2型糖尿病患者血清维生素D水平及相关研究

摘要

Objective To investigate the change of serum vitamin D level in type 2 diabetes mellitus (T2DM) patients,and explore the role of vitamin D in the metabolic disturbance of T2DM and relationship with other metabolic indexes.Methods Based on the diagnostic criteria of diabetes mellitus of the WHO (1999) and Asian adult obesity criterion established by International Obesity Special Work Group in 2002,32 patients were selected as T2DM group A[body mass index (BMI)≥25.00 kg/m2],and 38 patients were selected as T2DM group B(BMI ＜ 25.00 kg/m2).Thirty-three healthy subjects were selected as control group.The biochemical parameters of human were measured and serum 25-hydroxyvitamin D3 [ 25 (OH)D3] was measured by enzyme-linked immunoassay.The statistic data were compared among three groups.Results The levels of serum 25 (OH)D3 in T2DM group A,T2DM group B and control group were (20.59 ± 4.82 ),( 27.07 ± 5.73 ) and ( 32.27 ±: 8.49 ) μ g/L,and there were significant differences among three groups (P ＜ 0.05 ).The level of serum 25 (OH)D3 was (25.51 ± 6.12) μ g/L in T2DM patients with normal blood pressure (43 cases),(21.87 ± 5.78) μ g/L in T2DM patients with hypertension (27 cases),there was significant difference between the two patients ( P ＜ 0.05 ).The level of serum 25 ( OH ) D3 was (28.42 ± 5.20) pg/L in T2DM patients with normal blood lipids (8 cases),(23.55 ±6.15)μg/L in T2DM patients with dyslipidemia (62 cases),there was significant difference between the two patients (P＜ 0.05).The level of serum 25 (OH)D3 was negatively associated with weight,waistline,BMI,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,fasting insulin,insulin resistance index,total cholesterol,triaeylglycerol and low density lipoprotein cholesterol(P ＜ 0.01 or ＜ 0.05 ),and had no significant association with parathyroid hormone,calcium,phosphorus,high density lipoprotein cholesterol and age (P ＞ 0.05).Conclusion The level of serum vitamin D decrease in T2DM patients,especially remarkably in patients combined with obesity,hypertension and dyslipidemia.%目的 了解2型糖尿病患者血清维生素D水平的变化,并探讨其在2型糖尿病患者代谢紊乱中的作用及与其他代谢指标的关系.方法 按WHO 1999年关于糖尿病诊断标准筛选初发2型糖尿病患者70例,并按2002年国际肥胖特别工作组亚洲成年人标准,根据体质指数(BMI)分为2型糖尿病A组(BMI≥25.00 kg/m2) 32例和2型糖尿病B组(BMI＜ 25.00 kg/m2)38例,另筛选健康人33例作为对照组,检测人体参数和测量生化指标,用酶联免疫吸附试验法测定血清25羟基维生素D3 [25 (OH)D3]水平,对三组进行比较.结果 2型糖尿病A组血清25 (OH)D3水平为(20.59±4.82)μg/L,2型糖尿病B组为(27.07±5.73) μg/L,对照组为(32.27±8.49)μg/L,三组之间比较差异有统计学意义(P＜0.05).2型糖尿病患者血压正常者43例,血清25(OH)D3水平(25.51±6.12)μg/L,高血压者27例,血清25 (OH)D3水平(21.87±5.78)μg/L,两者比较差异有统计学意义(P＜0.05)；2型糖尿病患者血脂正常者8例,血清25(OH)D3水平(28.42±5.20)μg/I,血脂异常者62例,血清25 (OH)D3水平(23.55±6.15)μg/L,两者比较差异有统计学意义(P＜0.05).25(OH)D3与体重、腰围、BMI、收缩压、舒张压、空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇呈负相关(P＜0.01或＜0.05),与甲状旁腺素、钙、磷、高密度脂蛋白胆固醇、年龄无明显相关性(P＞0.05).结论 2型糖尿病患者血清维生素D水平降低,尤其是伴有肥胖、高血压、血脂异常者血清维生素D水平降低更明显.