血清25羟维生素D缺乏与2型糖尿病周围神经病变的相关性

目的 探讨血清25羟维生素D[25（OH）D]缺乏与糖尿病周围神经病变（DPN）的关系.方法 DPN患者（DPN组）76例、T2DM未合并DPN患者（T2DM组）70例以及正常对照者（NC组）50名.采用ECLIA测定血清25（OH）D水平,并进行3组间比较. 结果 DPN组25（OH）D水平（30.55±8.95） nmol/L低于T2DM组（58.86±15.79） nmol/L和NC组（60.10±6.63） nmol/L（P＜0.01）.相关分析显示,HbA1 c、TC、LDL-C与25（OH）D水平均呈负相关（P＜0.05）;二元Logistic回归分析显示,25（OH）D缺乏与DPN相关（OR=1.212,P=0.000）. 结论 25（OH）D缺乏是DPN的独立危险因素.     

大多数2型糖尿病患者缺乏维生素D

意大利研究人员的最新研究结果显示，3／5的2型糖尿病患者体内缺乏维生素D。意大利萨克罗科雷医院的研究人员测量了459名2型糖尿病患者血中维生素D的含量。分析结果发现，2型糖尿病患者中维生素D缺乏者所占的比例为61％，远高于参照组的43％，且女性患者居多。     

新诊断2型糖尿病患者25羟维生素D3与血糖波动相关性的分析

目的探讨新诊断T2DM患者25羟维生素D3[25(OH)D3]水平与血糖波动的关系。方法选取2014年1月至2017年12月于我院内分泌科就诊的188例新诊断T2DM患者,根据25(OH)D3水平分为正常组(≥30 ng/ml组)58例、减少组(20~30 ng/ml组)66例和缺乏组(<20 ng/ml组)64例,比较各组临床指标及血糖波动指标的差异。结果25(OH)D3≥30 ng/ml、<20 ng/ml组2 h C-P、胰岛素抵抗指数、血糖波动最大幅度(LAGE)、血糖变异系数(CVBG)均差异有统计学意义(P<0.05)。各组2 hPG、平均血糖波动幅度(MAGE)、血糖标准差(SDBG)比较,差异有统计学意义(P<0.05)。Pearson相关分析显示,25(OH)D3水平与2 hC-P呈正相关(r=0.395,P<0.05),与MAGE、SDBG呈负相关(r=-0.631、-0.456,P<0.05)。结论T2DM患者25(OH)D3水平与血糖波动显著相关。     

维持性血液透析患者血25羟维生素D缺乏对肾性贫血的影响

维持性血液透析患者普遍存在活性维生素D的缺乏,而维生素D的缺乏与尿毒症患者的多种并发症密切相关,包括骨、矿物质代谢异常、顽固性高血压、免疫功能异常、心血管疾病的发病率及死亡率升高等;但维生素D缺乏对血液透析患者血红蛋白水平的影响还不清楚.本研究探讨维持性血液透析患者25羟维生素D缺乏对肾性贫血的影响.     

2型糖尿病患者血清25-羟维生素D水平的调查与分析

目的调查2型糖尿病(T2DM)患者血清25-羟维生素D[25(OH)D]水平,并分析25(OH)D和糖尿病之间的相关性。方法选择2016年10月-2018年9月期间该院收治的80例T2DM患者并作为试验组,另选择同期体检健康的志愿者100名作为对照组,检测两组入选对象血清25(OH)D水平及相关临床及生化指标。结果试验组病例25(OH)D低于对照组,FBG、SDP、SBP、BUN、TG水平高于对照组,差异有统计学意义(P<0.05);将试验组病例分为不同年龄组,发现男、女性年龄≥70岁年龄组25(OH)D水平最高,分别为(39.69±17.33)mmol/L、(38.04±16.55)mmol/L,相同年龄段中男女25(OH)D水平差异有统计学意义(P<0.05);且相关性分析表明,25(OH)D水平和空腹血糖之间存在负相关性(P<0.05)。结论T2DM患者血清25(OH)D水平低于正常者,通常情况下年龄越大25(OH)D水平越高;空腹血糖水平越高,25(OH)D水平越低。     

2型糖尿病患者血清25羟维生素D3水平与周围神经病变的相关性

目的探讨2型糖尿病(T2DM)患者血清25羟维生素D3〔25-(OH)D3〕水平与周围神经病变(DPN)的相关性。方法选择2015年1~10月在该院就诊的T2DM患者124例,其中64例合并DPN的患者为观察组,另60例单纯T2DM患者为对照组,比较两组实验室指标水平及血清25-(OH)D3相关指标情况,分析血清25-(OH)D3与DPN的相关性。结果两组血肌酐、甲状旁腺激素(PTH)、血钙、血磷水平比较无显著差异(P0.05)。观察组的血清25-(OH)D3水平显著低于对照组,25-(OH)D3含量20 ng/ml的比例显著高于对照组(P0.05)。Pearson相关分析发现,血清25-(OH)D3与DPN的发病呈负相关。结论 T2DM合并DPN的患者血清25-(OH)D3水平显著低于单纯T2DM患者,且血清25-(OH)D3与DNP之间呈负相关联系。     

