血清25(OH)D_3与胰岛素抵抗及尿微量白蛋白的相关性研究  

The Correlation Study between Insulin Resistance,Urine Micro- albumin and Serum Vitamin D

作　　者：李元宾[1,2] 刘师伟[1] 苏丽清[2] 王海静[2] 杨坤[1] 薛雪花[1] 张晓琳[1] 

机构地区：[1]山西医学科学院,山西大医院内分泌科,太原030003 [2]山东省威海市立医院内分泌科,威海264200

出　　处：《中国中西医结合肾病杂志》2014年第4期325-328,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然基金资助项目(No.81200591);山西省留学办归国留学人员科研项目(No.2010-14-93)

摘　　要：目的:观察2型糖尿病及糖调节受损患者血清25(OH)D3与胰岛素抵抗及尿微量白蛋白的相关性。方法:对820例健康体检人员进行筛查,共筛选出104例2型糖尿病患者(T2DM组),其中初发糖尿病患者40例,既往诊断2型糖尿病患者64例,同时筛选出糖调节受损患者(IGR组)94例,选择同期170例非糖尿病血糖正常体检者为对照组(NGT组)。所有参与者记录身高、体重计算体重指数(BMI)、并行口服糖耐量及胰岛素释放试验检测;留取血清,运用ELISA法检测血清25(OH)D3水平;放免法检测尿微量白蛋白(尿MA);分析血清25(OH)D3与胰岛素抵抗及尿MA的相关性。结果:T2DM组及IGR组中25(OH)D3水平与对照组相比明显降低(P<0.05),2型糖尿病中有63.16%的患者维生素D缺乏,较非糖尿病患者(42.35%)明显增高(P<0.05);相关分析显示,血清25(OH)D3水平与空腹胰岛素呈正相关,而与年龄、BMI、空腹血糖水平、HOMA-IR、尿微量白蛋白呈负相关。结论:2型糖尿病患者血清维生素D缺乏非常严重,维生素D缺乏可能会加重胰岛素抵抗及促进尿微量白蛋白分泌。维生素D缺乏可能是2型糖尿病及糖尿病肾病发病中重要的危险因素。Objective： This study is to investigate the relationship between 25-Hydroxyvitamin D,insulin resistance and Urine micro-albumin under different glucose tolerance statuses. Methods：Subjects included total 820,（455 males,365 females）. aged 40-65 years. Serum25（OH）D3,Ca2＋,P3-,Parathyroid hormone（PTH）,Fasting plasma glucose（FPG）,2hPBG,INS. TG,TC were measured by ELISA and electrochemiluminescence, respectively. , Urine micro -albumin were measured by RIA. Homeostasis model （ Homa-IR） assessment,insulin acuity index （ IAI） were determined for insulin resistance. The current study has been carried out to assess association of serum 25-hydroxyvitamin D and the function of the insulin resistance and urine micro-albumin. Results：The levels of 25（OH）D3,in the T2DM group and IGR group were significantly lower than that in NGT group （P〈0. 05）. 63. 16% of the patients with T2DM had 25（OH）D3 deficiency （≤15 ng/ml） as compared to non-diabetic population of which 42. 35% patients had 25（OH）D3 deficiency. Multiple stepwise regression analysis showed that 25（OH）D3 was one of the influential factors of insulin resistance in patients with type 2 diabetes mellitus and Diabetic nephropathy. Conclusion：Our results suggest that 25（OH）D3 is close-ly related with insulin resistance and urine micro-albumin;It is maybe one of the influential factors of T2DM and diabetic nephropa-thy.

关 键 词：25(OH)D3 2型糖尿病 胰岛素抵抗 尿微量白蛋白 25(OH)D3 

分 类 号：R587.1[医药卫生—内分泌]