2型糖尿病患者血清维生素水平及其影响因素

王鸿, 申义, 杜扬帆, 宋川, 张熙洋, 董松

武警医学 ›› 2024, Vol. 35 ›› Issue (1) : 34-37.

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武警医学 ›› 2024, Vol. 35 ›› Issue (1) : 34-37.
论著

2型糖尿病患者血清维生素水平及其影响因素

  • 王鸿1, 申义1, 杜扬帆1, 宋川2, 张熙洋1, 董松1
作者信息 +

Analysis of serum vitamin levels and its influencing factors in patients with type 2 diabetes mellitus

  • WANG Hong1, SHEN Yi1, DU Yangfan1, SONG Chuan2, ZHANG Xiyang1, DONG Song1
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摘要

目的 分析影响2型糖尿病(T2DM)患者维生素水平的临床因素。方法 选取2020-07至2022-06在航天中心医院就诊的T2DM患者(糖尿病组)252例、非糖尿病体检者(对照组)228例,比较两组维生素A、B1、B6、B9、B12、C、D、E的水平;两组间均数的比较采用独立样本t检验,并对糖尿病组采用多元线性回归方程分析影响维生素的因素,可能的因素包含性别、年龄、体质量指数(BMI)、糖化血红蛋白(HbA1c)、并发症。结果 糖尿病组和对照组在性别及年龄构成上无统计学差异,糖尿病组BMI、空腹血糖、HbA1c高于对照组,维生素B1、B6、B9、B12、C水平低于对照组,差异均有统计学意义(P<0.05)。糖尿病患者中影响维生素A的主要因素有性别(β=-0.1, 95% CI: -0.2, 0.0; P=0.03),维生素B9的主要因素有年龄50~70岁(β=-0.9, 95% CI:-4.5,-0.6;P=0.03)、BMI>28(β=-2.3, 95% CI:-4.3,-0.4; P=0.02),维生素B12的主要因素有性别(β=37.7, 95% CI: 0.1, 75.6; P=0.05),维生素C的主要因素有性别(β=-2.4, 95% CI: -4.5, -0.4; P=0.02)、BMI>28(β=4.4, 95% CI: 1.3, 7.5; P=0.01)、HbA1c>10%(β=-3.3, 95% CI: -6.2, -0.4; P=0.02)、DR(β=0.9, 95% CI: 0.2, 3.1; P=0.02)、DKD(= 1.5, 95% CI: 1.1 3.6; P=0.03)、DPN(β=1.2, 95% CI: 1.0, 3.4; P=0.05),维生素D的主要因素年龄50~70岁(β=-6.4, 95% CI:-12.9, 0.1; P=0.05)、HbA1c 7.0%~10.0%(β=7.4, 95% CI: 1.7, 13.1; P=0.01)、HbA1c>10%(β=0.3, 95% CI:0.1, 4.9; P=0.02)。结论 T2DM患者存在多种维生素代谢紊乱,维生素水平与多种临床因素相关,T2DM患者应根据临床特征制定个体化的维生素补充方案。

Abstract

Objective To analyze the levels of serum vitamins and its influencing factors in patients with type 2 diabetes mellitus (T2DM). Methods A total of 252 T2DM patients (diabetes group) and 228 non-diabetic individuals (control group) were selected from the Aerospace Center Hospital from July 2020 to June 2022. The levels of vitamins A, B1, B6, B9, B12, C, D, and E were compared between the two groups. The comparison of means between the two groups was conducted using an independent samples t-test, and multiple linear regression equations were used to analyze the factors affecting the vitamins in the diabetes group, including gender, age, body mass index (BMI), glycated hemoglobin (HbA1c), and complications. Results There was no statistical difference between the diabetes group and the control group in gender and age composition. BMI, fasting blood glucose and HbA1c in the diabetes group were higher than those in the control group, and the levels of vitamin B1, B6, B9, B12, and C were lower than those in the control group, with statistical significance (P<0.05). The main factors affecting vitamin A in diabetic patients were gender (β=-0.1, 95% CI: -0.2, 0.0; P=0.03). The main factors affecting vitamin B9 were age 50-70 years (β=-0.9, 95% CI:-4.5, -0.6; P=0.03) and BMI > 28 (β=-2.3, 95% CI:-4.3,-0.4; P=0.02). The main factors affecting vitamin B12 were gender (β=37.7, 95% CI: 0.1, 75.6; P=0.05). The main factors affecting vitamin C were gender (β=-2.4, 95% CI:-4.5, -0.4; P=0.02), BMI >28 (β=4.4, 95% CI: 1.3, 7.5; P=0.01), HbA1c>10% (β=-3.3, 95% CI:-6.2, -0.4; P=0.02), DR (β=0.9, 95% CI: 0.2, 3.1; P=0.02), DKD (β=1.5, 95% CI: 1.1, 3.6; P=0.03), and DPN (β=1.2, 95% CI: 1.0, 3.4; P=0.05). The main factors affecting vitamin D were age 50-70 years (β=-6.4, 95% CI:-12.9, 0.1; P=0.05), HbA1c 7.0-10.0% (β=7.4, 95% CI: 1.7, 13.1; P=0.01), and HbA1c>10% (β=0.3, 95% CI: 0.1, 4.9; P=0.02). Conclusions Multi-vitamin metabolism disorder exists in patients with T2DM, vitamin level is related to various clinical factors, and individualized vitamin supplementation programs should be developed according to different clinical features.