2型糖尿病患者血清维生素D水平及影响因素分析

维生素D不仅调节钙磷代谢,还与糖尿病、代谢综合征、冠心病、高血压、外用血管病等疾病的发生发展有关。维生素D水平降低可能损伤胰岛B细胞功能,对2型糖尿病是一个潜在的危险因素。我们对2型糖尿病患者血清维生素D水平变化及影响因素进行分析。     

血清25羟维生素D3水平与2型糖尿病患者大血管病变的相关性

目的探讨血清25羟维生素D3(25(OH)D3)水平与2型糖尿病(T2DM)患者大血管病变的相关性。方法选取2013年5月至2015年3月该院收治的T2DM患者100例,根据是否存在大血管病变分为大血管病变组(n=53例)和T2DM组(n=47例),搜集患者的临床资料,并检测患者的25(OH)D3水平。结果大血管病变组25(OH)D3水平显著低于T2DM组(P0.05),两组患者年龄、T2DM病程和吸烟史比较有统计学意义(P0.05);多因素回归分析显示:年龄、T2DM病程、吸烟史是大血管病变的危险因素,25(OH)D3是大血管病变的保护因素(P0.05);T2DM患者血清25(OH)D3水平与年龄和T2DM病程呈负相关(P0.05)。结论血清25(OH)D3水平是T2DM患者大血管病变的保护性因素。     

血清25-羟维生素D3与2型糖尿病相关性分析

目的 探讨血清25-羟维生素D3 [25-（OH） D3]与2型糖尿病的关系.方法 选择2型糖尿病患者41例,同期健康体检者32例,比较两组间血糖、血脂、糖化血红蛋白（HbA1C）、空腹C-肽（FC-P）、血清25-（OH） D3等指标的差异,并对25-（OH）D3与上述指标进行相关性分析.结果 与对照组比较,2型糖尿病组患者空腹血糖（FPG）、餐后2小时血糖（2hPG）、HbA1C、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、HOMA模型胰岛素抵抗指数（HOMA-IR）均明显升高,血清25-（OH） D3水平、HOMA模型β细胞功能指数（HOMA-IS）明显降低,差异有统计学意义（P＜0.05）.两组FC-P、空腹胰岛素（FINS）、高密度脂蛋白胆固醇（HDL-C）比较,差异无统计学意义（P＞0.05）.血清25-（OH） D3与HbA1C呈负相关（r=-0.386,P＜0.05）,与TG呈负相关（r=-0.391,P＜0.05）,与HOMA-IS呈正相关（r=0.434,P＜0.05）.结论 血清25-（OH）D3可能通过直接或间接作用影响胰岛β细胞功能,并影响血脂代谢.     

维生素D及其活性代谢物与糖尿病

近年的研究结果显示,维生素D不仅在调节骨和矿物质代谢中起重要作用,而且还与多种慢性疾病密切相关。基础研究发现,维生素D及其活性代谢物参与炎性反应和免疫调节过程。临床研究发现,高血压、肥胖、心血管疾病和糖尿病等现代流行病的发生与发展与维生素D及其活性代谢物有不可分割的联系。本文讨论了维生素D与糖尿病的关系以及维生素D在不同类型糖尿病的预防和治疗中的作用及机制。     

The association between 25-hydroxy vitamin D deficiency and diabetic complications in patients with type 2 diabetes mellitus

AimsTo evaluation the relationship between serum 25-hydroxy vitamin D [25-(OH)D] deficiency and diabetic complications in patients with type 2 diabetes (T2DM).MethodsOne hundred and sixty three patients with T2DM [DM + uncomplicated (n = 36), DM + nephropathy (n = 31), DM + neuropathy (n = 30), DM + retinopathy (n = 30), DM + cardiovascular disease (CAD) (n = 36)], 35 CAD and 40 healthy volunteers were included.ResultsSerum 25-(OH)D levels were found as significantly lower in all patients compared to the control group (p < 0.05). 25-(OH)D in patients with DM + retinopathy (p < 0.006), DM + nephropathy (p < 0.001) and DM + neuropathy (p < 0.001) was significantly lower than that of the control group. 25-(OH)D in patients with DM + nephropathy (p < 0.001), DM + neuropathy (p < 0.01) and DM + retinopathy (p < 0.001) was significantly lower than in the DM + uncomplicated group. 25-(OH)D levels were found as significantly lower in DM + CAD compared to the CAD group (p < 0.01). Serum 25-(OH)D and HbA1c and parathyroid hormone (PTH) were found to be negatively correlated with each other in DM + all complications.ConclusionsLow serum 25-OHD levels were found to be associated with the development of diabetes and complications. Low serum 25-OHD levels may be a consequence of even worse metabolic control of diabetes.     

