RESUMO
Objective:To evaluate the influence of 25-hydroxyvitamin D[25(OH)D]on dyslipidemia in elderly female patients with type 2 diabetes(T2DM)mellitus aged 60 or over.Methods:We retrospectively reviewed the clinical records of 175 type 2 diabetic older women meeting the inclusion criteria, admitted to the Department of Endocrinology, Beijing Chuiyangliu Hospital, between January and December 2020, with an average age of 66(63, 70)years.According to the diagnostic criteria of dyslipidemia(cholesterol ≥6.2 mmol/L, high density lipoprotein cholesterol <1.0 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L or triglycerides ≥2.3 mmol/L), 110 participants(62.9%)were divided into a dyslipidemia group and 65 participants(37.1%)were assigned into a normal blood lipid group.Logistic regression was employed to investigate factors influencing dyslipidemia.Spearman correlation analysis was employed to analyze the correlation between serum 25(OH)D and blood lipid indexes.Results:The median serum 25(OH)D level of the 175 subjects was 10.92(8.1, 15.2)μg/L.For the dyslipidemia group, it was 9.1(5.8, 12.9)μg/L, lower than 11.9(8.4, 22.6)μg/L in the normal blood lipid group.The proportion of people with hypertension in the dyslipidemia group was higher than in the normal blood lipid group.The dyslipidemia group also had higher BMI, waist circumference and homocysteine levels( P<0.05). Results of multivariate logistic regression analysis demonstrated that hypertension, waist circumference, and homocysteine were significant risk factors for dyslipidemia in elderly women with T2DM, whereas serum 25(OH)D was a protective factor( P<0.05). Correlation analysis results identified that cholesterol and low density lipoprotein cholesterol were inversely correlated to 25(OH)D while high density lipoprotein cholesterol was positively correlated to it( P<0.05). Conclusions:There is a serious deficiency of serum 25(OH)D in older women with T2DM.25(OH)D is protective factor in elderly T2DM women against dyslipidemia.Clinicians should pay attention to vitamin D deficiency in patients during diagnosis and treatment and correct the deficiency.
RESUMO
Objective:To retrospectively analyze the pregnancy outcomes of patients with adenomyosis requiring fertility in a single center under real world condition.Methods:From June 2015 to May 2020, 231 cases of pregnancy complicated with adenomyosis diagnosed by ultrasound with fertility requirements were treated in the Women′s and Children′s Hospital Affiliated to Qingdao University with complete clinical data. And they were divided into three groups according to the treatment of adenomyosis before pregnancy: expectation group, drug group and operation group. The relevant data before pregnancy of the three groups were analyzed, and the pregnancy outcomes of the patients were summarized. According to whether the early pregnancy was treated with medication, the patients who were naturally conceived without symptoms of threatened abortion were divided into observation group and fetus protection group, and the pregnancy outcomes of the two groups were compared.Results:(1) Compared with the expectation group, the ages of patients in the drug group and the operation group were larger [(31.5±1.8) vs (34.1±3.7) vs (36.9±3.6) years old], and the difference was statistically significant ( P<0.05). Only 9 patients (11.5%, 9/78) had clinical symptoms in the expectation group, while the patients in the drug group and the operation group had a higher proportion of dysmenorrhea and increased menstrual volume. The uterine volume of the drug group and the operation group were larger than that of the expectation group [(151±46) vs (166±27) vs (97±18) cm 3], the difference was statistically significant ( P<0.05). 78.6% (33/42) of the operation group were focal adenomyosis. The proportion of natural pregnancy in the expectation group was 97.4% (76/78), and in vitro fertilization and embryo transfer was mainly used in the drug group and the operation group. (2) The abortion rates of the three groups were 48.7% (26/111), 4/17, 67.5% (27/78) respectively. Compared with the drug group and the operation group, the preterm birth rate was lower [55.9% (33/111) vs 11/17 vs 12.5% (5/78)] and the natural delivery rate was higher [44.1% (26/111) vs 4/17 vs 67.5% (27/78)] in the expectation group. (3) There were 89 cases of spontaneous pregnancy without threatened abortion symptoms, including 31 cases in the observation group and 58 cases in the fetus protection group. Compared with the observation group, the abortion rate of patients in the fetus protection group was lower [41.9% (13/31) vs 34.5% (20/58)], and the difference was statistically significant ( P<0.05). Conclusions:Patients with adenomyosis who have fertility requirements should be comprehensively evaluated and individualized treatment plans should be given. Pregnancy patients with adenomyosis have a high rate of miscarriage, and they should be included in the management of high-risk pregnant women. Active fetal protection treatment during early pregnancy might improve pregnancy outcomes.