2型糖尿病伴左心室舒张功能不全患者25-羟维生素D水平与胰岛素抵抗的相关性  

Correlationship between 25-hydroxyvitamin D level and insulin resistance in patients with type 2 diabetes mellitus complicating left ventricular diastolic dysfunction

作　　者：孙楠 苏钢 SUN Nan;SU Gang(Department of General Medicine,the First People's Hospital of Wuhu,Wuhu Anhui 241000,China)

机构地区：[1]芜湖市第一人民医院全科医学科,安徽芜湖241000

出　　处：《实用心电与临床诊疗》2025年第1期57-60,65,共5页PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

基　　金：芜湖市卫生健康委科研项目(WHWJ2023y021)。

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)伴左心室舒张功能不全(left ventricular diastolic dysfunction,LVDD)患者25羟维生素D[25-(OH)D]水平与胰岛素抵抗的相关性。方法选取住院治疗的T2DM伴LVDD患者109例,根据血清25-(OH)D水平分为两组:G1组(不足或缺乏)[25-(OH)D<20 ng/mL,n=64]和G2组(正常)[25-(OH)D≥20 ng/mL,n=45]。比较两组一般资料及生化指标,并分析25-(OH)D水平与其他指标及胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)的关联性。结果G1组糖尿病病程、空腹血糖(fasting blood glucose,FBG)、低密度脂蛋白胆固醇(LDL-C)、血清总胆固醇(TC)、甘油三酯(TG)、尿微量白蛋白/尿肌酐(A/C)水平显著高于G2组,G1组高密度脂蛋白胆固醇(HDL-C)、估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)显著低于G2组(均P<0.05)。Spearman相关性分析表明,25-(OH)D与病程、血清糖化血红蛋白(HbA1c)、TC、TG、LDL-C、HOMA-IR呈负相关,而与HDL-C、eGFR呈正相关。T2DM患者25-(OH)D水平与HOMA-IR的关联性为负相关(P<0.01)。结论25-(OH)D水平与T2DM伴LVDD患者的HOMA-IR具有相关性,通过适量补充外源性维生素D能改善这类患者的胰岛素抵抗程度。Objective To investigate the correlationship between 25 hydroxyvitamin D[25-(OH)D]level and insulin resistance in patients with type 2 diabetes mellitus(T2DM)complicating left ventricular diastolic dysfunction(LVDD).Methods A total of 109 T2DM inpatients with LVDD were selected,and divided into two groups according to the serum 25-(OH)D level:G1 group(insufficient or deficient)[25-(OH)D<20 ng/mL,n=64],and G2 group(normal)[25-(OH)D≥20 ng/mL,n=45].The general data and biochemical indexes were compared between the two groups;the correlationship between 25-(OH)D level,and other indexes and homeostatic model assessment of insulin resistance(HOMA-IR)was analyzed.Results The disease course of diabetes mellitus,fasting blood glucose(FBG),LDL-C,TC,TG and A/C in the G1 group were significantly higher than those in the G2 group,while HDL-C and estimated glomerular filtration rate(eGFR)in the G1 group were significantly lower than those in the G2 group(all P<0.05).Spearman correlation analysis showed that 25-(OH)D was negatively correlated with course of disease,HbA1c,TC,TG,LDL-C and HOMA-IR,while it was positive correlated with HDL-C and eGFR.The level of 25-(OH)D in T2DM patients was negatively related with HOMA-IR(P<0.01).Conclusion The level of 25-(OH)D is correlated with HOMA-IR in T2DM patients complicating LVDD.Appropriate supplementation of exogenous vitamin D could improve the degree of insulin resistance in these patients.

关 键 词：2型糖尿病 25-羟维生素D 左心室舒张功能不全 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]