不同剂量钙尔奇D对维生素D缺乏的糖耐量减低患者胰岛素抵抗的影响

摘要

Objective To observe the effects of different doses of Caltrate D supplementation on insulin resistance in patients with impaired glucose tolerance(IGT) and vitamin D deficiency.Methods A total of 116 IGT patients were divided into vitamin D sufficient group and vitamin D deficient group based on vitamin D level.And vitamin D deficient group were randomly divided into conventional dose group(Caltrate D for one tablet daily),double doses group(Caltrate D for tablet daily) and control group(without Caltrate D).The blood biochemical indicators was detected,HOMA-IR,HOMA-β were calculated,and the patients were reexamined after one year.Results After one year of treatment,FBG,HbA1C,BMI,HOMA-IR,25 (OH) D were significantly improved compared with treatment before (P ＜ 0.05),and compared with the single dose,the double doses group had better improvement in HbA1 C,25 (OH) D.Taking the 25 (OH) D level as a dependent variable,BMI,HbA1C,and other indicators as independent variables,multiple regression analysis showed that blood 25 (OH) D level was positively correlated with HOMA-β and Ca,and negatively correlated with HbA1 C and FPG.Conclusion Vitamin D supplementation can improve insulin resistance for patients with impaired glucose tolerance and vitamin D deficiency,and the degree of improvement is correlated with vitamin D doses.%目的 探讨不同剂量钙尔奇D对维生素D缺乏的糖耐量减低(IGT)患者胰岛素抵抗的影响.方法 将糖耐量减低的116例患者根据维生素D水平分为维生素D充足组和维生素D缺乏组.再将维生素D缺乏组随机分为常规剂量组(给予钙尔奇D 1片/d)、双倍剂量组(给予钙尔奇D2片/d)、对照组(不给予钙尔奇D).检测血液生化指标,并计算稳态模型胰岛素抵抗指数及稳态模型胰岛素β细胞功能指数,1年后复查.结果 治疗1年后,FBG、HbA1C、BMI、HOMA-IR、25 (OH) D均较治疗前有明显改善(P＜0.05),且与常规剂量相比较,双倍剂量组的HbA1C、25 (OH)D改善更明显(P＜0.05).将25 (OH)D水平作为因变量,将BMI、HbA1C等其他指标作为自变量,采取多元回归分析显示,血25 (OH)D水平与HOMA-β、Ca呈正相关,与HbA1C、FPG呈负相关.结论 补充维生素D可以更好地改善维生素D缺乏的IGT患者胰岛素抵抗状况,且改善程度与维生素D剂量有相关性.