肥胖型2型糖尿病患者血清25-羟基维生素D和γ-谷氨酰转肽酶水平变化及其与胰岛素抵抗的相关性研究  

Changes of serum 25-hydroxyvitamin D andγ-glutamyl transpeptidase levels in obese patients with type 2 diabetes mellitus and their correlation with insulin resistance

作　　者：苏丽娜 许冰涵 林艳 SU Li'na;XU Binghan;LIN Yan(Department of Clinical Laboratory,Inner Mongolia Xilingol League Central Hospital,Xilinhot,Inner Mongolia Autonomous Region,026000,China)

机构地区：[1]内蒙古锡林郭勒盟中心医院医学检验中心,内蒙古锡林浩特026000

出　　处：《当代医学》2024年第34期130-134,共5页Contemporary Medicine

摘　　要：目的探讨肥胖型2型糖尿病患者血清25-羟基维生素D[25-hydroxy vitamin D,25-(OH)D]、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,γ-GT)水平变化及其与胰岛素抵抗的相关性。方法选取2021年8月至2023年6月内蒙古锡盟中心医院收治的44例肥胖型2型糖尿病患者作为观察组,另选取同期本院50名健康体检者作为对照组。分析观察组患者血糖控制情况,比较两组及不同血糖控制水平患者血清25-(OH)D、γ-GT及胰岛素抵抗水平,分析肥胖型2型糖尿病患者血清25-(OH)D、γ-GT与胰岛素抵抗的相关性。结果44例肥胖型2型糖尿病患者,血糖控制良好23例,血糖控制不良21例。观察组血清γ-GT水平及稳态模型评估-胰岛素抵抗指数(homeostasis model assessmentdoiiinsulin resistance,HOMA-IR)均高于对照组,血清25-(OH)D水平低于对照组,差异有统计学意义(P<0.05);血糖控制不良患者血清γ-GT水平及HOMA-IR均高于血糖控制良好患者,血清25-(OH)D水平低于血糖控制良好患者,差异有统计学意义(P<0.05);经Pearson相关系数分析结果显示,血清25-(OH)D与HOMA-IR呈负相关(r<0,P<0.05),血清γ-GT水平与与HOMA-IR呈正相关(r>0,P<0.05)。结论肥胖型2型糖尿病患者血清25-(OH)D水平越低,血清γ-GT水平越高,则胰岛素抵抗越严重,临床医师可依据HOMA-IR结合血清25-(OH)D、γ-GT水平判断胰岛素抵抗程度,从而制订针对性治疗方案。Objective To investigate the changes of serum levels of 25-hydroxy vitamin D(25-[OH])D andγ-glutamyl transpeptidase(γ-GT)in patients obese with type 2 diabetes and their correlation with insulin resistance.Methods 44 patients with obese type 2 diabetes admitted to Inner Mongolia Xilingol League Central Hospital from August 2021 to June 2023 were selected as the observation group,and another 50 healthy subjects who underwent health examination in our hospital at the same time were selected as the control group.Blood glucose control in the observation group was analyzed,the serum levels of 25-(OH)D,γ-GT and insulin resistance were compared between the two groups and the well-controlled group and the poorly controlled group,and the correlation between serum 25-(OH)D,γ-GT and insulin resistance was analyzed.Results Among 44 obese patients with type 2 diabetes,23 had good blood glucose control and 21 had poor blood glucose control.The serumγ-GT level and homeostasis model assessment-iinsulin resistance(HOMA-IR)in the observation group were higher than those in the control group,and the serum 25-(OH)D level was lower than that in the control group,and the differences were statistically significant(P<0.05).The serumγ-GT level and HOMA-IR in paitents with poor blood glucose control were higher than those in paitents with good blood glucose control,and the serum 25-(OH)D level was lower than that in paitents with good blood glucose control,and the differences were statistically significant(P<0.05).The results of Pearson correlation coefficient analysis showed that serum 25-(OH)D was negatively correlated with HOMA-IR(r<0,P<0.05),and serumγ-GT level was positively correlated with HOMA-IR(r>0,P<0.05).Conclusion The lower the serum 25-(OH)D level and the higher the serumγ-GT level,the more serious the insulin resistance will be.Clinicians can judge the degree of insulin resistance according to HOMA-IR combined with serum levels of 25-(OH)D andγ-GT,so as to making targeted treatment plans.

关 键 词：肥胖型2型糖尿病 25-羟基维生素D Γ-谷氨酰转肽酶 胰岛素抵抗 相关性 

分 类 号：R58[医药卫生—内分泌]