目的 了解男性2型糖尿病患者维生素D营养状况及其对骨代谢指标的影响。方法 采用Roche E170全自动电化学发光免疫分析仪检测258例男性2型糖尿病患者血清的25羟维生素D[25（OH）D]、总I型前胶原氨基端肽（tPINP）和I型胶原羧基端肽（β-CTX）。根据血清25（OH）D水平分为维生素D严重缺乏（<25 nmol/L）、缺乏（≥25 nmol/L且<50 nmol/L）、不足（≥50 nmol/L且<75 nmol/L）和充足（≥75 nmol/L）。结果 男性2型糖尿病患者总体25（OH）D浓度为33.80±18.43 nmol/L，为维生素D缺乏水平。根据年龄将受试者分为中年组（35～49岁）、老年前期组（50～59岁）、老年1组（60～69岁）、老年2组（>70岁），发现随着年龄的增长，25（OH）D的浓度呈逐渐降低趋势，老年2组的25（OH）D显著低于中年组（P=0.044），而骨标志物在各年龄组间差异均无统计学意义（P>0.05）。258例男性2型糖尿病患者中维生素D严重缺乏、缺乏、不足、充足的比例分别为36.43%（94/258）、48.45%（125/258）、11.63%（30/258）和3.49%（9/258）。维生素D严重缺乏组的β-CTX明显高于其他各营养状况组（均P<0.05），而tPINP在各营养状况组间差异均无统计学意义（P>0.05）。相关分析表明，血清25（OH）D水平与β-CTX呈负相关（r=-0.197，P=0.001），与tPINP无相关性（r=-0.046，P=0.464）。结论 男性2型糖尿病患者存在严重维生素D缺乏和不足状况，维生素D严重缺乏对骨吸收可能有影响。

Objective To evaluate the Vitamin D nutritional status in male patient with type 2 diabetes (T2DM) and its effects on bone markers. Methods 258 cases of male patients with T2DM were recruited, their serum levels of 25-hydroxyvitamin D[25（OH）D], tPINP and β-CTX were measured by Roche E170 automatic electrochemiluminescence immunoassay analyzer. According to 25（OH）D levels, patients were divided into 4 groups: severe deficiency (<25 nmol/L) , deficiency (≥25 nmol/L and <50 nmol/L) , insufficiency (≥50 nmol/L and <75 nmol/L) and sufficiency (≥75 nmol/L) groups. Results The total 25（OH）D level in T2DM patients was 33.80±18.43 nmol/L，which indicated vitamin D deficiency．The participants were divided into 4 age groups, middle-aged group (35-49 year old), presenium group (50-59 year old), gerontism group 1 (60-69 year old), gerontism group 2 (>70 year old). As the increase of age, the concentration of 25（OH）D decreased gradually. The 25 (OH) D levels in gerontism group 2 was significantly lower than that of middle-aged group, but bone markers had no significant difference among various age groups. The proportion of vitamin D in severe dificiency，defiency，insufficiency and sufficiency groups were 36.43%（94/258）, 48.45%（125/258）, 11.63%（30/258） and 3.49%（9/258）respectively. The level of β-CTX in severe deficiency group was apparently higher than other groups (P<0.05). tPINP had no difference between various nutritional status groups. The level of serum 25（OH）D was negatively correlated with serum β-CTX (r=-0.197，P=0.001), however 25（OH）D had no relevance with tPINP（r=-0.046，P=0.464）. Conclusion Vitamin D severe deficiency and insufficiency are highly prevalent among male patient with type 2 diabetes.There is no evidence shows that the serum 25（OH）D severe deficiency is associated with bone formation, while the bone absorption increases.