第一临床医学院知识库

目的:探讨中老年人群维生素D水平与代谢综合征（MS）及其组分的相关性。方法:使用“Reaction”研究甘肃地区的基线资料，选取了符合条件的居民共9760例，提取该人群部分问卷、体格检查、25(OH)D、血糖、血脂四项、肝肾功等生化检查的数据进行分析。按修订的NCEP-ATPIII诊断标准统计MS及其各组分的患病率。将血清25(OH)D水平分为3组：维生素D充足组、维生素D不足组和维生素D缺乏组。运用Pearson相关和二分类Logistic回归分析方法探讨不同维生素D水平与MS之间的关系。

结果:（1）9760例研究对象中，男性2835例（29.05%），女性6925例（70.95%）；平均年龄为（57.97±8.52）岁；MS的患病率为51.3%，男女之间MS患病率无差异（51.0% vs 51.5%，P>0.05）。（2）本调查人群中，25(OH)D的水平为（16.39±6.98）ng/ml；维生素D缺乏者、不足者、充足者所占总人群的比例分别为75.1%、22.7%、2.2%；维生素D缺乏组MS的患病率高于维生素D不足组和充足组（P<0.05）。（3）与非MS组相比，MS组人群25(OH )D的水平偏低（15.88 vs 16.90ng/ml，P<0.05），维生素D缺乏的患病率偏高（77.6% vs 72.4%，P<0.05），随着MS组分数增多，25(OH )D水平呈下降趋势，维生素D缺乏的患病率呈升高趋势。（4）Pearson相关分析显示：血清25(OH)D水平与WC、TG、SBP均呈负相关，相关系数分别为-0.021、-0.049、-0.035（P均<0.05）。（5）Logistic回归分析显示：调整多种混杂因素后，维生素D缺乏与MS的患病风险呈正相关（OR=1.422，P<0.05），与中心性肥胖的患病风险呈正相关（OR=1.424，P<0.05），与高TG血症的患病风险呈正相关（OR=1.369，P<0.05)，此特点在男性人群中表现更为突出。结论:维生素D缺乏可增加MS、中心性肥胖和高TG血症的患病风险。

Objective:To explore the relationship between vitamin D status and metabolic syndrome (MS) and its components among middle-aged and elderly Chinese individuals.
Methods Taking advantage of the baseline data of the "Reaction" study in the Gansu region,We select a total of 9760 eligible residents,Then we extract some data about questionnaires, physical examinations and biochemical tests(including 25-hydroxyvitamin D(25 (OH) D), blood sugar, four items of blood lipid, liver and kidney function, etc.) of them to analyse. the modified US National Cholesterol Education Program Adult Treatment Panel III criteria(NCEP-ATPIII)was used to calculate the prevalence of MS and its components . The vitamin D status was divided into three groups according to the concentration of serum 25(OH)D:vitamin D deficient group,vitamin D insufficient group and vitamin D sufficient group.Pearson correlation analysis and multivariate Logistic regression analysis were used to explore the relationship between vitamin D status and metabolic syndrome.

Results:(1) Among the 9760 subjects, 2835 subjects were male (29.05%) and 6925 subjects were female (70.95%); The mean age of the all subjects was (57.97±8.52) years. The prevalence of MS was 51.3%, and there was no difference between male and female (51.0% vs 51.5%, P>0.05). (2) In the survey population,the mean concentration of 25(OH)D was (16.39±6.98ng/ml); The proportion of vitamin D deficiency, insufficiency and sufficiency were 75.1%, 22.7% and 2.2%, respectively;The prevalence of MS in vitamin D deficient group was higher than that in vitamin D sufficient group and vitamin D insufficient group(P<0.05). (3) Compared with non MS group,the 25(OH)D levels in MS group were lower(15.88 vs 16.90ng/ml, P<0.05), and the prevalence of vitamin D deficiency was higher (77.6% vs 72.4%, P<0.05); with the components of MS increasing, the 25(OH)D levels were decreasing, and the prevalence of vitamin D deficiency was increasing. (4) Pearson correlation analysis showed that: Plasma 25(OH)D levels  was negatively correlated with WC, TG, SBP, and the correlation coefficients were -0.021,-0.049,-0.035,respectively(all P<0.05). (5) Binary Logistic regression analysis showed that:  After adjusting multiple confounding factors,vitamin D deficiency was associated with increased risk of MS (OR=1.422, P<0.05), vitamin D deficiency was associated with increased risk of central obesity (OR=1.424, P<0.05), vitamin D deficiency was associated with increased risk of hypertriglyceridemia(OR=1.369, P<0.05),and this characteristic was more prominent in the male crowd.Conclusions:Vitamin D deficiency can increase the risk of MS,central obesity,and hypertriglyceridemia.