2 型糖尿病患者血清维生素 D 与糖尿病肾病风险之间的关系

Yujie Wang, Chenggang Hu, Ying Li, Qi Liu, Lichao Gao, Dongmei Zhang, Ling Cao
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摘要

这项横断面研究评估了来自美国国家健康与营养调查(NHANES)数据集的4570名T2DM患者。这项横断面研究对来自美国国家健康与营养调查(NHANES)数据集的 4570 名 T2DM 患者进行了评估,并利用限制性三次样条来检验 T2DM 患者血清维生素 D 水平与 DKD 风险之间的剂量-反应关系。血清维生素 D 浓度被分为四等分,用于多变量逻辑回归分析,以评估不同血清维生素 D 水平与 T2DM 患者 DKD 风险之间的关系。此外,还进行了性别分层分析,以确定结果的一致性。采用 Cox 回归模型评估了维生素 D 浓度对死亡风险的影响。限制立方样条图显示,维生素 D 水平与 DKD 风险之间呈 U 型关系,在中间范围具有保护作用,表明最佳血清维生素 D 浓度在 59.6 nmol/L 至 84.3 nmol/L 之间。多变量 Cox 回归分析表明,VID 水平越高,死亡风险越低,尤其是男性患者。公共卫生战略应强调定期监测维生素 D 水平,尤其是在高危人群中,以缓解 DKD 的进展并降低相关死亡率。
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Association between serum vitamin D and the risk of diabetic kidney disease in patients with type 2 diabetes
This investigation explored the potential correlation between serum vitamin D concentration and diabetic kidney disease (DKD) among patients with type 2 diabetes mellitus (T2DM).This cross-sectional study assessed 4,570 patients with T2DM drawn from the National Health and Nutrition Examination Survey (NHANES) dataset. Restricted cubic splines were utilized to examine the dose–response relationship between serum vitamin D levels and the risk of DKD in patients with T2DM. Serum vitamin D concentrations were divided into quartiles for multivariable logistic regression analysis to evaluate the association between varying serum vitamin D levels and DKD risk in patients with T2DM. Additionally, sex-stratified analyses were conducted to determine consistency of the results. The influence of vitamin D concentrations on mortality risk was assessed using a Cox regression model.Of the patients with T2DM, 33% were diagnosed with DKD. Restricted cubic spline plots revealed a U-shaped relationship between vitamin D levels and DKD risk, with a protective effect noted in the mid-range, indicating optimal serum vitamin D concentrations between 59.6 nmol/L and 84.3 nmol/L. The multivariate Cox regression analysis suggested that higher VID levels were associated with a reduced mortality risk, particularly in male patients.The regulation and monitoring of serum vitamin D levels within an optimal range may play a pivotal role in the prevention of DKD in patients with T2DM. Public health strategies should emphasize the regular monitoring of vitamin D levels, especially among populations at elevated risk, to mitigate the progression of DKD and decrease the associated mortality rates.
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