1型糖尿病患儿血清25-羟维生素D水平与脂代谢、骨代谢的相关性分析  

Correlation between serum 25-hydroxy vitamin D and lipid and bone metabolism in children with type 1 diabetes mellitus

作　　者：王宝平[1] 赵梦 葛青玮[1] 张泓[1] WANG Bao-ping;ZHAO Meng;GE Qing-wei;ZHANG Hong(Clinical Lab, Children＇s Hospital of Shanghai, Shanghai 200062, China)

机构地区：[1]上海市儿童医院检验科,上海200062

出　　处：《中国医学前沿杂志（电子版）》2018年第4期102-105,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析1型糖尿病(type 1 diabetes mellitus,T1DM)患儿血清25-羟维生素D[25-hydroxy vitamin D,25(OH)D]水平与脂代谢、骨代谢的相关性。方法选取2016年1月至2017年3月于本院诊断并治疗的56例T1DM患儿纳入观察组,并选取本院同期45例健康体检儿童纳入对照组。采用电化学发光法检测两组儿童25(OH)D、血清骨钙素(osteocalcin,OST)、血清1型前胶原氨基端前肽(procollagen type 1 amino-terminal propeptide,P1NP)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)水平;采用化学发光法检测胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)水平;采用全自动生化分析仪检测血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(high density lipoprotein-cholesterol,LDL-C)、血清钙及磷水平;采用骨密度仪检测患儿骨密度T值。结果观察组患儿血清25(OH)D、IGF-1、HDL-C、BALP、OST、P1NP水平及骨密度T值均显著低于对照组(P<0.05),LDL-C水平显著高于对照组(P<0.05)。25(OH)D水平与IGF-1水平具有相关性(r=0.342,P=0.011),25(OH)D水平和IGF-1水平与LDL-C水平均呈负相关(r=-0.317,P=0.036;r=-0.354,P=0.043),与骨密度T值均呈正相关(r=0.542,P=0.006;r=0.374,P=0.032)。结论 T1DM患儿IGF-1水平与血清25(OH)D水平具有相关性,能够通过25(OH)D影响患儿脂代谢及骨代谢,适当提高25(OH)D水平有可能改善患儿脂代谢及骨代谢状况,增加患儿骨密度。Objective To study the correlation between serum 25-hydroxy vitamin D [25（OH）D], lipid metabolism and bone metabolism. Method 56 children with type 1 diabetes mellitus（T1 DM） who were diagnosed and treated in our hospital from January 2014 to March 2017 were enrolled in observation group, and 45 healthy children were enrolled in control group. Electrochemiluminescence was used to detect the levels of 25（OH）D, serum osteocalcin（OST）, serum procollagen type 1 aminoterminal propeptide（P1NP） and bone alkaline phosphatase（BALP） in the two groups of children. IGF-1 was tested by ELISA assay. The total serum total cholesterol（TC）, triglyceride（TG）, high density lipoprotein-cholesterol（HDL-C）, low density lipoproteincholesterol（LDL-C）, serum calcium and phosphorus were detected by automatic biochemical analyzer. Used bone densitometer to detect T value of bone density in the two groups of children. Result The levels of serum 25（OH）D, IGF-1, HDL-C, BALP, OST, P1 NP and T value of bone density in observation group were significantly lower than control group（P〈0.05）, the LDL-C level was significantly higher than control group（P0.05）. The serum 25（OH）D level was related to the level of IGF-1（r=0.342, P=0.011）. 25（OH） D level and IGF-1 level were negatively correlated with LDL-C level（r =-0.317, P = 0.036; r =-0.354, P = 0.043）, and were positively correlated with the T value of bone density（r = 0.542, P = 0.006; r = 0.374, P = 0.032）. Conclusion The level of IGF-1 in T1 DM children is related to the serum level of 25（OH）D, and it can influence the lipid and bone metabolism. 25（OH）D supplement can improve the status of the lipid and bone metabolism in children with T1DM, and increase bone mineral density.

关 键 词：1型糖尿病 胰岛素样生长因子-1 25羟维生素D 脂代谢 骨代谢 

分 类 号：R446.1[医药卫生—诊断学] R725.8[医药卫生—临床医学]