2型糖尿病合并颈动脉粥样硬化患者血清甲状旁腺激素及25羟维生素D与糖脂代谢的相关性

吴振; 徐燕; 苏文韬; 吴刚勇

doi:10.7619/jcmp.20221479

2型糖尿病合并颈动脉粥样硬化患者血清甲状旁腺激素及25羟维生素D与糖脂代谢的相关性

Correlations of serum parathyroid hormone and 25 hydroxyvitamin D with glycolipid metabolism in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis

摘要

摘要:
目的分析2型糖尿病合并颈动脉粥样硬化(CAS)患者血清甲状旁腺激素(PTH)、25羟维生素D25-(OH)-D与糖脂代谢的相关性。
方法收集2019年4月—2021年12月110例2型糖尿病患者的临床资料，入院后均常规行颈动脉超声、糖脂代谢及PTH、25-(OH)-D检查。根据颈动脉内中膜厚度(CIMT)检查结果将患者分为单纯2型糖尿病组(n=51)与合并CAS组(n=59)。比较2组PTH、25-(OH)-D、血糖指标空腹血糖(FBG)、糖化血红蛋白(HbA1c)及血脂指标总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平，分析血清PTH、25-(OH)-D与血糖及血脂代谢的关系。
结果 2组性别、年龄、体质量指数、病程比较，差异无统计学意义(P＞0.05)。合并CAS组患者血清PTH水平高于单纯2型糖尿病组，25-(OH)-D水平低于单纯2型糖尿病组，差异有统计学意义(P＜0.01); 合并CAS组FBG、HbA1c水平均高于单纯2型糖尿病组，差异有统计学意义(P＜0.05); 合并CAS组患者TC、TG、LDL-C均高于单纯2型糖尿病组，HDL-C低于单纯2型糖尿病组，差异有统计学意义(P＜0.05)。双变量Pearson直线相关检验结果显示, 2型糖尿病合并CAS患者血清PTH与FBG、HbA1c、TC、TG呈正相关(P＜0.05), 与HDL-C呈负相关(P＜0.05); 25-(OH)-D与HbA1c、TC、TG呈负相关(P＜0.01), 与HDL-C呈正相关(P＜0.05)。
结论 2型糖尿病合并CAS患者血清PTH、25-(OH)-D水平与糖脂代谢密切相关。

Abstract:
Objective To analyze the correlations of serum parathyroid hormone (PTH) and 25 hydroxyvitamin D25-(OH)-Dwith glycolipid metabolism in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis (CAS).
Methods The clinical materials of 110 patients with type 2 diabetes mellitus from April 2019 to December 2021 were collected, and carotid ultrasound, glucose and lipid metabolism examination, and PTH and 25-(OH)-D detections were routinely performed after hospital admission. They were divided into simple type 2 diabetes group (n=51) and CAS group (n=59) according to the results of carotid artery intima-media thickness (CIMT) examination. The levels of PTH, 25-(OH)-D, blood glucose indexes fasting blood glucose (FBG), glycated hemoglobin (HbA1c)and blood lipids indexes total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)were compared between the two groups, and the relationships of serum PTH and 25-(OH)-D with blood glucose and lipid metabolism were analyzed.
Results There were no significant differences in gender, age, body mass index and course of disease between the two groups (P > 0.05); the level of serum PTH in the CAS group was significantly higher than that in the simple type 2 diabetes group, while the level of 25-(OH)-D was significantly lower than that in the simple type 2 diabetes group (P < 0.05); the levels of FBG and HbA1c in the CAS group were significantly higher than those in the simple type 2 diabetes group (P < 0.05); levels of TC, TG and LDL-C in the CAS group were significantly higher than those in the simple type 2 diabetes group, while the HDL-C was significantly lower than that in the simple type 2 diabetes group (P < 0.05). The results of bivariate Pearson linear correlation test showed that serum PTH was positively correlated with FBG, HbA1c, TC and TG (P < 0.05), and negatively correlated with HDL-C in patients with type 2 diabetes complicated with CAS (P < 0.05). 25-(OH)-D was negatively correlated with HbA1c, TC and TG (P < 0.01), and positively correlated with HDL-C (P < 0.05).
Conclusion Serum PTH and 25-(OH)-D levels in type 2 diabetes mellitus patients with CAS are closely related to glucose and lipid metabolism.

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