目的：分析上海地区部分中老年糖尿病患者血矿物质水平变化。方法：收集2016年1月1日至2016年11月30日至上海交通大学医学院附属瑞金医院中老年门诊体检的1 100名体检者,将其中2型糖尿病患者264例纳入糖尿病组,另836名非糖尿病体检对象作为非糖尿病对照组。所有观察对象均检测了血矿物质含量（钙、镁）及糖化血红蛋白（hemoglobin A1c,HbA1c）,分析糖尿病组与非糖尿病组间的矿物质水平变化情况;糖尿病患者进一步以HbA1c≥7.0%为切点,分为血糖控制达标组（HbA1c<7.0%,192例）与未达标组（HbA1c≥7.0%,72例）,进行亚组分析,并观察HbA1c与体内矿物质间的相关性。结果：与非糖尿病组相比,糖尿病组血钙水平较高[（2.36±0.14） mmol/L比（2.35±0.10） mmol/L],血镁水平较低[（0.85±0.07） mmol/L比（0.89±0.06） mmol/L],差异均有统计学意义 (P<0.05,P<0.01)。以HbA1c≥7.0%为切点,糖尿病患者中,血糖控制达标组及未达标组之间的血钙、血镁水平差异均有统计学意义[分别为（2.35±0.14） mmol/L比（2.40±0.11） mmol/L、（0.87±0.07） mmol/L比（0.83±0.07） mmol/L;P均<0.01]。线性相关分析显示,所有研究对象的HbA1c与血钙水平呈正相关,与血镁水平呈负相关（r=0.074,P<0.05;r=-0.120,P<0.01）。结论：与非糖尿病者相比,糖尿病患者体内的血镁水平偏低,血钙水平偏高;与血糖控制达标的糖尿病患者相比,血糖控制未达标的糖尿病患者体内血镁水平偏低,血钙水平偏高。上海部分中老年居民血HbA1c水平与血钙正相关,与血镁水平呈负相关。
Objective: To investigate the changes in mineral levels in middle aged and elderly patients with diabetes mellitus in Shanghai. Methods: A total of 1 100 middle aged and elderly subjects undergone health examination during January 2016 to November 2016 were enrolled. Of these subjects, 264 were diabetes and 836 were non-diabetes. All the subjects were tested for minerals(calcium, magnesium) and glycosylated hemoglobin(HbA1c), and the mineral levels between diabetic and non-diabetic groups were compared. According to the level of glycosylated hemoglobin(HbA1c) <7.0 or ≥7.0, subjects with type 2 diabetes mellitus were further divided into 2 groups: well-controlled group and poor-controlled group. The correlations of HbA1c with mineral levels were examined. Results: Compared with non-diabetes, diabetic patients had a higher serum calcium level and lower magnesium level (P<0.01 or P<0.05). Patients with HbA1c ≥7 had higher level of calcium and lower level of magnesium than patients with HbA1c<7.0 (P<0.01 or P<0.05). Linear correlation analysis showed that level of HbA1c was positively correlated with serum calcium level (r=0.074, P=0.015) and negatively correlated with serum magnesium level(r=-0.120, P<0.01). Conclusions: Compared with non-diabetes, patients with diabetes have lower level of serum magnesium and higher level of serum calcium. Poor-controlled diabetic patients have lower level of serum magnesium and higher level of serum calcium than well-controlled diabetic patients. Glycosylated hemoglobin is positively correlated with serum calcium while negatively correlated with serum magnesium.
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