【摘要】 目的分析中老年人血清维生素D(Vit D)水平与代谢综合征(MS)的相关性,探讨Vit D在MS发病中的作用。方法选取2014年7月—2016年2月在安徽省铜陵市人民医院住院和门诊就诊的中老年(年龄45岁及以上)MS患者519例为MS组。另外选取2015年10—12月年龄45岁及以上无MS的社区体检人员510例为对照组。测定身高、体质量、血压[收缩压(SBP)、舒张压(DBP)];检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B100(Apo-B100)、脂蛋白a[Lp(a)]、非酯化脂肪酸(FFA)、同型半胱氨酸(HCY)、血钙、血磷、Vit D、甲状旁腺激素(PTH)及空腹胰岛素(FINS);计算BMI、稳态模式评估胰岛素抵抗指数(HOMA-IR)、钙磷乘积。结果两组性别、年龄、身高、体质量、BMI、TC、TG、HDL-C、LDL-C、FFA、血钙、血磷、钙磷乘积比较,差异无统计学意义(P>0.05);MS组SBP、DBP、Apo-B100、Lp(a)、HCY、FPG、FINS、HOMA-IR高于对照组,Apo-A1、Vit D、PTH低于对照组,差异有统计学意义(P<0.05)。两组Vit D水平分布比较,差异有统计学意义(P<0.05)。不同Vit D水平的MS患者性别、HOMA-IR、PTH比较,差异有统计学意义(P<0.05);不同Vit D水平的MS患者年龄、身高、体质量、BMI、SBP、DBP、TC、TG、HDL-C、LDL-C、Apo-A1、Apo-B100、LP(a)、FFA、HCY、FPG、FINS、血钙、血磷、钙磷乘积比较,差异无统计学意义(P>0.05)。Vit D与性别、BMI、DBP、Apo-B100、HCY、FPG、HOMA-IR、PTH呈负相关(P<0.05),与SBP、LDL-C呈直线正相关(P<0.05)。结论MS患者常表现为高血压、高血糖、高血脂等代谢紊乱综合征,血清Vit D水平与血压、血糖、胰岛素抵抗等存在相关性,Vit D水平的降低可能是MS发病的机制之一。更多还原

【Abstract】 Objective To explore the role of Vit D in the pathogenesis of metabolic syndrome(MS) by investigating the correlation of serum vitamin D(Vit D) with MS in the middle-aged and elderly.Methods We selected 519 middle-aged and elderly(45 years old or over) outpatients and inpatients with MS treated in Tongling People’ s Hospital,Anhui Province between July 2014 and February 2016 as the MS group,and other age-matched 510 community residents without MS underwent physical examination between October and December 2015 as the control group.The measurement of height,weight,blood pressure [systolic blood pressure(SBP),diastolic blood pressure(DBP) ],fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(Apo-A1),apolipoprotein B100(Apo-B100),lipoprotein a [Lp(a) ],free fatty acids(FFA),Homocysteine(HCY) serum calcium,phosphorus,Vit D,parathyroid hormone(PTH),and fasting insulin(FINS) was performed in all the participants.BMI and homeostasis model assessment of insulin resistance(HOMA-IR) and calcium-phosphorus product were calculated.Results The two groups showed no significant differences in terms of gender,age,height,weight,BMI,TC,TG,HDL-C,LDL-C,FFA,serum calcium and phosphorus,and calcium-phosphorus product(P > 0.05).Compared with the control group,MS group had higher levels of SBP,DBP,Apo-B100,Lp(a),HCY,FPG,FINS and HOMA-IR(P < 0.05) but lower levels of Apo-A1,Vit D and PTH(P < 0.05).The distribution of Vit D levels in the control group was significantly different from that in the MS group(P < 0.05).Gender,levels of HOMA-IR and PTH were obviously associated with the differences in Vit D levels in MS patients(P < 0.05),while age,height,weight,BMI,levels of SBP,DBP,TC,TG,HDL-C,LDL-C,Apo-A1,Apo-B100,LP(a),FFA,HCY,FPG,FINS,calcium,phosphorus,and value of calcium-phosphorus product were not(P > 0.05).Vit D levels decreased with the increased proportion of females,rise of BMI,levels of DBP,Apo-B100,HCY,FPG,HOMA-IR and PTH(P < 0.05),whereas it grew in straight line with the elevation of levels of SBP and LDL-C(P < 0.05).Conclusion MS patients usually have metabolic disorders such as hypertension,hyperglycemia,and hyperlipidemia.Serum Vit D levels are correlated with blood pressure,FPG and insulin resistance.Decreased Vit D levels might play a role in the pathogenesis of MS.更多还原