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中国临床药理学与治疗学 ›› 2023, Vol. 28 ›› Issue (6): 641-652.doi: 10.12092/j.issn.1009-2501.2023.06.006

• 临床药理学 • 上一篇    下一篇

基线血清25-羟维生素D3水平与代谢综合征发病风险的前瞻性队列研究

谢晶晶1,尹鸿涛2,刘进进2,孙蔚明2,甄东户1,2
  

  1. 1兰州大学第一临床医学院,2兰州大学第一医院内分泌科,兰州 730000,甘肃
  • 收稿日期:2023-02-14 修回日期:2023-04-25 出版日期:2023-06-26 发布日期:2023-07-12
  • 通讯作者: 甄东户,女,博士,主任医师,硕士生导师,研究方向:内分泌与代谢性疾病。 E-mail: zhdh8279@163.com
  • 作者简介:谢晶晶,女,硕士研究生,研究方向:内分泌与代谢性疾病。 E-mail: xjj74562798@163.com
  • 基金资助:
    甘肃省自然科学基金(21JR1RA096,21JR1RA116);上海市医药卫生发展基金会糖尿病临床研究项目(I期10研究);国家标准化代谢性疾病管理中心专项研究基金(2018-mmczxjj-3);兰州大学第一医院院内基金项目(ldyyyn2015-22);医学院校硕士研究生学位论文质量提升策略研究(lzuyxcx-2022-112;820809036)

Baseline serum 25-hydroxyvitamin D3 levels and risk of metabolic syndrome: a prospective cohort study

XIE Jingjing1, YIN Hongtao2, LIU Jinjin2, SUN Weiming2, ZHEN Donghu1,2   

  1. 1First Clinical Medical College, Lanzhou University; 2 Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730000, Gansu, China
  • Received:2023-02-14 Revised:2023-04-25 Online:2023-06-26 Published:2023-07-12

摘要:

目的:探讨兰州市中老年人基线血清25-羟维生素D3[25-hydroxyvitamin D3,25-(OH)D3]水平与代谢综合征(metabolic syndrome,MS)发病风险的相关性。方法:于2011年选取兰州市3个社区非MS人群2 754人建立队列研究人群,于2014年进行了平均3.1年的随访,对2次调查资料完整的2 309例对象进行研究。根据25-(OH)D3四分位数水平将基线人群分为Quartile1(Q1)、Quartile2(Q2)、Quartile3(Q3)、Quartile4(Q4)组。比较不同25-(OH)D3水平MS的发病情况,分析25-(OH)D3与MS之间的相关性。结果:随着基线血清25-(OH)D3水平升高,MS患病率降低(P<0.05);基线血清25-(OH)D3水平与腰围(waist circumference,WC)、甘油三酯(triglyceride,TG)、空腹血糖(fasting plasma glucose,FPG)、OGTT-2 h后血糖(2 h-postprandial plasma glucose,2 h-PG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、收缩压(systolic blood pressure,SBP)呈负相关(P均<0.01);Logistic回归分析显示:基线血清25-(OH)D3水平是WC、TG、FPG增加及MS发生的独立保护因素(P均<0.05)。平均随访3.1年后,共有341人发展为MS(14.8%);Cox回归分析显示:基线血清25-(OH)D3水平与随访后发生异常高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及2 h-PG的风险相关(P<0.05)。结论:在甘肃兰州市中老年人群中,基线血清25-(OH)D3水平是WC、TG、FPG增加及MS发生的独立保护因素,随访后发现较低的血清25-(OH)D3水平与HDL-C水平降低的发生风险相关,尚未发现基线血清25-(OH)D3水平的高低与MS及其他组分的发生风险相关。

关键词:  25-羟维生素D3, 代谢综合征, 前瞻性队列研究

Abstract:

AIM: To investigate the association between baseline serum 25-(OH)D3 level and the risk of metabolic syndrome in middle-aged and elderly people in Lanzhou. METHODS: A total of 2 754 non-MS people were selected from three communities in Lanzhou in 2011 to establish a cohort study population, In 2014, 2 309 subjects with complete data from two surveys were followed up for an average of 3.1 years. According to the quartile level of 25-(OH)D3, the baseline population was divided into Q1, Q2, Q3 and Q4 groups. The incidence of MS at different levels of 25-(OH)D3 was compared, and the correlation between 25-(OH)D3 and MS was analyzed. RESULTS: With the increase of baseline serum 25-(OH)D3 level, the prevalence of MS decreased (P<0.05). Baseline serum 25-(OH)D3 level was negatively correlated with WC, TG, FPG, 2h-PG, HbA1c and SBP (P<0.01).Logistic regression analysis showed that baseline serum 25-(OH)D3 level is an independent protective factor for the increase of WC, TG, FPG and MS (P<0.05). After an average follow-up of 3.1 years, a total of 341 patients developed MS (14.8%). Cox regression analysis showed that baseline serum 25-(OH)D3 level was correlated with the risk of abnormal HDL-C and 2 h-PG after follow-up (P<0.05). CONCLUSION: In the middle-aged and elderly population in Lanzhou, Gansu Province, baseline serum 25-(OH)D3 level is an independent protective factor for the increase of WC, TG, FPG and MS, the lower serum 25-(OH)D3 level is associated with the risk of decreased HDL-C level after follow-up. It has not been found that the baseline serum 25-(OH)D3 level is associated with the risk of MS and other components.

Key words: 25-hydroxyvitamin D3, metabolic syndrome, prospective cohort study

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