北京地区青年人群血清维生素D水平及其与糖代谢的关系  

Vitamin D level and its association with glucose metabolism among youth in Beijing

作　　者：付俊玲[1] 候聪[2] 韩兰稳[2] 高珊[2] 黎明[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科国家卫生和计划生育委员会内分泌重点实验室,北京100730 [2]首都医科大学北京朝阳医院内分泌科,北京100043

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2017年第3期216-221,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：北京市科技计划重点项目(D111100000611001;D111100000611002);中国医学科学院NNDU糖尿病英才基金(2011A002)

摘　　要：目的调查北京地区青年人群血清25-羟维生素D(25-hydroxy vitamin-D,25OHD)水平,探讨其与糖代谢指标的相关性。方法招募来自北京儿童和青少年代谢综合征研究队列的517名(14~28岁)青年人群。行2 h 75 g口服葡萄糖耐量试验(oral glucose tolerance test,OGTT),采用稳态模型及糖耐量相关指标评估胰岛素抵抗和胰岛β细胞功能。采用生物阻抗法检测体脂百分比(percent body fat,Fat%),采用化学发光免疫分析法检测血清25OHD。结果该人群维生素D缺乏的检出率(25OHD<50 nmol/L)为78.7%,其中男性69.0%,女性89.4%。调整性别、年龄和日照时间的偏相关分析显示,血清25OHD水平与空腹血糖(r=-0.088,P=0.046)、2 h血糖(r=-0.128,P=0.004)及糖化血红蛋白(r=-0.088,P=0.047)呈负相关。进一步调整Fat%后,除与2 h血糖(r=-0.120,P=0.007)相关外,还与OGTT中0.5 h胰岛素(r=0.091,P=0.042)相关;未发现血清25OHD水平与胰岛素抵抗相关指标的相关性(P>0.1)。协方差分析发现,2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清25OHD水平明显低于糖耐量正常(P=0.003)、空腹血糖受损(P=0.009)和糖耐量减低(P=0.010)人群。结论本青年人群维生素D缺乏率高,青年2型糖尿病人群中血清25OHD水平明显降低,提示可能与低水平维生素D水平影响了胰岛β细胞分泌功能相关。Objective To investigate vitamin D levels among youth in Beijing and to explore its relationship with glucose metabolism. Methods A total of 517 subjects （aged 14-28 years） were recruited from the cohort of Beijing Children and Adolescents Metabolic Syndrome study. All subjects underwent a 2h - 75 g oral glucose tolerance test. Insulin resistance （IR） was estimated using homeostasis model assessment of IR （HOMA-IR） and insulin sensitive index. Pancreatic β-cell function was assessed by HOMA-β, insulinogenic index （IGI） , oral disposition index, and area under the curve of insulin. Percent body fat （ Fat% ） was measured by bioimpedance analysis. Serum 25-hydroxy vitamin D （25OHD） levels were measured by electro-chemiluminescence immunoassay. Results The prevalence of vitamin D deficiency （25OHD 〈 50 nmol/L） is 78.7% （male 69.0% and female 89.4% ）. After adjusting for age, gender, and sun exposure, serum 25OHD levels were significant negatively correlated to fasting glucose （r = -0. 088, P = 0. 046） , 2- hour glucose （r= -0.128, P=0.004）, and HbAlc （r= -0.088, P=0.047） level. After further adjusting for Fat%, the above differences between serum levels of 25OHD 2-hour glucose （r = -0. 120, P = 0. 007）, we also found positive correlation between serum 25OHD and 0. 5-hour insulin levels （r =0. 091, P =0. 042）. However, there was no association between 25OHD and IR （ P 〉 0. 1 ）. Covariance analysis showed that serum level of 25OHD was significantly lower in subjects with type 2 diabetes mellitus （T2DM） than those in healthy controls （ P = 0. 003 ）, impaired fasting glucose （ P =- 0. 009）, and impaired glucose tolerance （ P = 0. 010） subjects. Conclusion The prevalence of vitamin D deficiency in this cohort is relatively high. The significantly lower 25OHD level in youth with T2DM indicates that lower level of vitamin D may play a negative role in pancreatic β-cell function.

关 键 词：25-羟基维生素D 糖代谢 青年 

分 类 号：R587.1[医药卫生—内分泌]