·糖尿病视网膜病变·　

　　【摘要】 目的 探讨T2DM患者血清25羟维生素D(25-OH-VitD)水平与DR的关系。 方法 选取T2DM患者509例,根据免散瞳眼底照相机摄片程度将患者分为糖尿病视网膜病变(DR，n=229)组及无糖尿病视网膜病变(NDR，n=280)组。DR组根据视网膜病变程度分为DR1亚组(n=172)和DR2亚组(n=57)，比较各组的临床和生化特征。 结果 DR组糖尿病病程、SBP、BMI、HbA1c、糖化血清蛋白(GA)、UAER均高于NDR组(P<0.05)，血清25-OH-VitD及镁水平低于NDR组(P<0.05)。DR2组年龄、病程、SBP、HbA1c、UAER水平高于DR1组(P<0.05)，血清25-OH-VitD水平低于DR1组(P<0.05)。Spearman相关分析表明，DR与病程、SBP、BMI、HbA1c、GA、LDL-C及UAER呈正相关(P<0.05);与血清25-OH-VitD及镁水平呈负相关(P<0.05)。多元逐步回归分析显示,UAER(β= 0.375，P=0.000)、病程(β=0.049，P=0.000)、血清25-OH-VitD(b=-0.033，P=0.000)、HbA1c(β=0.071，P=0.002)及SBP(β=0.006，P=0.040)是DR的独立危险因素。 结论 血清25-OH-VitD水平降低与DR发生及严重程度相关。

　　【关键词】 25羟维生素D;糖尿病视网膜病变;糖尿病，2型

Low Serum 25-hydroxy vitamin D Level is associated with the retinopathy in Type 2 Diabetic Patients   WU Ping，YIN Jun，LIU Fang，et al. Fengxian District, Shanghai Chinese Medicine Hospital，Shanghai 201400，China

Corresponding author：LIU Fang

　　【Abstract】 Objective To exploreinvestigate the relationship between serum 25-hydroxy vitamin D (25-OH-VitD) level and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods Totally 509 T2DM patients were recruited, and were divided into two groups including DR group(n=229) and NDR group(n=280) according to the fluorescence fundus angiographies. The DR group was assigned to 2 subgroups based on the severity of diabetic retinopathy: DR1 group (n=172) and DR2 group (n=57). Their clinical characteristics and biochemical parameters were compared and the associated factors of DR were analyzed. Results The duration, SBP, BMI, HbA1c,GA, UAER of DR group were significantly higher in DR group than inthose of NDR group (P<0.05), but the levels of serum 25-OH-VitD and magnesium in DR group were significantly lower in DR group than in NDR group (P<0.05). The age, duration, SBP, BMI, HbA1c, UAER of DR2 group were significantly higher in DR2 group than inthose of DR1 group (P<0.05), and the serum 25-OH-VitD level of DR2 group was significantly lower in DR2 group than inthat of DR1 group(P<0.05). Spearman correlation analysis revealed that DR was positively correlated with the level of duration, SBP, BMI, HbA1c,GA,LDL-L, UAER was positively correlated with DR(P<0.05); DR was negatively correlated with the levels of serum 25-OH-VitD and magnesium was negatively correlated with DR(P<0.05). Multiple stepwise regression analysis further revealed that except for 24h urinary albumin (β= 0.375, P=0.000), diabetic duration (β=0.049, P=0.000), HbA1c (β=0.071, P=0.002) and SBP (β=0.006, P=0.040), 25-OH-VitD (b= -0.033, P=0.000) were also an independent risk factors of DR. Conclusion s Low serum 25-OH-Vit hydroxy vitamin D level is associated with the occurrence and severity of diabetic retinopathy.

　　【Key words】 25- hydroxy vitamin D (25-OH-VitD) ;Diabetic, diabetic retinopathy;Diabetes mullitus,retinopathy, type 2