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过刊目录

2019 年第 8 期 第 14 卷

维生素D在2型糖尿病患者中的临床价值

Clinical value of vitamin D in patients with type 2 diabetes mellitus

作者:王莹吴东红程瑶梁桂敏马晶

英文作者:

单位:150010哈尔滨市第一医院内分泌科一病房

英文单位:

关键词:2型糖尿病;维生素D;血糖

英文关键词:

  • 摘要:
  • 【摘要】目的    观察2型糖尿病(T2DM)患者体内血清25-羟基维生素D[25-(OH)D]水平,并探讨补充维生素D对T2DM患者血糖水平、胰岛β细胞功能及胰岛素抵抗的影响。方法    选取2018年3—10月哈尔滨市第一医院T2DM患者72例,根据血清25-(OH)D水平筛选其中合并维生素D缺乏或不足患者60例,完全随机分为观察组(30例)和对照组(30例);另选取同期本院36例健康体检者(健康组)。对照组采用常规降糖治疗,观察组在常规治疗基础上加服骨化三醇。分析比较治疗前后空腹血糖、餐后2 h血糖、空腹胰岛素、糖化血红蛋白、稳态模型胰岛素抵抗指数(HOMA-IR)及稳态模型胰岛β细胞功能指数(HOMA-β)指标的变化。结果    本组T2DM患者体内维生素D缺乏或不足者占83.3%(60/72)。治疗前,观察组和对照组患者空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、HOMA-IR明显高于健康组,25-(OH)D水平、HOMA-β明显低于健康组(均P<0.05)。治疗后,观察组和对照组空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、HOMA-IR较治疗前明显降低,25-(OH)D、HOMA-β较治疗前明显升高,且观察组明显优于对照组[(6.4±1.9)mmol/L比(7.1±1.4)mmol/L、(12.4±3.6)mmol/L比(14.8±2.9)mmol/L、(6.2±1.2)%比(7.9±1.1)%、(9.7±3.5)mIU/L比(13.4±3.0)mIU/L、(3.2±2.6)比(4.1±2.3)、(32±4)μg/L比(25±5)μg/L、(5.8±0.5)比(5.3±0.4)],差异均有统计学意义(均P<0.05)。结论    T2DM患者体内普遍存在25-(OH)D缺乏,补充维生素D有助于T2DM患者的血糖控制。

  • 【Abstract】Objective    To observe the level of serum 25-hydroxy-vitamin D[25-(OH)D]in patients with type 2 diabetes mellitus(T2DM) and to analyze the effect of vitamin D supplementation on blood glucose, islet β cell function and insulin resistance. Methods    From March to October 2018, 72 T2DM patients admitted to the First Hospital of Harbin were included; 60 patients with vitamin D lack or deficiency defined by serum 25-(OH)D content were randomly divided into observation group and control group, with 30 patients in each group; 36 healthy people were enrolled as healthy group. The control group had routine hypoglycemic therapy; the observation group took calcitriol on the basis of routine therapy. Fasting blood glucose, postprandial 2 h blood glucose, fasting insulin, glycosylated hemoglobin, homeostasis model assessment insulin resistance index(HOMA-IR) and islet β-cell function index(HOMA-β) were analyzed. Results    Vitamin D lack or deficiency took a percentage of 83.3%(60/72) in T2DM patients. Before therapy, fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin, fasting insulin and HOMA-IR in observation group and control group were significantly higher than those in healthy group; serum 25-(OH)D level and HOMA-β in observation group and control group were significantly lower than those in healthy group(all P<0.05). After therapy, fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin, fasting insulin and HOMA-IR significantly decreased and 25-(OH)D level and HOMA-β significantly increased in T2DM patients; the changes were more significant in observation group[(6.4±1.9)mmol/L vs (7.1±1.4)mmol/L, (12.4±3.6)mmol/L vs (14.8±2.9)mmol/L, (6.2±1.2)% vs (7.9±1.1)%, (9.7±3.5)mIU/L vs (13.4±3.0)mIU/L, (3.2±2.6) vs (4.1±2.3), (32±4)μg/L vs (25±5)μg/L, (5.8±0.5) vs (5.3±0.4)](all P<0.05). Conclusion    Insufficiency of 25-(OH)D is common in patients with T2DM; vitamin D supplementation can improve blood glucose regulation.

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