐增长呈现递减趋势。在pearson相关性分析中,25(OH)D与年龄、纤维蛋白原(FIB)、TC、UA呈负相关,与D-二聚体、高密度脂蛋白(HDL-C)呈正相关,其中与FIB、TC呈显著相关(p0.01);在Logistic回归分析中,以心血管疾病是否发病作为因变量,以25(OH)D与其他心血管危险因素作为自变量,结果显示25(OH)D缺乏组的心血管发生风险为1.17倍(OR 1.17,p=0.0350.05)。【结论】1.本研究为首例对青岛地区老年住院患者维生素D缺乏情况调查,发现青岛老年住院患者维生素D缺乏现象严重,其缺乏率为88.41%;老年男性及75岁以上高龄人群缺乏率分别为88.75%、89.19%。2.老年2型糖尿病患者中血清25(OH)D水平与年龄、FIB、TC、UA、D-二聚体、HDL-C等心血管危险因素具有相关性。3.维生素D缺乏是老年2型糖尿病患者心血管疾病发病的独立危险因素。
[Abstract]:Objective to investigate the status of vitamin D deficiency in elderly inpatients in Qingdao, and to explore the relationship between vitamin D and cardiovascular morbidity and risk factors in elderly patients with type 2 diabetes. Methods from November 2014 to April 2015, 1821 elderly patients over 60 years old who were hospitalized in the affiliated Hospital of Qingdao University and detected the serum 25-hydroxyvitamin D (25-hydroxyvitamin D) were collected and collected the basic data of clinical diagnosis, age, sex and so on. The patients were divided into two groups according to their age and clinical diagnosis. The differences of 25(OH)D among the groups were analyzed by SPSS19 software, 94 patients with type 2 diabetes who met the criteria of entering the group were selected, and the general situation and disease history were collected. Laboratory indicators, etc. The patients were divided into groups according to the condition of the complicated disease, the course of diabetes and the level of serum 25(OH)D. Multivariate Logistic regression analysis was used to analyze the relationship between cardiovascular disease and risk factors, and pearson was used to analyze the correlation between 25(OH)D and risk factors. Results among 1821 elderly patients, the VD deficiency rate of male group was 88.755.The deficiency rate of female group was 87.87.The serum 25(OH)D content in male group was lower than that in female group, but there was no significant difference between male group and female group. The serum 25(OH)D level in the elderly group (鈮，

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