2型糖尿病患者血清维生素水平及其影响因素

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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。

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	董松

关键词 ：糖尿病,2型, 维生素, 糖化血红蛋白, 并发症

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.

Key words： type 2 diabetes vitamin glycosylated hemoglobin complication

收稿日期: 2023-08-10

ZTFLH:

R587.1

基金资助:

中国航天科工集团公司医疗卫生科研项目(2019-LCYL-011)

通讯作者: 董松,E-mail:qljs2015@163.com

作者简介: 王鸿,硕士,主任医师。

引用本文:

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. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(1): 34-37.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I1/34

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