25羟维生素D对老年2型糖尿病患者胰岛β细胞功能的影响  

Effects of 25(OH)D on isletβ-cells function in the elderly with type 2 diabetes

作　　者：徐永霞[1] 谢明珠 宫牧雪 黄嘉莹 赵丽 朱德发[1] XU Yongxia;XIE Mingzhu;GONG Muxue;HUANG Jiaying;ZHAO Li;ZHU Defa(Department of Endocrinology,Anhui Geriatric Institute,the First Affiliated Hospital of Anhui Medical University;Second School of Clinical Medicine of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院老年内分泌科 [2]安徽医科大学第二临床医学院,安徽合肥230032

出　　处：《中国临床药理学与治疗学》2020年第9期1021-1026,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金资助项目(81272152);安徽省大学生创新创业计划项目(20810366108)。

摘　　要：目的:研究老年2型糖尿病患者(type 2 diabetes mellitus,T2DM)血清25羟维生素D[25(OH)D]对血糖水平及胰岛β细胞功能的影响。方法:以2019年6月至2020年1月入院的58例老年T2DM患者为研究对象,根据其血清25(OH)D水平分组,分析病人年龄、体质量指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)等指标,并进行馒头餐-C肽释放试验:测定0、30、60、120和180 min血糖和C肽水平,研究血清25(OH)D对胰岛β细胞功能的影响。结果:血清25(OH)D缺乏或不足的老年T2DM患者比充足的患者的HbA1c和馒头餐试验的120 min和180 min血糖水平显著升高(P<0.05);60 min和120 min的C肽含量,各时间点的C肽指数和180 min内C肽曲线下面积(AUC CP180)均显著降低(P<0.01);血清25(OH)D水平与HbA1c呈负相关,但与60、120 min的C肽,60、120、180 min的C肽指数及AUC CP180呈正相关,多元回归分析显示C肽指数是血清25(OH)D水平的重要相关因素。结论:血清25(OH)D不足或缺乏的老年2型糖尿病患者胰岛β细胞功能受损更严重。AIM:To investigate the effects of serum 25-hydroxyvitamin D(25(OH)D)on the blood glucose and isletβ-cells function in the elderly with type 2 diabetes(T2DM).METHODS:Fifty-eight elderly patients with type 2 diabetes were recruited from June 2019 to January 2020,and all the patients were divided into three groups according to levels of serum 25(OH)D.Age,body mass index(BMI)and the levels of fasting blood glucose(FBG),hemoglobin A1c(HbA1c)were analyzed.Steamed bread meal test was performed in all patients,and the levels of blood glucose and C-peptide were compared among the three groups at the time points of 0,30,60,120 and 180 min to investigate the effect of serum 25(OH)D on the isletβ-cells function.RESULTS:Compared with the elderly T2DM patients with sufficient 25(OH)D,the HbA1c increased significantly in the elderly T2DM patients with deficiency of 25(OH)D(P<0.05).The levels of blood glucose were increased at the time points of 120 min and 180 min,while the levels of C-peptide at the time point of 60 min and 120 min,C peptide index and AUC CP180 in elder T2DM patients decreased significantly(P<0.05).Pearson correlation analysis showed that serum was negatively correlated with HbA1c,and positively correlated with the C peptide and C peptide index and AUC CP180(P<0.05).And stepwise multiple regression analysis indicated that C peptide was a factor influencing 25(OH)D levels.CONCLUSION:Elderly T2DM patients with deficiency of 25(OH)D are more likely to suffer with severe dysfunction of isletβ-cells.

关 键 词：老年人 25羟维生素D 2型糖尿病 Β细胞 

分 类 号：R587.1[医药卫生—内分泌]