65岁以上老年人血清25-羟维生素D水平与代谢综合征的相关性分析

目的分析65岁以上患者血清25-羟维生素D水平同代谢综合征（MS）之间的关系。 方法选取2016年6月至2017年6月期间的164例65岁以上体检人员进行研究，根据MS诊断标准分为MS组（64例）和非MS组（100例），对比两组患者的骨生化指标；根据血清25-羟维生素D水平是否<51 nmol/L分为缺乏组（148例）和非缺乏组（16例），对两组患者糖尿病病程、高血压病程、高脂血症病程、空腹血糖、收缩压、舒张压、体质量指数（BMI）、甘油三酯、总胆固醇、低密度脂蛋白胆固醇（LDL-C）以及高密度脂蛋白胆固醇（HDL-C）进行比较；对所有患者25-羟维生素D水平与上述代谢指标的相关性进行Pearson相关分析。 结果MS组患者25-羟维生素D平均水平显著低于非MS组患者（31 ± 7）mmol/L vs.（35 ± 9）mmol/L，t= 2.741，P= 0.007]，而骨特异性碱性磷酸酶、血清钙和血清磷水平间的比较差异均无统计学意义（P均>0.05）。缺乏组患者高血压病程长于非缺乏组（13.0 ± 3.7）年vs.（8.5 ± 2.2）年，t= 8.654，P<0.001]，且空腹血糖（5.7 ± 0.8）mmol/L vs.（5.2 ± 0.6）mmol/L，t= 6.764，P= 0.011]和甘油三酯水平（1.6 ± 0.6）mmol/L vs.（1.0 ± 0.4）mmol/L，t= 1.608，P<0.001]均高于非缺乏组，而高脂血症病程（1.58 ± 0.24）年vs.（1.97 ± 0.37）年，t= 2.452，P<0.001]短于非缺乏组。两组患者糖尿病病程、收缩压、舒张压、BMI、总胆固醇、LDL-C及HDL-C比较，差异均无统计学意义（P均>0.05）。相关性分析显示，25-羟维生素D水平与高血压病程（r=-0.102，P= 0.031）、空腹血糖（r=-0.125，P= 0.028）、甘油三酯（r= -0.139，P= 0.038）呈负相关，与HDL-C呈正相关（r= 0.175，P= 0.024）。 结论25-羟维生素D水平与个体BMI水平无关，与糖代谢、甘油三酯代谢有关。补充外源性维生素D可能改善MS患者的糖脂代谢。

Relationship between serum 25-hydroxyvitamin D and metabolic syndrome in patients aged over 65 years

ObjectiveTo investigate the relationship between 25-hydroxyvitamin D and metabolic syndrome (MS) in patients aged over 65 years. MethodsA total of 164 patients aged over 65 years from June 2016 to June 2017 were divided into the MS group (64 cases) and non-MS group (100 cases) according to the diagnostic criteria of MS. The bone biochemical markers in the two groups were detected and compared. Meanwhile, all patients were divided into the deficiency group (148 cases) and non deficiency group (16 cases) according to 25- hydroxyvitamin D levels (<51 nmol/ L). The duration of diabetes, hypertension and hyperlipidemia, and the levels of fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index (BMI), triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected. The relationship between 25-hydroxyvitamin D levels and above indexes were analyzed by Pearson correlation analysis. ResultsThe level of 25-hydroxyvitamin D was much lower in the MS group than in the non-MS group (31 ± 7) mmol/L vs. (35 ± 9) mmol/L, t= 2.741, P= 0.007]. The levels of bone alkaline phosphates, serum calcium and serum phosphate showed no significant differences between the two groups (all P>0.05). Compared to the non deficiency group, the duration of hypertension was longer (13.0 ± 3.7) years vs. (8.5 ± 2.2) years, t= 8.654, P<0.001], the levels of fasting blood glucose (5.7 ± 0.8) mmol/L vs. (5.2 ± 0.6) mmol/L, t= 6.764, P= 0.011] and triglyceride (1.6 ± 0.6) mmol/L vs. (1.0 ± 0.4) mmol/L, t= 1.608, P<0.001] were much higher, and the duration of hyperlipidemia was shorter (1.58 ± 0.24) years vs. (1.97 ± 0.37) years, t= 2.452, P<0.001] in the deficiency group. However, the duration of diabetes, systolic blood pressure, diastolic blood pressure, BMI, total cholesterol, LDL-C and HDL-C all showed no significant differences between two groups (all P>0.05). Pearson correlation analysis showed that 25-hydroxyvitamin D levels were negatively correlated with the duration of hypertension (r=-0.102, P= 0.031), fasting blood glucose (r=-0.125, P= 0.028) and triglyceride (r=-0.139, P= 0.038), and positively correlated with HDL-C (r= 0.175, P= 0.024). ConclusionsThe levels of serum 25-hydroxyvitamin D is independent of BMI, and related to glucose metabolism and triglyceride metabolism in patients aged over 65 years. Supplementation of exogenous vitamin D may improve glucose and triglyceride metabolism in MS patients..