摘要
目的探讨糖尿病与非糖尿病维持性血液透析(maintenance hemodialysis,MHD)患者体内25-羟-维生素D水平的差异及影响因素。方法纳入四川省肾血液净化中心135例维持性血液透析患者,其中糖尿病41例(糖尿病组),非糖尿病94例(非糖尿病组),收集一般资料,检测血25-羟-维生素D水平、血生化、血常规及甲状旁腺激素(iPTH)。采用脉搏波传导速度及踝肱指数评价血管病变;比较糖尿病与非糖尿病组血25-羟-维生素D水平的差异。以25-羟-维生素D水平小于30ng/ml为降低标准,采用多因素Logistic回归分析法分析维生素D水平下降的影响因素。结果与非糖尿病组相比,糖尿病组患者透析前血肌酐水平较低,25-羟-维生素D水平较低;多元回归分析提示较高的iPTH水平、临床给予维生素D治疗的患者以及糖尿病为维生素D下降的独立危险因素。结论糖尿病维持性透析患者较非糖尿病MHD患者有较高的维生素D不足的风险,应重视该人群维生素D不足的治疗。
Objective To investigate the difference and influent factors of serum levels 25-hydroxy-vitamin D（25-OH-VD）be- tween maintenance hemodialysis patients with diabetics and non-diabetics. Methods One hundred and thirty-five maintenance hemodi- alysis （MHD） patients, in which 41 were diabetics and 94 were non-diabetics, were enrolled. The general information was collected. Se- rum 25-OH-VD, serum biochemistry,whole blood cell count and iPTH were determined. Pulse wave velocity and ankle-brachial index was applied to evaluate vascular disease. Difference in serum 25-OH-VD levels was compared between diabetic and non-diabetic MHD patients,and multiple logistic regressions was applied to study risk factors of Vit D deficiency. Results Serum creatinine and 25-OH- VD was lower in diabetic MHD patients than that in non-diabetic patients. Multiple logistic regressions showed that higher iPTH, patients received vitamin D therapy and diabetes were independently associated with 25-OH-VD deficiency. ConclusiOns Diabetic MHD patients are more likely to have serum 25-OH-VD deficiency than non-diabetic MHD patients. More attention should be paid on treat- ment vitamin D deficiency in these patients.
出处
《实用医院临床杂志》
2013年第4期50-52,共3页
Practical Journal of Clinical Medicine
