维生素D缺乏对老年糖耐量异常患者胰岛素抵抗的影响  

Relationship between vitamin D deficiency and insulin resistance in elderly with impaired glucose tolerance

作　　者：林青[1] 李嫣然[1] 高利红[1] 吴方[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,上海200025

出　　处：《内科理论与实践》2015年第6期424-427,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的 :评价维生素D(VitD)缺乏对老年糖耐量异常(IGT)患者胰岛素抵抗(IR)及血糖的影响。方法 :收集2012年1月至2014年1月在我科门诊和住院的老年IGT患者146例,根据血清25羟VitD(25-OH-VitD)水平,分为VitD缺乏组(<50 nmol/L)和VitD正常组(≥50 nmol/L),收集患者年龄、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、稳态模型评估IR指数(HOMA-IR)、体质量指数(BMI)等,观察2组IR及血糖各参数变化,并进行VitD与年龄、FPG、2hPG、FINS、HOMA-IR、BMI等多因素相关性分析。结果:VitD缺乏组70例,VitD正常组76例,平均随访(19.6±2.4)个月,基线水平及随访后VitD缺乏组HOMA-IR均显著高于VitD正常组(2.154±2.136比3.237±2.766,2.297±1.455比3.993±0.942,均P<0.01)。VitD缺乏组随访后的HOMA-IR显著高于基线水平(3.237±2.766比3.993±0.942,P<0.01),VitD正常组随访前后IR无显著变化(2.154±2.136比2.297±1.455,P>0.05)。VitD与年龄、HOMA-IR呈显著负相关(r分别为-0.351,-0.455,均P<0.01)。结论 :VitD缺乏明显加重老年IGT患者的IR,可能是影响IGT进展的危险因素之一。Objective To explore the relationship between vitamin D（VitD） deficiency and insulin resistance（IR） in elderly with impaired glucose tolerance（IGT）. Methods One hundred and forty-six elderly IGT patients were collected in outpatient and hospitalized in January 2012 to January 2014. According to the level of serum 25 hydroxy VitD（25-OH-VitD）, the patients were divided into VitD deficiency group（50 nmol/L） and VitD normal group（≥50 nmol/L）. Questionnaire,body mass index（BMI）, fasting plasma glucose（FPG）, postprandial 2 h glucose（2hPG）, fasting insulin（FINS）,homeostasis model assessment-IR index（HOMA-IR） were measured in all patients. To observe the changes of IR and blood glucose in 2 groups. And the correlation among FPG, 2hPG, age, FINS, HOMA-IR, BMI was analyzed. Results Seventy subjects with hypovitaminosis D and 76 subjects with normal VitD were enrolled. Subjects were followed for（19.6±2.4） months.HOMA-IR increased significantly in hypovitaminosis D group compared with normal VitD group in both the baseline and follow up（2.154±2.136 vs 3.237±2.766; 2.297±1.455 vs 3.993±0.942, all P0.01）. In hypovitaminosis D group, HOMAIR increased significantly in follow up as compared with the baseline（3.237 ±2.766 vs 3.993±0.942, P0.01）, and there was no significant change between baseline and follow up in normal VitD group（2.154 ±2.136 vs 2.297±1.455, P0.05）.VitD was negatively correlated with age and HOMA-IR（r =-0.351,-0.455,all P 0.01）. Conclusions VitD deficiency was related to insulin resistance in elderly with IGT, and VitD might be a factor influencing the development of IGT in elderly.

关 键 词：维生素D 胰岛素抵抗 糖耐量异常 

分 类 号：R587.1[医药卫生—内分泌]