广西医学2025，Vol.47Issue(5)：679-685,7.DOI:10.11675/j.issn.0253-4304.2025.05.07
血清25-羟维生素D3水平和骨密度与中老年2型糖尿病患者并发糖尿病足溃疡的相关性
Correlation of serum 25-hydroxy vitamin D3 level and bone mineral density with concomitant diabetic foot ulcers in middle-aged and elderly patients with type 2 diabetes mellitus
摘要
Abstract
Objective To investigate the correlation of serum 25-hydroxy vitamin D3[25(OH)D3]level and bone mineral density with concomitant diabetic foot ulcers(DFU)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 240 hospitalized T2DM patients were enrolled,including 120 cases with concomitant DFU(the DFU group)and 120 cases without concomitant DFU(the T2DM group).The DFU group was further divided into mild DFU(Wagner grade 1-2,n=60)or severe DFU(Wagner grade 3-5,n=60)according to Wagner grade.General data were compared between various groups.The Logistic regression model was used to analyze influencing factors for concomitant DFU in middle-aged and elderly patients with T2DM.The receiver operating characteristic(ROC)curve and decision curve were adopted to analyze the predictive value and net income ratio of serum 25(OH)D3 level and bone mineral density for concomitant DFU in middle-age and elderly patients with T2DM.The distribution of vitamin D nutritional level and bone mass status was compared between DFU various groups.The Spearman correlation was used to analyze the correlation of serum 25(OH)D3 level and bone mineral density with Wagner grade.Results Compared with the T2DM group,the DFU group exhibited longer diabetes duration,and higher levels of fasting blood glucose,HbA1c,and lipoprotein a,whereas lower diastolic blood pressure,body mass index,bone mineral density,and lower levels of serum 25(OH)D3,total bile acids,total protein,serum albumin,ALT,AST,uric acid,total cholesterol,triglyceride,HDL-C,LDL-C,and very-low-density lipoprotein cholesterol(P<0.05).The multivariate Logistic regression analysis revealed that serum 25(OH)D3 level and bone mineral density were the influencing factors for concomitant DFU in middle-aged and elderly patients with T2DM(P<0.05).ROC curve analysis indicated that areas under the curve(AUC)of serum 25(OH)D3 level and bone mineral density for predicting middle-aged and elderly patients with T2DM and concomitant DFU were 0.725 and 0.698,respectively(P<0.05),with sensitivities and specificities of 45.0%,78.3%and 88.3%,52.5%,respectively.AUC of the combined prediction of the two mentioned as above for predicting middle-aged and elderly patients with T2DM and concomitant DFU was 0.775(P<0.05),with sensitivity and specificity of 72.5%and 74.2%,respectively,demonstrating superior predictive performance and overall net income over individual indicators.The severe DFU group yielded lower serum 25(OH)D3 level and bone mineral density,higher proportions of vitamin D deficiency,and of osteoporosis as compared with the mild DFU group(P<0.05).The results of Spearman correlation analysis indicated that serum 25(OH)D3 level and bone mineral density negatively correlated with Wagner grade(P<0.05).Conclusion Serum 25(OH)D3 level and bone mineral density are influencing factors for concomitant DFU in middle-aged and elderly T2DM patients,and negatively correlate with Wagner grade of DFU.The combination of the two mentioned as above exerts superior predictive performance on concomitant DFU in middle-aged and elderly patients with T2DM.关键词
2型糖尿病/糖尿病足溃疡/25-羟维生素D3/骨密度/中老年人Key words
Type 2 diabetes mellitus/Diabetic foot ulcers/25-Hydroxy vitamin D3/Bone mineral density/Middle-aged and elderly people分类
医药卫生引用本文复制引用
黄丽娜,岑妮秒,向玥腴,刘艺,吴标良..血清25-羟维生素D3水平和骨密度与中老年2型糖尿病患者并发糖尿病足溃疡的相关性[J].广西医学,2025,47(5):679-685,7.基金项目
国家自然科学基金(81960875) （81960875）
广西自然科学基金(2023GXNSFDA026008) （2023GXNSFDA026008）
广西医疗卫生适宜技术开发与推广应用项目(S2022134) （S2022134）
