血清25-羟维生素D水平与胰岛素抵抗的关系  

The relationship between serum 25 hydroxyvitamin D levels and insulin resistance

作　　者：王晓丽 于法常[2] 马洪伟[1] 王远方 徐华[1] WANG Xiaoli;YU Fachang;MA Hongwei;WANG Yuanfang;XU Hua(Department of Endocrinology,the Fifth People’s Hospital of Jinan,Jinan 250031,Shandong,China;Oncology Hematology Department,the Fifth People’s Hospital of Jinan,Jinan 250031,Shandong,China;Department of Geriatrics,Zaozhuang Mental Health Center,Zaozhuang 277100,Shandong,China)

机构地区：[1]济南市第五人民医院内分泌科,山东济南250031 [2]济南市第五人民医院肿瘤血液科,山东济南250031 [3]枣庄市精神卫生中心老年病科,山东枣庄277100

出　　处：《中国现代医生》2025年第3期9-12,共4页China Modern Doctor

基　　金：潍坊医学院附属医院科技发展项目(2023FYQ028)。

摘　　要：目的探讨25-羟维生素D[25(OH)D]与胰岛素抵抗的关系。方法采用随机数字表法选取济南市第五人民医院内分泌科2021年6月至2022年12月112例糖尿病住院患者为观察组,61例血糖正常的内分泌科门诊就诊患者作为对照组。比较两组患者的25(OH)D、血糖水平、稳态模型评估胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、稳态模型评估胰岛β细胞功能(homeostasis model assessment ofβ-cell function,HOMA-β)、甲状腺球蛋白抗体、糖尿病相关抗体[抗胰岛素抗体(insulin autoantibodies,IAA)、抗胰岛细胞抗体(islet cell antibody,ICA)和谷氨酸脱羧酶抗体(glutamic acid decarboxylase antibody,GAD)]等指标,并对血糖、甲状腺球蛋白抗体、糖尿病相关抗体及胰腺功能等指标与25(OH)D进行相关性分析。结果观察组患者的25(OH)D水平低于对照组,差异有统计学意义(P<0.05);相关性分析显示,患者的血清25(OH)D水平与甲状腺球蛋白抗体、糖化血红蛋白、IAA、GAD、ICA、HOMA-IR等均呈负相关(P<0.01),血清25(OH)D水平与性别、HOMA-β均呈正相关(P<0.01);观察组患者的25(OH)D水平与HOMA-IR呈负相关(P<0.01),与HOMA-β呈正相关(P<0.01)。结论胰岛素抵抗、免疫损伤可能与体内血清25(OH)D水平不足有关,建议糖尿病患者及糖尿病高危人群在早期适当补充维生素D。Objective To explore the relationship between 25-hydroxyvitamin D[25(OH)D]and insulin resistance.Methods A total of 112 diabetic patients hospitalized in Department of Endocrinology,the Fifth People’s Hospital of Jinan from June 2021 to December 2022 were selected as observation group by using random number table method,and 61 individuals in endocrinology clinic with normal blood glucose levels were selected as control group.The levels of 25(OH)D,blood glucose level,homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment of β-cell function(HOMA-β),thyroglobulin antibodies,and diabetes-related antibodies[insulin autoantibodies(IAA),islet cell antibody(ICA)and glutamic acid decarboxylase antibody(GAD)]etc indexs were measured in two groups,and the correlation between 25(OH)D and blood glucose,thyroglobulin antibody,diabetes-related antibody and pancreatic function was analyzed.Results The level of 25(OH)D in observation group was significantly lower than that in control group,and the difference was statistically significant(P<0.05).Correlation analysis showed that the level of 25(OH)D was negatively correlated with thyroglobulin antibodies,glycosylated hemoglobin,IAA,GAD,ICA,and HOMA-IR etc(P<0.01)in all subjects,and positively correlated with gender and HOMA-β(P<0.01).In observation group,the level of 25(OH)D was negatively correlated with HOMA-IR(P<0.01)and positively correlated with HOMA-β(P<0.01).Conclusion Insulin resistance and immune damage may be related to insufficient the level of serum 25(OH)D.It is suggested that individuals with diabetes and those at high risk of diabetes should supplement with vitamin D appropriately in the early stage.

关 键 词：25-羟维生素D 胰岛素抵抗 稳态模型评估胰岛素抵抗指数 稳态模型评估胰岛β细胞功能 甲状腺球蛋白抗体 糖尿病 

分 类 号：R587[医药卫生—内分泌]