维生素D对老年2型糖尿病患者胰岛素抵抗影响的研究

目的：探讨维生素D对老年2型糖尿病（T2DM）患者胰岛素抵抗的影响，为该类患者的临床治疗提供可参考依据。方法共纳入160例该院诊断为T2DM的老年患者作为研究对象，采用随机数字法平均分为观察组与对照组，两组患者均给予常规降糖治疗，观察组同时加用骨化三醇（0.5μg/d ，12周）。所有患者均于治疗前及治疗后空腹抽取静脉血检测血糖相关指标及血清25羟基维生素D325-（OH）D3]水平。结果治疗后体质量指数（BMI）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胰岛素（Fins）、25-（OH）D3及胰岛素抵抗指数（IRI）均较治疗前有明显改善，差异有统计学意义（P＜0.05）；且治疗后观察组BMI、FBG、HbA1c、Fins、25-（OH）D3及IRI较对照组改善更明显，差异有统计学意义（P＜0.05）。不同血清25-（OH）D3水平患者补充维生素D后IRI均有明显改善，差异有统计学意义（P＜0.05）；血清25-（OH）D3水平低于25 nmol/L的患者同时伴有BMI、FBG、HbA1c、Fins、25-（OH）D3水平的明显改善，差异有统计学意义（P＜0.05）。血清25-（OH）D3与BMI、FBG、HbA1c、Fins及IRI存在正相关关系（P＜0.05）。结论老年T2DM患者在常规降糖治疗的基础上，补充维生素D可以更好地改善胰岛素抵抗状况，促进患者血糖的平稳。

Study on effects of vitamin D supplementation on insulin resistance in patients with type 2 diabetes mellitus

Objective To explore the effects of oral vitamin D supplementation on insulin resistance(IR)in the patients with type 2 diabetes mellitus(T2DM ) .Methods A total of 16 elderly patients with T2DM in our hospital were included as the research subjects and divided into the observation and control groups according to the random number method .The two groups received the conventional hypoglycemic therapy .The observation group was simultaneously added with calcitriol (0 .50μg/d for 12 weeks) .The blood sugar related indicators and serum 25-(OH)D3 level were detected by collecting fasting venous blood before and after treat-ment measured .Results BMI ,FBG ,HbA1c ,Fins ,25-(OH)D3 and IRI after treatment in the two groups were improved signifi-cantly with statistically significant difference (P<0 .05) ,moreover BMI ,FBG ,HbA1c ,Fins ,25-(OH)D3 and IRI after treatment in the observation group were improved more significantly compared with the control group ,and the differences were statistically sig-nificant (P<0 .05) .The patients with 25-(OH)D3 level < 25 nmol/L had significant improvement in BMI ,FBG ,HbA1c ,Fins and 25-(OH)D3 level ,the differences were statistically significant (P<0 .05) .There was positive correlation between 25-(OH)D3 with BMI ,FBG ,HbA1c ,Fins and IRI (P<0 .05) .Conclusion The vitamin D supplementation can better improve the IR status on the basis of conventional hypoglycemic therapy and promotes the blood glucose stability in the elderly patients with T2DM .