不同维生素D水平社区2型糖尿病患者胰岛功能研究  

Study of islet function of community type 2 diabetes patients with different vitamin D levels

作　　者：刘薇[1] 华琳[2] 苏志燕[1] 张雪莲[1] 杨金奎[1] Liu Wei;Hua Lin;Su Zhiyan;Zhang Xuelian;Yang Jinkui(Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;不详)

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京100730 [2]首都医科大学生物医学工程学院

出　　处：《临床内科杂志》2021年第7期465-468,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨不同维生素D水平社区2型糖尿病(T2DM)患者的胰岛功能。方法收集1024例社区T2DM患者的全部临床资料,包括一般资料、生化指标、糖代谢指标、骨代谢指标及骨密度(BMD),以胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(IS)协助评价胰岛功能。根据患者的25羟维生素D[25(OH)D]水平四分位数将其分为4组,比较最高四分位组[17.15 ng/ml≤25(OH)D水平<62.11 ng/ml]和最低四分位组[3.00 ng/ml≤25(OH)D水平<8.53 ng/ml]患者各项临床资料的差异,并分析T2DM患者25(OH)D水平的影响因素。结果最高四分位组患者的睾酮(TT)和高密度脂蛋白胆固醇(HDL-C)水平明显高于最低四分位组,年龄明显低于最低四分位组(P<0.05)。在最高四分位组中,2h C肽(2h CP)与Ⅰ型胶原氨基末端肽(P1NP)、β-胶原降解产物(β-CTX)均呈正相关(P<0.05);在最低四分位组中,空腹C肽(FCP)与β-CTX呈正相关(P<0.05)。HDL-C水平升高(β=11.214,P=0.004)、PTH水平降低(β=-0.186,P=0.004)、年龄增长(β=0.186,P=0.030)是T2DM患者25(OH)D水平升高的独立影响因素。结论不同25(OH)D水平社区T2DM患者胰岛功能差异不显著,部分骨代谢指标与胰岛功能相关。Objective To investigate the differences of islet function in community type 2 diabetes(T2DM)with different vitamin D levels.Methods All clinical data of 1024 community T2DM patients were screened,including general data,blood biochemical indicators,glycometabolism index,bone turnover markers and bone mineral density(BMD).Insulin sensitivity index(ISI),insulin resistance index(HOMA-IR)and insulin secretion index(IS)were used to assist the evaluation of pancreatic function.According to quartiles of 25-hydroxyvitamin D[25(OH)D]levels of patients,they were divided into 4 groups.The differences in clinical data of patients in the highest quartile group[17.15 ng/ml≤25(OH)D level<62.11 ng/ml]and the lowest quartile group[3.00 ng/m l≤25(OH)D level<8.53 ng/ml]were compared,and the 25(OH)D influencing factors of T2DM patients were analyzed.Results The testosterone(TT)and high-density lipoprotein cholesterol(HDL-C)levels of patients in the highest quartile group were significantly higher than those in the lowest quartile group,while their age was significantly lower than that of the lowest quartile group(P<0.05).In the highest quartile group,2h C peptide(2h CP)was positively correlated with typeⅠcollagen amino terminal peptide(P1NP)andβ-collagen degradation products(β-CTX,P<0.05).In the lowest quartile group,FCP was positively correlated withβ-CTX(P<0.05).The increasing of HDL-C level(β=11.214,P=0.004),decreasing of PTH level(β=-0.186,P=0.004)and increasing of age(β=0.186,P=0.030)were the independent influencing factors for elevated 25(OH)D levels in T2DM patients.Conclusion There is no significant difference in islet function among community T2DM patients with different 25(OH)D levels.Some bone metabolism indexes are related to islet function.

关 键 词：维生素D 社区 2型糖尿病 胰岛功能 

分 类 号：R589.1[医药卫生—内分泌]