马海萍,何煜暐

随着经济发展，由于人们生活方式、膳食结构及生活环境的改变，糖尿病发病率逐年增加，一跃成为全球公共卫生的严重威胁。糖尿病及其并发症造成了巨大的经济负担以及患者精神和身体残疾，导致患者生活质量差和高死亡率。维生素D作为钙磷代谢调节剂的一种，现已有许多研究结果显示其不仅仅参与骨代谢、肿瘤、自身免疫性疾病等，而且在2型糖尿病及其并发症的发生发展及治疗上同样起到重要的作用。糖尿病大血管病变是T2DM最常见的并发症之一，潘长玉，高妍等发现[1]，由于糖尿病大血管病变发病隐匿，病变初期无症状，一旦出现临床症状，大多患者的血管病变程度较严重，给患者带来病痛的折磨，严重影响生活质量。目前心血管疾病是糖尿病患者致残致死的主要原因，本文就血清25-羟维生素D同2型糖尿病患者大血管病变之间的相关研究进展做一综述。

25-羟维生素D；2型糖尿病；大血管病变

[1] 李莎4.潘长玉,高妍,袁申元,等.2型糖尿病下肢血管病变发生率及相关因素[J].中国糖尿病杂志,2001,9(6):323-332. [2] 王卓,宋威,杨博,等.探讨维牛素D缺乏的2型糖尿病患者血清胆红素､25羟维生素D3水平与胰岛素抵抗的关系[J].检验医学与临床,2022,19(22):3139—3142. [3] 王翠娟,王蕊,尹福在,等.维生素D缺乏的2型糖尿病患者血清胆红素､25羟维牛素D,水平与胰岛素抵抗的关系[J]临床内科杂志,2020,37(4):294—296. [4] 黄靓,陆邦超.血清25羟维生素D､瘦素水平与女性绝经后2型糖尿病患者骨密度的关系[J].中国医药导报,2019,16(29):132-135. [5] ABDERHAL5DEN L A,MEYER S,DAWSON-HUGHES B,et al.Effectof daily 2 000 IU versus 800 IU vitamin D on blood pressure among adultsage 60 years and older:a randomized clinical trial[J].Am J Clin Nutr,2020,112(3):527-537. [6]PITTAS A G,DAWSON-HUGHES B,SHEEHAN P,et al.Vitamin Dsupplementation and prevention of type 2 diabetes[J].N Engl J Med,2019,381(6):520-530. [7] YU C,XUE H L,WANG L Q,et al.Serum bioavailable and free25-hydroxyvitamin D levels,but not its total level,are associated with therisk of mortality in patients with coronary artery disease[J].Circ Res,2018,123(8):996-1007. [8] ATHANASSIOU L,KOSTOGLOU-ATHANASSIOU I,KOUTSILIERISM,et al.Vitamin D and autoimmune rheumatic diseases[J].Biomolecules,2023,13(4):709. [9] SOBHI P,BAHRAMI M,MAHDIZADEH F,et al.Vitamin D andpotential effects on cancers:a review[J].Mol Biol Rep,2024,51(1):190. [10] 马宁,边瓯,闫思蒙,等.血清25-羟基维生素D水平与老年脑小血管病变相关性研究[J].临床军医杂志,2019,47(4):345-347. [11] AltayH,ZorluA,BilgiM,ErolT,Yilmaz MB.Usefulness of parathyroid hormone as a predictor of heart failure with preserved ejection fraction.Biomarkers.2012.17(5):447-54. [12] SnellmanG,MelhusH,GedeborgR,Determining vitaminD status:a comparison between commercially available assays.PLoS One.2010.5(7):e1155. [13] 王卓,宋威,杨博,等.探讨维牛素D缺乏的2型糖尿病患者血清胆红素､25羟维生素D3水平与胰岛素抵抗的关系[J].检验医学与临床,2022,19(22):3139—3142. [14] 王翠娟,王蕊,尹福在,等.维生素D缺乏的2型糖尿病患者血清胆红素､25羟维牛素D,水平与胰岛素抵抗的关系[J]临床内科杂志, 2020,37(4):294—296. [15] 黄靓,陆邦超.血清25羟维生素D､瘦素水平与女性绝经后2型糖尿病患者骨密度的关系[J].中国医药导报,2019,16(29):132-135. [16] Holick MF,Binkley NC,Bischoff-Ferrari HA,et al.Evaluation,treatment,and prevention of vitamin D defificiency:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab,1911,96(7):1911-30. [17] 郁娃林,白剑,王彦涵,等.25-羟维生素D､血清甲状旁腺激素与射血分数减低心力衰竭的相关性分析[J].南京医科大学学报(自然版),2018,38(8):1124-1130. [18] Ford E S,Ajani U A,McGuire L C,et a1.Concentrations of serum vitamin D and the metabolic syndrome among U.S.a-duhs[J].Diabetes Care,2005,28(5):1228-1230. [19] Eekus E,Aktas G,Kocak M.Z,et al.Diabetic regu-lation of subjects with type 2 diabetesmellitus is associated with serum vitamin D levels[J].Rev Assoc Med Bras(1992),2019,65(1):51-55; [20] Lee S,Lee D K,Choi E,et a1.Identif ication ofa functi onal vi-tamin D response element in the murine Insig-2 promoter and its potential role in the differentiation of 3T3一L1 predipocytes[J].Mol Endocrinol,2005,19(2):399-408. [21] Kanikarla‐Marie P,Micinski D,Jain SK.Hyperglycemia(high‐glucose)decreases L‐cysteine and glutathione levels in cultured monocytes and blood of Zucker diabetic rats.Mol Cell Biochem,2019,459(1–2):151‐156. [22] Matuz‐Mares D,Riveros‐Rosas H,Vilchis‐Landeros MM,et al.Glutathione participation in the prevention of cardiovascular diseases. Antioxidants,2021,10(8):1220. [23] Cojic M,Kocic R,Klisic A,et al.The effects of vitamin D supplementation on metabolic and oxidative stress markers in patients with type 2 diabetes:a 6‐month follow up randomized