感染新型冠状病毒前后2型糖尿病患者维生素D水平与代谢指标的相关性研究
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国家自然科学基金项目(82104751);国家重点研发计划项目(2018YFC2002503)


Correlation between vitamin D levels and metabolic indicators in patients with type 2 diabetes mellitus before and after infection with the novel coronavirus
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    摘要:

    目的 探讨感染新冠病毒前后2型糖尿病(T2DM)患者维生素D水平与代谢指标的相关性。方法 随机选取2015年12月—2017年9月(未感染COVID-19)及2023年1月—2023年12月(感染过COVID-19)1994 例T2DM住院患者,根据25-羟维生素D[25(OH)D]水平分为25(OH)D水平缺乏组、不足组和充足组。回顾性分析感染COVID-19前后,不同25(OH)D水平的T2DM患者的性别、年龄、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、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)、甘油三脂(TG)、血尿酸(UA)、糖化血红蛋白(HbA1c)、24 h尿蛋白定量(24 h UTP)的差异。结果 感染前,相关分析结果显示,FINS、HOMA-IR、TG、HbA1c和24 h UTP与25(OH)D呈负相关(P<0.05),年龄与25(OH)D呈正相关(P<0.05)。有序多分类Logistic回归分析示,T2DM患者中25(OH)D水平对TG、HbA1c、24 h UTP有影响,其中低水平TG、24 h UTP为25(OH)D保护因素(OR分别为0.991、0.899,均P<0.005),HbA1c增高为危险因素(OR=1.002,P<0.001)。感染后,相关分析结果显示,性别、FINS、FPG、HOMA-IR和24 h UTP与25(OH)D呈负相关(P<0.05);年龄与25(OH)D呈正相关(P<0.05)。有序多分类Logistic回归分析模型结果显示,T2DM患者中25(OH)D水平对年龄、24 h UTP有影响,其中低水平24 h UTP为保护因素(OR=0.999,P<0.001),年龄增加为危险因素(OR=1.023,P<0.001)。结论 感染COVID-19前后,25(OH)D的缺乏与T2DM血糖达标程度均呈负相关。感染前后低水平24 h UTP均是25(OH)D的保护因素,但感染后患者的24 h UTP较未感染患者显著升高

    Abstract:

    Objective To analyze 25(OH)D levels and influencing factors in type 2 diabetic patients before and after COVID-19 infection. Methods A total of 1994 inpatients with T2DM were randomly selected from December 2015 to September 2017(before COVID-19 pandemic) and from January 2023 to December 2023(after COVID-19 pandemic). These inpatients were divided into the 25(OH)D level-deficient group, the 25(OH)D level-insufficient group, and the 25(OH)D level-sufficient group. Based on that, we retrospectively analyzed the differences in gender, age, fasting insulin(FINS), fasting plasma glucose(FPG), homa insulin-resistance(HOMA-IR), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), triglyceride(TG), uric acid(UA), hemoglobin a1c(HbA1c), as well as urine total protein(UTP) in T2DM inpatients with different vitamin D levels before and after infection with the novel coronavirus. Results The results in patients before infection with the novel coronavirus showed that the levels of FINS, HOMA-IR, TG, HbA1c, and UTP were negatively correlated with 25(OH)D levels(P<0.05), but age was positively correlated with 25(OH)D levels(P<0.05). In addition, the multivariate ordered logistic regression analysis indicated that changes of 25(OH)D levels in patients with T2DM could affect the levels of TG, HbA1c, and UTP, where low levels TG and UTP were considered as protective factors(OR=0.991, P<0.001; OR=0.899, P<0.001), but high levels HbA1c were considered a risk factor(OR=1.002, P<0.002). On the other hand, the results in patients after infection with the novel coronavirus showed that the gender, FINS, FPG, HOMA-IR, and UTP were negatively correlated with 25(OH)D levels(P< 0.05). However, age was positively correlated with vitamin D levels(P< 0.05). Besides, the results of the multivariate ordered logistic regression analysis model indicated that the differences in 25(OH)D levels among T2DM patients were influenced by gender, age, and UTP levels, where UTP was considered as protective factors(OR=0.999, P<0.001), but age was considered as a risk factor(OR=1.023, P<0.001).Conclusion Before and after the infection, the deficiency of 25(OH)D is negatively correlated with the degree of blood sugar control in T2DM patients. Low levels of 24hUTP are protective factors for 25(OH)D deficiency, However, the 24-hour urinary total protein(UTP) levels in patients infected with the virus are significantly higher compared to those not infected

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陈玉华,徐健,李楠,等.感染新型冠状病毒前后2型糖尿病患者维生素D水平与代谢指标的相关性研究[J].西部医学,2025,37(10):1456-1460.

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  • 在线发布日期: 2025-10-20
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