维生素D与2型糖尿病防治的相关性研究  

Correlation between vitamin D and the primary prevention of type 2 diabetes

作　　者：邱云霞[1] 赵桂东[1] 秦建华[1] 楚云超 徐涛[1] 曲燕[1] 高玉霞[1] 

机构地区：[1]胜利石油管理局胜利医院内分泌科,山东东营市257055 [2]潍坊医学院研究生部

出　　处：《中国骨质疏松杂志》2014年第1期54-57,共4页Chinese Journal of Osteoporosis

摘　　要：目的观察初诊中青年男性2型糖尿病(T2DM)患者维生素D(25-(OH)D3)水平与胰岛素抵抗及胰岛早期分泌功能之间的关系,探讨与糖尿病(DM)防治的相关性。方法随机选取初诊中青年男性2型糖尿病患者86名为糖尿病组,健康中青年男性58名为对照组(NC),测定25-(OH)D3、糖化血红蛋白浓度(HbA1c)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C),并同期进行精氨酸-胰岛素兴奋试验。结果①糖尿病组25-(OH)D3、胰岛β细胞功能指数(HOMA-β)和精氨酸-胰岛素兴奋试验6min胰岛素均低于对照组(P<0.05),而TG、FPG、HbA1c、胰岛素抵抗指数(HOMA-IR)、SPB均高于对照组(P<0.01)。②单因素方差分析显示糖尿病家族史对25-(OH)D3水平有影响(P<0.05);对照组无糖尿病家族史与其他各组比较均有统计学意义(P<0.01),余各组间差别无显著性意义;对照组无糖尿病家族史受试者的25-(OH)D3水平最高,糖尿病组有糖尿病家族史受试者25-(OH)D3水平最低(P<0.01)。③相关分析显示25-(OH)D3与HbA1c、BMI和HOMA-IR呈负相关(P<0.05);与胰岛素分泌的峰值倍数呈正相关;调整BMI后25-(OH)D3与HOMA-β呈正相关(P<0.05)。结论中青年糖尿病患者普遍存在维生素D缺乏,尤其有糖尿病家族史者下降明显,维生素D水平影响胰岛素抵抗及胰岛素早期分泌功能,补充维生素D可能成为糖尿病防治的手段之一。Objective To observe the relationship between vitamin D （25-（OH）D3） level and insulin resistance and the early secretary function of pancreatic cells in young and middle-aged men with newly diagnosed type 2 diabetes, and to explore its correlation with the primary prevention of diabetes.Methods Eight-six young and middle-aged men, who were newly diagnosed with type 2 diabetes, were randomly selected into the diabetes group.And 58 healthy young and middle-aged men were included in the control group.The serum levels of 25-（OH） D3, glycated hemoglobin （HbA1c）, fasting blood glucose （FBG）, triglycerides （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C）, and low-density lipoprotein cholesterol （LDL-C） were detected.The arginine-insulin stimulation test was performed simultaneously.Results The 25-（ OH） D3 level, pancreatic islet βcell function index （ HOMA-β） , and the insulin level at the 6 th minute after arginine-insulin stimulation test in the diabetes group were lower than those in the control group （P＆lt;0.05）, while the levels of TG, FPG, and HbA1c, insulin resistance index （HOMA-IR）, and SPB were higher than those in the control group （P＆lt;0.01）.The univariate analysis of variance showed that the family history of diabetes could influence the 25-（OH） D3 level （p＆lt;0.05）.In control group, those without a family history of diabetes were statistically significant comparing to the other groups （ P ＆lt;0.01 ） , while no significant difference was observed between other groups.The 25-（ OH） D3 level of the subjects without a family history of diabetes in control group was the highest, and the 25-（OH） D3 level of the subjects with a family history of diabetes in diabetes group was the lowest （P＆lt;0.01）.The correlation analysis showed that 25-（OH） D3 level was negatively correlated with HbA1c, BMI, and HOMA-IR （p＆lt;0.05）, while positively correlated with the insulin secretion peak multiples.

关 键 词：糖尿病防治 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]