摘要
目的检测糖尿病酮症酸中毒(DKA)患者的血清维生素D水平,并探讨不同维生素D状态DKA患者与血酮体、血糖水平、病情严重程度的相关性。方法按照1∶1∶1比例选取2021年1月至2023年12月于河南宏力医院就诊的60例DKA患者作为DKA组、60例无DKA的糖尿病患者作为糖尿病组、60例无糖尿病人群作为对照组。比较三组受检者的临床特征、血清维生素D水平及不同维生素D状态;比较不同维生素D状态DKA患者的血酮体、血糖水平及病情严重程度;采用Spearman相关性分析不同维生素D状态与DKA患者血酮体、血糖水平的相关性。结果DKA组患者的空腹血糖(FBG)、糖化血红蛋白(HbA1c)分别为(12.12±2.55)mmol/L、(11.36±1.96)%、糖尿病组分别为(9.83±2.12)mmol/L、(9.25±1.79)%,对照组分别为(5.33±0.86)mmol/L、(5.50±0.38)%,DKA组>糖尿病组>对照组,差异均有统计学意义(P<0.05);DKA组、糖尿病组、对照组受检者的维生素D水平分别为14.84(3.00,39.17)ng/mL、18.35(7.20,46.92)ng/mL、21.98(5.72,36.92)ng/mL,DKA组<糖尿病组<对照组,两两比较,差异均有统计学意义(P<0.05);DKA组与糖尿病组、DKA组与对照组生素D状态两两比较差异均有统计学意义(P<0.05),但糖尿病组与对照组比较差异无统计学意义(P>0.05);维生素D严重缺乏患者的血酮体、血糖水平明显高于维生素D充足、不足、缺乏患者,且DKA严重程度高于维生素D充足、不足、缺乏患者,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,维生素D状态与DKA患者的血酮体、血糖、病情严重程度呈负相关(r=-0.625、-0.680,-0.527,P<0.001)。结论DKA患者维生素D水平较低,维生素D缺乏状态较严重,且不同维生素D状态与DKA严重程度密切相关,积极检测维生素D水平对评估DKA患者严重程度具有重要意义。
Objective To detect the serum level of vitamin D in patients with diabetic ketoacidosis(DKA),and investigate the correlation of different vitamin D status with blood ketone body,blood glucose level,and disease severity of DKA patients.Methods According to 1∶1∶1,60 patients with DKA who visited Henan Hongli Hospital from January 2021 to December 2023 were selected as DKA group,60 patients with diabetes without DKA as diabetes group,and 60 non-diabetic population without diabetes as control group.The clinical characteristics of the subjects,serum vitamin D levels,and different vitamin D status were compared among the three groups.The blood ketone body,blood glucose levels,and disease severity of DKA were compared among patients with different vitamin D status.The correlation of different vitamin D status with blood ketone body and blood glucose levels was analyzed by Spearman correlation analysis.Results The fasting blood glucose(FBG)and hemoglobin A1c(HbA1c)in the DKA group were(12.12±2.55)mmol/L and(11.36±1.96)%,respectively,(9.83±2.12)mmol/L and(9.25±1.79)%in the diabetes group,and(5.33±0.86)mmol/L and(5.50±0.38)%in the control group,with the levels decreased successively in DKA group,diabetes group,and control group(P<0.05).The level of vitamin D in DKA group,diabetes group,and control group was 14.84(3.00,39.17)ng/mL,18.35(7.20,46.92)ng/mL,and 21.98(5.72,36.92)ng/mL,respectively,which decreased successively in DKA group,diabetes group,and the control group(P<0.05).Comparison of the vitamin D status among the three groups:there was significant difference between DKA group and diabetes group,DKA group and control group(P<0.05),but there was no significant difference between diabetes group and control group(P>0.05).Blood ketone body,blood glucose levels in DKA patients with severe vitamin D deficiency were significantly higher than those with vita-min D sufficiency,insufficiency,or deficiency,and the severity of DKA was higher than that of patients with vitamin D sufficiency,insufficiency,or deficiency,with statistically significant differences(P<0.05).Spearman correlation analysis showed that the Vitamin D status was negatively correlated with blood ketone bodies,blood glucose,and the se-verity of DKA(r=-0.625,-0.680,-0.527,P<0.001).Conclusion DKA patients have lower levels of vitamin D and se-vere vitamin D deficiency,and different vitamin D status is closely related to the severity of DKA.Actively detecting vi-tamin D levels is of great significance for evaluating the severity of DKA patients.
作者
杨清敏
丁红霞
叶晓晓
YANG Qing-min;DING Hong-xia;YE Xiao-xiao(Department of Endocrinology,Henan Hongli Hospital,Xinxiang 453400,Henan,CHINA;Department of Endocrinology,the First People's Hospital of Pingdingshan City,Pingdingshan 467000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第21期3070-3074,共5页
Hainan Medical Journal
基金
河南省医学科技攻关联合共建项目(编号:LHGJ20223020)。
作者简介
第一作者:杨清敏(1981-),女,副主任医师,主要研究方向为糖尿病,甲状腺疾病,维生素D缺乏等;通讯作者:丁红霞(1980-),女,副主任医师,主要研究方向为糖尿病及其急慢性并发症,矮小,性早熟,维生素D缺乏等,E-mail:pdsdinghongxia@163.com。