关键词

糖尿病,2型 / 维生素 / 糖化血红蛋白 / 并发症

Key words

type 2 diabetes / vitamin / glycosylated hemoglobin / complication

引用本文

导出引用
王鸿, 申义, 杜扬帆, 宋川, 张熙洋, 董松. 2型糖尿病患者血清维生素水平及其影响因素[J]. 武警医学. 2024, 35(1): 34-37
WANG Hong, SHEN Yi, DU Yangfan, SONG Chuan, ZHANG Xiyang, DONG Song. Analysis of serum vitamin levels and its influencing factors in patients with type 2 diabetes mellitus[J]. Medical Journal of the Chinese People Armed Police Forces. 2024, 35(1): 34-37
中图分类号: R587.1   

参考文献

[1] 谢叶红, 黄明春. 二甲双胍降低T2DM血清维生素B12的研究进展[J].国际内分泌代谢杂志,2020,40(1):35-38.
[2] Lind M V, Lauritzen L, Kristensen M, et al. Effect of folate supplementation on insulin sensitivity and type 2 diabetes: a meta-analysis of randomized controlled trials[J]. AJCN, 2019, 109(1): 29-42.
[3] Hani R, Mellati A, Tabaei B S, et al. Association of serum zinc and vitamin A levels with severity of retinopathy in type 2 diabetic patients: a cross-sectional study[J]. BTER, 2019, 192(2): 123-128.
[4] 高 芸,吴 萍,周宇洁. 2型糖尿病不同血管并发症与脂溶性维生素及营养代谢指标的关系[J].同济大学学报, 2019, 40(5): 629-643.
[5] Patterson S, Flatt P R, Brennan L, et al. Detrimental actions of metabolic syndrome risk factor, homocysteine, on pancreatic beta-cell glucose metabolism and insulin secretion[J]. JE, 2006, 189(2): 301-310.
[6] 鲜彤章,潘 琦,张丽娜,等. 住院2型糖尿病患者血清25-羟维生素D水平与糖代谢指标的相关性[J].中华临床营养杂志,2016,24(3): 144-148.
[7] Renke G, Starling-Soares B, Basso T, et al. Effects of vitamin D on cardiovascular risk and oxidative stress[J]. Nutrients, 2023, 15(3): 769.
[8] 何玉玲,梁瑜祯.内分泌疾病与钙代谢异常[J].临床内科杂志,2013,30(3):152-153.
[9] Yuan J, Jia P, Hua L, et al. Vitamin D deficiency is associated with risk of developing peripheral arterial disease in type 2 diabetic patients [J]. BMC Cardiovase Disord, 2019, 19:1-7.
[10] Niu Y, Li J, Peng R, et al. Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle-aged patients [J]. Diabetes Metab Res Rev, 2019, 35: 1-8.
[11] 周 婉,叶山东.维生素D与糖尿病慢性并发症的研究进展[J]. 中国糖尿病杂志, 2021, 29(1):67-69.
[12] 季鹏程,张 舒,孙 璟,等. 上海地区部分中老年糖尿病患者体内维生素水平分析[J].诊断学理论与实践,2018,17(3):285-289.
[13] Kim Y, Oh Y K, Lee J, et al. Could nutrient supplements provide additional glycemic control in diabetes management? A systematic review and meta-analysis of randomized controlled trials of as an add-on nutritional supplementation therapy [J]. APR, 2022, 45(3): 185-204.
[14] Nosratabadi S, Ashtray-larky D, Hosseini F, et al. The effects of vitamin C supplementation on glycemic control in patients with type 2 diabetes: A systematic review and meta-analysis [J]. DMS 2023, 17(8): 102824.
[15] Pramanik S, Banerjee K, Mondal L K. The amelioration of detrimental biochemical anomalies by supplementing B, C, and E vitamins in subjects with type 2 diabetes mellitus may reduce the rate of development of diabetic retinopathy [J]. JDR, 2022, 2022: 3886710.
[16] Feng M, Shing H, Liu H, et al. High glucose-induced apoptosis in hunan endothelial cells is mediated by sequential activations of c-Jun NH2-Terminal kinase and caspase-3[J]. Circulation, 2000, 101(6): 2618.

基金

中国航天科工集团公司医疗卫生科研项目(2019-LCYL-011)


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