北京地区中青年人群维生素D不足现状及补充治疗对血糖和血脂的影响

摘要

目的 研究北京地区中青年人群维生素D不足的现状及补充治疗对血糖和血脂的影响.方法 在北京3个社区随机选取20~44岁中青年人396名,检测血25-(OH)D含量、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)和胰岛素水平,并计算胰岛素抵抗指数(HOMA-IR),比较维生素D充足组和维生素D非充足组中各项血糖血脂等指标的表达水平.同时将维生素D非充足组中愿意参加干预研究者(签署知情同意书)随机分为对照组和干预组,在生活方式改善基础上分别给予安慰剂和维生素D3治疗;另外干预组每3个月监测血清25-(OH)D含量,并依据25-(OH)D含量调整补充治疗方案,补充治疗12月后,检测血清25-(OH)D含量及各项血糖血脂等指标的表达,分析干预治疗的安全性和疗效.结果 研究对象中维生素D充足者仅为23.5%,维生素D非充足者高达76.5%.低维生素D水平的中青年人中,血FBG、HOMA-IR和TG、TC和LDL-C都显著高于正常维生素D水平者,而HDL-C水平显著低于正常维生素D水平者.小剂量补充方案未发生中毒情况,干预组补充维生素D312个月后血清25-(OH)D含量显著升高,而且维生素D营养状态构成比也发生了明显改善:维生素D充足者由干预前的0%升至40%,维生素D不足者由81%降至48%,维生素D缺乏者由19%降至10%.补充维生素D3后,上述各项血糖血脂等指标明显改善.结论 北京地区中青年人维生素D不足情况较为严重,维生素D不足影响血糖和血脂代谢,小剂量补充安全性良好,可提高血清25-(OH)D水平,改善血糖和血脂代谢.%Objective To study the status of vitamin D deficiency and the effect of supplementation on blood glucose and lipids in young and middle-aged residents in Beijing. Methods (1)Present Status Investigation:396 residents, aged 20-44, were randomly selected from three communities in Beijing. Serum 25(OH)D and serum triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG)and insulin levels were examined and the insulin resistance index(HOMA-IR)was calculated.These indicators were compared between the Vitamin D Sufficiency Group and Vitamin D Non-Sufficiency Group.(2)Intervention Study: The non-sufficiency vitamin D residents who provided informed content were randomly divided into two groups:Control Group and Intervention Group. On the basis of improved lifestyle,placebo and vitamin D3were given to subjects in the Control and Intervention Groups.The serum content of 25(OH)D in the Intervention Group was monitored every 3 months, and the supplemental treatment was adjusted according to the serum content of 25 (OH)D.After 12 months,the serum content of serum 25(OH)D and the expression levels of blood glucose and blood lipid indicators were measured.The safety and efficacy of the vitamin D3intervention treatment were analyzed. Results (1)Only 23.5% of subjects were in a vitamin D sufficient status, and 76.5% of subjects were in a vitamin D insufficient status.(2)Serum FBG、HOMA-IR, TG、TC、and LDL-C were significantly higher in subjects with low vitamin D levels than in subjects with normal levels of vitamin D. HDL-C levels were significantly lower in subjects with low vitamin D levels than in subjects with normal levels of vitamin D.(3)After 12 months of supplementation,the serum 25(OH)D level was significantly improved.The vitamin D sufficiency percentage increased to 42% from 0%,the percentage of vitamin insufficiency was decreased to 48% from 81%,and the percentage of vitamin D deficiency was only 10%. Blood glucose and blood lipid indicators were substantially improved with increased 25(OH)D levels. Conclusion The status of vitamin D deficiency is relatively serious in young and middle-aged residents in Beijing. Vitamin D deficiency affects serum sugar and lipid indicators.Low-dose supplementation is safe and can increase the level of 25(OH)D and improve the levels of blood glucose and lipids.