摘要目的 探讨肥胖人群中血清25-羟维生素D3[25-hydroxyvitamin D3,25-(OH)D3]与其相关代谢指标的关系.方法 收集2016年12月至2018年3月在江苏省人民医院减重门诊就诊的肥胖患者239例,其中男性109例,女性130例,检测其25-(OH)D3水平,分析其与肥胖、糖代谢、脂代谢指标的关系.结果 所有研究人群身体质量指数(body mass index,BMI)平均为(38.57±8.10)kg/m2,25-(OH)D3水平平均为(40.53±17.05)nmol/L.男性BMI显著高于女性,差异有统计学意义(t=3.308,P=0.001).男女之间25-(OH)D3水平无显著性差异.随BMI的增高,25-(OH)D3水平均呈下降趋势,差异有统计学意义(χ2=10.066,P<0.05).在25-(OH)D3缺乏组中单纯性肥胖的患病率显著低于25-(OH)D3不足组,差异有统计学意义(χ2=6.121,P<0.05).尽管25-(OH)D3缺乏组的高血压、2型糖尿病、高尿酸血症、高胰岛素血症的患病率高于25-(OH)D3不足组,但差异无统计学意义.Pearson相关性分析显示,25-(OH)D3与BMI(r=-0.197)、C-肽(C-peptide,C-P)(r=-0.134)呈负相关,与年龄呈正相关(r=0.168).以25-(OH)D3为应变量,其他各项指标为自变量,进行多元线性回归分析,年龄、BMI、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)与25-(OH)D3独立相关,β值分别为0.157、-0.164、0.513、-0.473.结论 肥胖及相关代谢异常与25-(OH)D3下降密切相关,肥胖者易发生25-(OH)D3水平下降,而25-(OH)D3下降又会导致肥胖、高血压等代谢异常.

abstractsObjective To investigate the correlation between serum 25-hydroxyvitamin D3 [25-hydroxyvitamin D3,25-(OH)D3]and its related metabolic indicators in obese people. Methods From Decem-ber 2016 to March 2018,239 obese patients,including 109 males and 130 females,were collected from the weight reduction clinic in Jiangsu Province Hospital. Their serum 25 -(OH)D3 levels were measured,and their relationships with obesity,sugar metabolism and lipid metabolism indexes were analyzed. Result The average of body mass index (BMI)and 25 -(OH)D3 were (38. 57 ± 8. 10)kg/ m2 and (40. 53 ± 17. 05)nmol/ L,re-spectively. The BMI of men was significantly higher than that of women(t = 3. 308,P = 0. 001). There was no significant difference in the level of 25-(OH)D3 between men and women. With the increase of BMI,the level of 25-(OH)D3 showed a significantly downward trend(χ2 = 10. 066,P < 0. 05). The prevalence of simple obe-sity in the 25 - (OH)D3 deficiency group was significantly lower than that in the 25-(OH)D3 insufficient group(χ2 = 6. 121,P < 0. 05). Compared with the insufficient group,the hypertension,type 2 diabetes,hyperuri-cemia and hyperinsulinemia were higher in 25-(OH)D3 deficiency group,but no significant difference has been found. Pearson correlation analysis showed that 25-(OH)D3 was negatively correlated with BMI(r = - 0. 197 ) and C-peptide(C-P)(r = - 0. 134),and it positively correlated with age(r = 0. 168)(P < 0. 05 ). Taking 25-(OH)D3 as dependent variable and other indexes as independent variables,multiple linear regression analy-sis was performed. Age,BMI,total cholesterol (TC),low density lipoprotein cholesterol (LDL-C)were inde-pendently correlated with 25-(OH)D3(β values were 0. 157,- 0. 164,0. 513,and - 0. 473 respectively). Conclusion Obesity and related metabolic abnormalities are closely related to the decline of 25-(OH)D3. The level of 25-(OH)D3 usually decreased in obese people,and the decline of 25-(OH)D3 will lead to meta-bolic abnormalities such as obesity and hypertension.