controlled study[J].Front Endocrinol(Lausanne),2021,12:610893. [24] El Askary A,Gharib AF,Almehmadi M,et al.The role of vitamin D deficiency and elevated inflammatory biomarkers as risk factors for the progression of diabetic nephropathy in patients with type 2 diabetes mellitus[J].Open Chemistry,2021,19(1):1174‐1183. [25] Ao T,Kikuta J,Ishii M.The effects of vitamin D on Immune system and inflammatory diseases[J].Biomolecules,2021,11(11):1624. [26] Almeida Moreira Leal LK,Lima LA,Alexandre de Aquino PE,et al.Vitamin D(VD3)antioxidative and anti‐inflammatory activities: Peripheral and central effects[J].Eur J Pharmacol,2020,15(879):173099. [27] Ansari MGA,Sabico S,Clerici M,et al.Vitamin D supplementation is associated with increased glutathione peroxidase‐1 levels in Arab adults with prediabetes[J].Antioxidants(Basel),2020,9(2):118. [28] Zhang C,Wang J,Xie X,et al.Low serum vitamin D concentration is correlated with anemia,microinflammation,and oxidative stress in patients with peritoneal dialysis[J].J Transl Med,2021,19(1):411. [29] Trimarco V,Manzi MV,Mancusi C,et al.Insulin Resistance and Vitamin D Deficiency:A Link Beyond the Appearances[J].Front Cardiovasc Med,2022 Mar 17,9:859793. [30] Hsiao YF,Cheng SB,Lai CY,et al.The prognostic role of glutathione and its related antioxidant enzymes in the recurrence of hepatocellular carcinoma[J].Nutrients,2021,13(11):4071. [31] Pittas A G,Lau J,Hu F B,et a1.The role of vitamin D and cal-cium in type 2 diabetes.A systematic review and meta—analysis[J].J Clin EndocrinolMetab,2007,92(6):2017—2029. [32] 刘仲书,付丽媛,杨进.2型糖尿病大血管病变机制的中西医研究进展[J].世界科学技术-中医药现代化,2015(10):2125-2129. [33] 闫双群,肖乐,薛双亮,等.糖尿病血管病变的分子机制研究进展[J].陕西医学杂志,2014(12):1685-1686. [34] 杨茜,张海雄,韩雪梅,等.2型糖尿病伴大血管病变患者血清高敏C反应蛋白水平变化及意义[J].山东医药,2015(3):18-20. [35] 傅春江,何作云,王旭开,等.胰岛素对SHR血管平滑肌细胞增殖和表型转化的MAPK机制的研究[J].重庆医学,2008,37(6):569-571. [36] 舒珍珍,臧淑妃.糖尿病患者血脂紊乱对大血管病变及胰岛素抵抗的影响[J].中国现代医生,2016,54(07):1-4. [37] 王席.血浆超敏C反应蛋白､血脂检测与2型糖尿病大血管病变的关系[J].中国现代医生,2013,51(32):93-94. [38] 曹清清.血尿酸､血脂检测在2型糖尿病及其并发血管病变中的意义[J].中国伤残医学,2012,20(06):18-19. [39] Jandeleit-Dahm K,Cooper M E.Hypertension and diabetes:role of the rennin-angiotensin system[J].Endocrinol Metab Clin North Am, 2006,35(3):469-490. [40] 罗娜,张真稳,朱妍,等.血清25羟维生素D3水平与2型糖尿病大血管病变的关系研究[J].南京医科大学学报(自然科学版), 2012(7):952-956. [41] 邱凌,王伟,曲毅,等.血浆25-羟维生素D3在2型糖尿病动脉硬化损害中的作用[J].同济大学学报(医学版),2016,37(5):67-70. [42] KALKAN GY,GURM,KOYUNSEVER N Y,et al.Serum 25⁃hydroxyvitamin D level and aortic intima⁃media thick⁃ness inpatients without clinical manifestation of athero⁃sclerotic cardiovascular disease[J].J Clin Lab Anal,2015,29(4):305-311. [43] HIRATA M,SERIZAWA K,AIZAWA K,et al.22⁃oxacal⁃citriol prevents progression of endothelial dysfunction through antioxidative effects in rats with type 2 diabetes and early⁃stage nephropathy[J].Nephrol Dial Transplant,2013,28(5):1166-1174;Oh J,Weng S,Felton S K, et al.1,25(OH)2 vitamin d inhibits foam cell form-ation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus[J].Circulation,2009,120(8):687-698. [44] Shuichi J,Yoshiki N.1,25-Dihydroxyvitamin D3 increases in vitrovascular calcification by modulating secretion of endogenous parathyroid hormone-relate peptide[J].Circulation,1998,98(11):1302-1306. [45] 丁和远,石蕾,盛励,等.2型糖尿病(T2DM)患者血清25羟维生素D[25(OH)D]与振动感觉阈值(VPT)的相关性[J].复旦学报(医学版),2020,47(1):89-92. [46] Pittas A G,Lau J,Hu F B,et a1.The role of vitamin D and cal-cium in type 2 diabetes.A systematic review and meta—analysis[J].J Clin EndocrinolMetab,2007,92(6):2017—2029. [47] 许小红,梁愿.血清25-羟基维牛素D与2型糖尿病代谢性炎性反应综合征的关系[J].吉林医学,2020,41(11):2643-2645.

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