天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (4): 415-418.doi: 10.11958/20171386

• 临床研究 • 上一篇    下一篇

2型糖尿病患者体质量指数与甲状旁腺素、 25羟维生素D的相关性研究

李艳 1，刘佳 2，王广 2△   

  1. 作者单位：1北京市第二医院综合内科（邮编100031）；2首都医科大学附属北京朝阳医院内分泌科 作者简介：李艳（1979），女，学士，主治医师，主要从事内分泌及代谢及疾病临床和研究工作 △通讯作者 E-mail: drwg6688@aliyun.com
  • 收稿日期:2017-12-04 修回日期:2018-02-09 出版日期:2018-04-15 发布日期:2018-04-15
  • 通讯作者: 李艳 E-mail:liydoctor@163.com

The correlation between body mass index, parathyroid hormone and 25-hydroxyvitamin D in patients with type 2 diabetes

LI Yan1, LIU Jia2, WANG Guang2△   

  1. 1 Department of Internal Medicine, the Second Hospital of Beijing, Beijing 100031, China; 2 Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University △Corresponding Author E-mail: drwg6688@aliyun.com
  • Received:2017-12-04 Revised:2018-02-09 Published:2018-04-15 Online:2018-04-15

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摘要： 摘要：目的 探讨 2 型糖尿病（T2DM）患者体质量指数（BMI）与甲状旁腺素（PTH）、25 羟维生素 D［25（OH）D］的 相关性。方法 收集首都医科大学附属北京朝阳医院内分泌科住院治疗的 2 型糖尿病患者 110 例，BMI 在 18.5～ 23.9 kg/m2患者作为正常体质量组（n=24），BMI 在 24.0～27.9 kg/m2患者作为超重组（n=47），BMI≥28.0 kg/m2患者作为 肥胖组（n=39）。记录患者年龄、性别、吸烟史、BMI、腹围和臀围。采集清晨空腹外周血，通过全自动生物化学分析仪 检测总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、血清白蛋白 （ALB）、尿素氮（BUN）、血肌酐（Cr）、血清钙（Ca2+）、血清磷（P）、游离脂肪酸（FFA）、空腹血糖（FPG）和空腹胰岛素 （FINS）。高效液相色谱法测定糖化血红蛋白（HbA1c）。采用乳胶增强免疫透射比浊法测定超敏 C 反应蛋白（hs CRP）。采用免疫化学发光法测定 PTH、25（OH）D。计算稳态模型胰岛素抵抗指数（HOMA-IR）。利用简化肾脏病膳 食改善公式（MDRD）估算肾小球滤过率（eGFR）。比较 3 组间 PTH、25（OH）D 及各指标的差异，多重线性逐步回归 分析 BMI 与 PTH、25（OH）D 等指标的相关性。结果 与正常体质量组比较，超重组的腹围、臀围、FINS 明显升高 （P＜0.05）；肥胖组的腹围、臀围、PTH、FINS、HOMA-IR 明显升高（P＜0.05）。与超重组比较，肥胖组的腹围、臀围、 hs-CRP、PTH 明显升高（P＜0.05）。多元线性逐步回归分析结果提示，BMI 与臀围（β=0.293）、腹围（β=0.060）、FINS （β=0.026）、PTH（β=0.019）呈正相关（P＜0.05）。结论 T2DM 患者 BMI 与 PTH 密切相关，与 25（OH）D 无关。

关键词: 糖尿病, 2 型, 人体质量指数, 甲状旁腺素, 25 羟维生素 D

Abstract: Abstract: Objective To explore the correlation between body mass index (BMI), parathyroid hormone (PTH) and 25- hydroxyvitamin D [25(OH)D] in patients with type 2 diabetes mellitus (T2DM). Methods A total of 110 patients with T2DM were selected in Beijing Chaoyang Hospital. According to the BMI level, patients were divided into normal weight group (BMI 18.5-23.9 kg/m2, n=24), overweight group (BMI 24.0-27.9 kg/m2, n=47) and obesity group (BMI≥28.0 kg/m2, n=39). Data of age, gender, smoking history, BMI, abdominal circumference and hip circumference were recorded in three groups of patients. Fasting peripheral blood samples were collected in early morning, and serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), serum albumin (ALB), urea nitrogen (BUN), serum creatinine (Cr), serum calcium (Ca2+ ), serum phosphorus (P), free fatty acids (FFA), fasting blood glucose (FPG) and fasting insulin (FINS) were detected by automatic biochemical analyzer. The glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. The high sensitivity C-reactive protein (hs CRP) was detected by latex enhanced immunoturbidimetric method. The PTH and 25(OH)D were detected by immunochemical method. The homeostasis model assessment-insulin resistance (HOMA-IR) index was calculated. The estimated glomerular filtration rate (eGFR) was calculated according to the modification of diet in renal disease (MDRD) formula. The levels of PTH, 25(OH)D and other indicators were compared between three groups. The correlation of BMI and other indicators were analyzed by multiple linear stepwise regression. Results The abdominal circumference, hip circumference and FINS were significantly higher in overweight group than those in normal weight group (P＜0.05). The abdominal circumference, hip circumference, PTH, FINS and HOMA-IR were significantly higher in obesity group than those in normal weight group (P＜0.05). Compared with overweight group, abdominal circumference, hip circumference, hs CRP and PTH were significantly higher in obesity group (P＜0.05). Multiple linear stepwise regression analysis showed that BMI was positively correlated with hip circumference (β=0.293), abdominal circumference (β=0.060), FINS (β=0.026) and PTH (β=0.019). Conclusion There is a significant association between higher BMI and PTH in patients with T2DM, but the relationship with 25(OH)D remains to be further studied.

Key words: diabetes mellitus, type 2, body mass index, arathyroid hormone, 25-hydroxyvitamin D