基于限制性立方样条分析2型糖尿病患者系统免疫炎症指数与维生素D的关系

doi:10.3969/j.issn.1006-5725.2025.15.015

Abstract

Abstract:

Objective To investigate the correlation between plasma vitamin D levels and a novel inflammatory marker， the systemic immune-inflammatory index （SII）， in patients with type 2 diabetes. Methods This study adopted a cross-sectional design， in which patients diagnosed with type 2 diabetes who were admitted to the First Affiliated Hospital of Guangxi Medical University were enrolled as study participants. Data on demographic characteristics， medical history， physical examination findings， and laboratory test results were systematically collected. Participants were categorized into three groups based on their serum vitamin D levels： deficient， insufficient， and sufficient. The relationship between vitamin D levels and the SII was evaluated using a multivariate linear regression model. Additionally， a restricted cubic spline model was employed to assess the nonlinear dose-response association between vitamin D levels and SII. Results This study enrolled a total of 5，716 patients with type 2 diabetes. A statistically significant difference in the SII was observed across groups with varying vitamin D levels （P < 0.05）， with the highest SII value found in the vitamin D-deficient group. Multivariate linear regression analysis revealed that， after adjusting for potential confounding factors including gender， age， season of blood collection， body mass index， hypertension， dyslipidemia， and chronic kidney disease， vitamin D levels were negatively associated with SII （β = -2.68， 95%CI： -3.56 to -1.81， P < 0.001）. Compared with the vitamin D-deficient group， the vitamin D-sufficient group exhibited significantly lower SII levels （β = -78.42， 95%CI： -137.90 to -18.93， P = 0.01）. Furthermore， the restricted cubic spline model indicated a nonlinear dose-response relationship between vitamin D levels and SII （P < 0.001）. Conclusion There is a significant inverse correlation between plasma vitamin D levels and the SII in patients with type 2 diabetes.

Key words: vitamin D, type 2 diabetes, systemic immune inflammation index, restricted cubic spline

CLC Number:

R589

Min ZHAO,Zhiwen LI,Chenglong HUANG,Xiaoju SHEN,Guangming HUANG. Relationship between systemic immune inflammation index and vitamin D in patients with type 2 diabetes based on restricted cubic spline[J]. The Journal of Practical Medicine, 2025, 41(15): 2393-2397.

Figures/Tables 4

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References 24

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项目	缺乏组（n = 3 082）	不足组（n = 2 130）	充足组（n = 504）	总体（n = 5 716）	P值
年龄（x ± s）/岁	58.98 ± 13.63	59.32 ± 13.22	60.51 ± 12.77	59.24 ± 13.41	0.057
BMI［M（P₂₅，P₇₅）］/（kg/m²）	24.1（21.6，26.7）	24.0（21.8，26.6）	23.9（21.6，25.9）	24.0（21.6，26.6）	0.576
SII［M（P₂₅，P₇₅）］	590.2（384.0，949.6）	510.1（358.6，757.1）	521.4（359.5，765.9）	549.4（371.0，854.8）	< 0.001
25（OH）D［M（P₂₅，P₇₅）］/（nmol/L）	36.7（27.7，43.6）	59.1（54.3，64.8）	83.7（78.3，93.7）	48.1（35.6，60.3）	< 0.001
性别［例（%）］					0.002
男	1 875（60.8）	1 367（64.2）	342（67.9）	3 584（62.7）
女	1 207（39.2）	763（35.8）	162（32.1）	2 132（37.3）
采血季节［例（%）］					< 0.001
春（3 — 5月）	956（31.0）	545（25.6）	121（24.0）	1 622（28.4）
夏（6 — 8月）	775（25.1）	707（33.2）	169（33.5）	1 651（28.9）
秋（9 — 11月）	617（20.0）	534（25.1）	121（24.0）	1 272（22.3）
冬（12 — 2月）	734（23.8）	344（16.2）	93（18.5）	1 171（20.5）
慢性肾脏病/［例（%）］					< 0.001
无	1 965（63.8）	1 714（80.5）	390（77.4）	4 069（71.2）
有	1 117（36.2）	416（19.5）	114（22.6）	1 647（28.8）
血脂异常/［例（%）］					< 0.001
无	2 048（66.5）	1 288（60.5）	375（74.4）	3 711（64.9）
有	1 034（33.5）	842（39.5）	129（25.6）	2 005（35.1）
高血压/［例（%）］					< 0.001
无	1 260（40.9）	1 015（47.7）	270（53.6）	2 545（44.5）
有	1 822（59.1）	1 115（52.3）	234（46.4）	3 171（55.5）

指标		模型1	模型2	模型3
维生素D（连续变量）	β（95%CI）	-4.20（-5.05 ~ -3.35）	-4.26（-5.12 ~ -3.40）	-2.68（-3.56 ~ -1.81）
	P值	< 0.001	< 0.001	< 0.001
维生素D（分组）
缺乏组		参考	参考	参考
不足组	β（95%CI）	-148.54（-183.80 ~ -113.28）	-147.67（-183.22 ~ -112.11）	-93.40（-128.82 ~ -57.95）
	P值	< 0.01	< 0.01	< 0.001
充足组	β（95%CI）	-116.58（-176.71 ~ -56.45）	-119.29（-179.62 ~ -58.96）	-78.42（-137.90 ~ -18.93）
	P值	< 0.001	< 0.001	0.010
趋势P值		< 0.001	< 0.001	< 0.001

组别	β（95%CI）	P值	交互作用P值
性别			0.431
男	-2.45（-3.51 ~ -1.40）	<0.001
女	-3.06（-4.58 ~ -1.56）	<0.001
慢性肾脏病			0.001
无	-1.65（-2.55 ~ -0.76）	<0.001
有	-4.70（-6.73 ~ -2.67）	<0.001
高血压			0.965
无	-2.52（-3.76 ~ -1.28）	<0.001
有	-2.98（-4.21 ~ -1.75）	<0.001
血脂异常			0.327
无	-2.82（-3.93 ~ -1.70）	<0.001
有	-2.38（-3.71 ~ -1.05）	<0.001

Relationship between systemic immune inflammation index and vitamin D in patients with type 2 diabetes based on restricted cubic spline

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