矿物质代谢失调：白蛋白校正钙和维生素D与2型糖尿病肾病的关联——一项横断面研究

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

European Journal of Medical Research Pub Date : 2025-10-22 DOI:10.1186/s40001-025-03277-w

Qiong Ma, Xue Li, Lin Liu, Fuqiang Liu, Ying Lv, Junkui Wang, Ting Wang

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引用次数: 0

摘要

背景：钙（Ca）、维生素D和电解质平衡紊乱与糖尿病肾病（DKD）有关，但现有证据仍不一致。此外，在2型糖尿病（T2DM）患者中，白蛋白校正型钙（一种更准确的低白蛋白血症患者生物活性钙的测量方法）的作用仍不明确。我们的目的是在一个大型T2DM队列中研究白蛋白校正钙、维生素D、电解质和DKD之间的关系。方法：在这项横断面研究中，纳入了5550例T2DM患者，其中包括1574例DKD患者。采用多变量回归分析评估白蛋白校正钙、维生素D和DKD之间的关系。进行Spearman相关分析，检查电解质水平、维生素D与肾功能损害指标之间的相关性。结果：与没有DKD的T2DM患者相比，伴有DKD的患者年龄较大，以男性为主，糖尿病病程较长，血压较高，血糖控制较差，糖尿病并发症较多。值得注意的是，DKD患者还表现出明显的电解质失衡，表明矿物质代谢失调。多因素logistic回归显示，白蛋白校正Ca（比值比[OR]: 4.032, 95%可信区间[CI]: 2.017-8.062）， P 2-VitD3（比值比：0.967,95% CI: 0.960-0.974）与T2DM患者DKD显著相关。这些发现表明矿物质代谢参数的潜力，特别是白蛋白校正的钙，可以增强早期发现和风险分层。未来的前瞻性队列研究是建立因果关系和明确其临床治疗指导价值的必要条件。

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Dysregulation of mineral metabolism: association of albumin-corrected calcium and vitamin D with diabetic kidney disease in type 2 diabetes-a cross-sectional study.

Background: Disturbances in calcium (Ca), vitamin D, and electrolyte balance have been implicated in diabetic kidney disease (DKD), yet existing evidence remains inconsistent. Moreover, the role of albumin-corrected Ca-a more accurate measure of biologically active Ca in patients with frequent hypoalbuminemia-remains poorly defined in type 2 diabetes mellitus (T2DM). We aimed to investigate the association between albumin-corrected Ca, vitamin D, electrolytes and DKD in a large T2DM cohort.

Methods: In this cross-sectional study, 5550 T2DM patients were enrolled, including 1574 participants with DKD. Multivariable regression analyses were used to assess the association between albumin-corrected Ca, vitamin D and DKD. Spearman's correlation analyses were conducted to examine the correlation between electrolyte levels, vitamin D and indicators of renal impairment.

Results: Patients with DKD in T2DM were older, predominantly male, with longer diabetes duration, higher blood pressure, poorly glycemic control and more diabetic complications compared to those without DKD. Notably, patients with DKD also showed significant electrolyte imbalances, suggesting dysregulated mineral metabolism. Multivariate logistic regression revealed albumin-corrected Ca (odds ratio [OR]: 4.032, 95% confidence interval [CI]: 2.017-8.062, P < 0.001), 1,25-(OH)₂-VitD₃ (OR: 0.967, 95% CI: 0.960-0.974, P < 0.001) were independently associated with DKD after accounting for confounding factors.

Conclusions: We demonstrated that elevated albumin-corrected Ca and decreased 1,25-(OH)₂-VitD₃ were significantly associated with DKD in T2DM patients. These findings suggest the potential of mineral metabolism parameters, particularly albumin-corrected Ca, to enhance early detection and risk stratification. Future prospective cohort studies are essential to establish a causal relationship and clarify their clinical therapeutic guidance value.

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来源期刊

European Journal of Medical Research 医学-医学：研究与实验

CiteScore

3.20

自引率

0.00%

发文量

247

审稿时长

>12 weeks

期刊介绍： European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.