2型糖尿病患者下肢血管病变与血清25羟维生素D及骨密度的相关性

发布时间：2018-11-09 19:08

【摘要】：目的探讨2型糖尿病患者下肢血管病变与血清25羟维生素D及骨密度的相关性。方法选取2型糖尿病患者235例,按踝肱指数(ankle brachial index,ABI)(采用多普勒血流探测仪测定)的数值将患者分为两组,分别为下肢血管病变组(PAD组,ABI0.9)115例和非下肢血管病变组(NPAD组,ABI≥0.9)120例。采用双能X线骨密度仪进行腰椎(L1~4)、左侧股骨颈(Neck)、大转子(Troch)、华氏三角(Ward's)骨密度(bone mineral density,BMD)的测定。测定受试者血清25(OH)D的水平,并记录所有受试者的临床资料和生化指标。结果 PAD组血清25(OH)D的平均水平低于NPAD组[(12.89±1.48)ng/mL vs(15.82±2.35)ng/mL,P0.05];PAD组的Neck、Troch、Ward's的BMD均分别低于NPAD组[(0.706±0.171)g/cm~2vs(0.823±0.133)g/cm~2,(0.501±0.111)g/cm~2vs(0.595±0.125)g/cm~2,(0.455±0.121)g/cm~2vs(0.524±0.210)g/cm~2,P0.05]。Pearson相关分析发现,ABI与年龄、糖尿病病程、收缩压(systolic blood pressure,SBP)、胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein,LDL-C)、糖化血红蛋白(hemoglobin A1c,Hb A1c)呈负相关,与25(OH)D及Neck、Troch、Ward's的BMD呈正相关,差异有统计学意义(P0.05)。Logistic分析显示:SBP、Hb A1c、TC、25(OH)D、Neck的BMD均为2型糖尿病患者发生下肢血管病变的危险因素。结论 2型糖尿病合并下肢血管病变患者往往同时伴有骨量减少或骨质疏松,低水平的25(OH)D及低下肢骨密度可能共同参与了2型糖尿病患者下肢动脉病变的发生发展。
[Abstract]:Objective to investigate the correlation between lower extremity vascular lesion and serum 25 hydroxyvitamin D and bone mineral density in type 2 diabetes mellitus. Methods 235 patients with type 2 diabetes mellitus were divided into two groups according to ankle brachial index (ankle brachial index,ABI) (measured by Doppler blood flow detector). The patients were divided into two groups: lower extremity vascular lesion group (PAD group). There were 115 cases of ABI0.9 and 120 cases of non-lower extremity vascular lesions (NPAD group, ABI 鈮，

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