1型糖尿病患者维生素D缺乏与冠状动脉钙化的关系

Vitamin D Deficiency and Coronary Artery Calcification in Subjects With Type 1 Diabetes

1型糖尿病患者维生素D缺乏与冠状动脉钙化的关系
OBJECTIVE The objective of this study is to examine the relationship among serum levels of 25-hydroxyvitamin D (25[OH]D), polymorphisms in vitamin D-associated genes, and the presence and progression of coronary artery calcification (CAC) in adults with type 1 diabetes. 海南医学院附属医院内分泌科王新军

目的  本研究的目的是观察成年1型糖尿病患者中血清25羟维生素D（25[OH]D）水平、维生素D相关基因多态性与冠状动脉钙化（CAC）及其进展的关系。

RESEARCH DESIGN AND METHODS This prospective study included 374 non-Hispanic white individuals with type 1 diabetes (mean age 40 ± 9 years; 46% were male). CAC was measured at the baseline and 3- and 6-year follow-up visits were determined by electron beam computed tomography. Serum 25[OH]D levels were measured by liquid chromatography tandem mass spectrometry at the 3-year visit.

研究设计和方法  本前瞻性研究包括374例患1型糖尿病的非西班牙裔白人（平均年龄40±9岁；46％为男性）。用电子束CT测量基线和随访3年、6年的冠状动脉钙化。用液相色谱串联质谱测定患者随访3年时的血清25[OH] D水平。

RESULTS Normal (>30 ng/mL), insufficient (20?30 ng/mL), and deficient (<20 ng/mL) 25-[OH]D levels were present in 65%, 25%, and 10% of the individuals with type 1 diabetes, respectively. 25[OH]D deficiency was associated with the presence of CAC at the 3-year visit, odds ratio (OR) = 3.3 (95% CI 1.6?7.0), adjusting for age, sex, and hours of daylight. In subjects free of CAC at the 3-year visit, 25[OH]D deficiency predicted the development of CAC over the next 3 years in those with the vitamin D receptor M1T CC genotype (OR = 6.5 [1.1?40.2], P = 0.04) than in those with the CT or TT genotype (OR = 1.6 [0.3?8.6], P = 0.57).

结果  在1型糖尿病患者，25- [OH] D为正常（>30 ng/mL）、不足（20-30 ng/mL）和缺乏（<20 ng/mL）的比例分别为65％，25％和10％。 在3年随访时，25[OH] D缺乏与CAC钙化相关，校正年龄、性别和日照时间后的风险比（OR）=3.3（95％CI为1.6-7.0）。在随访3年没有CAC的患者，25 [OH] D缺乏可预测未来3年维生素D受体M1T CC基因型患者 CAC的发生(OR = 6.5 [1.1?40.2], P = 0.04)，而在基因型为CT或TT的患者则不能(OR = 1.6 [0.3?8.6], P = 0.57)。

CONCLUSIONS Vitamin D deficiency independently predicts prevalence and development of CAC, a marker of coronary artery plaque burden, in individuals with type 1 diabetes.

结论  维生素D缺乏可独立预测1型糖尿病患者中冠状动脉斑块标志物CAC的发生和发展。

Diabetes Care February 2011 34:454-458