The role of vitamin D in protecting type 1 diabetes mellitus

The relationship between autoimmune diabetes or type 1 diabetes mellitus and vitamin D has been reported in the literature. Many factors, environmental and genetic, have been known, as risk factors, to cause both type 1 diabetes and vitamin D deficiency. Vitamin D treatment has improved or prevented type 1 diabetes mellitus in animals and humans. Vitamin D also has been known to protect from autoimmune diseases in animal models. Therefore, it would be interesting to review the role of vitamin D in type 1 diabetes mellitus.     

Transmission disequilibrium of rs4809957 in type 2 diabetes mellitus families and its association with vitamin D deficiency: A family-based case-control study

Aims

Association between T2DM and vitamin D was found in many epidemiologic reports. And 24-hydroxylase encoded by CYP24A1 is the very enzyme that degrades the active vitamin D metabolite. We aimed to investigate the association between rs4809957 in CYP24A1 and T2DM, as well as vitamin D level.

Metabolic effects of supplementation with vitamin D in type 2 diabetic patients with vitamin D deficiency

AimEpidemiological studies suggest that vitamin D status influences type 2 diabetes mellitus. We investigate the metabolic effects of vitamin D.Material and methodsWe studied consecutive type 2 diabetic patients without insulin therapy with vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) lower than 20 ng/ml). They were treated with 16,000 IU of calcifediol orally once a week for a minimum of 8 weeks.ResultsTwenty eight patients were treated for a mean time of 84.1 days (range 56 to 120 days). All patients achieved serum levels of 25(OH)D higher than 20 ng/ml. There was a significant reduction in fasting glucose (145.6 ± 35.5 vs. 131.7 ± 30.4 mg/dl, p < 0.001). There were small non-significant reductions in HbA1c, fasting insulin and Homeostasis Model Assesment (HOMA)-insulin resistance (IR). There were small non-significant increases in HOMA-insulin sensitivity (S) and HOMA-beta cell function (B) and a small significant increase in Quantitative Insulin Sensitivity Check Index (QUICKI).ConclusionsCorrection of vitamin D deficiency in type 2 diabetic patients decreases fasting glucose. Our results do not rule out improvements in metabolic control, insulin-resistance and function of the beta cell.     

Role of vitamin D in the pathogenesis of type 2 diabetes mellitus

Vitamin D deficiency has been shown to alter insulin synthesis and secretion in both humans and animal models. It has been reported that vitamin D deficiency may predispose to glucose intolerance, altered insulin secretion and type 2 diabetes mellitus. Vitamin D replenishment improves glycaemia and insulin secretion in patients with type 2 diabetes with established hypovitaminosis D, thereby suggesting a role for vitamin D in the pathogenesis of type 2 diabetes mellitus. The presence of vitamin D receptors (VDR) and vitamin D–binding proteins (DBP) in pancreatic tissue and the relationship between certain allelic variations in the VDR and DBP genes with glucose tolerance and insulin secretion have further supported this hypothesis. The mechanism of action of vitamin D in type 2 diabetes is thought to be mediated not only through regulation of plasma calcium levels, which regulate insulin synthesis and secretion, but also through a direct action on pancreatic β-cell function. Therefore, owing to its increasing relevance, this review focuses on the role of vitamin D in the pathogenesis of type 2 diabetes mellitus.     

2型糖尿病合并下肢动脉粥样硬化病变患者血清脂蛋白相关磷脂酶A2、25羟维生素D与同型半胱氨酸关系的研究

目的探讨T2DM合并下肢动脉粥样硬化病变(LEAD)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、25羟维生素D[25(OH)D]与同型半胱氨酸(Hcy)之间的关系。方法选取2018年1~7月于我院内分泌科住院的100例T2DM患者,按踝肱指数(ABI)分为T2DM合并LEAD组(LEAD组)50例和T2DM无LEAD组(T2DM组)50例;同期选取我院体检中心健康人群50名为正常对照组(NC组)。ELISA法检测Lp-PLA2,电化学发光法检测25(OH)D水平,酶循环法检测Hcy水平。结果与T2DM、NC组比较,LEAD组血清Lp-PLA2、Hcy水平升高,25(OH)D水平降低(P<0.05)。Pearson相关分析显示,LEAD组血清25(OH)D水平与ABI呈正相关(P<0.05),与Lp-PLA2、Hcy、Hb A1c、TG、TC、LDL-C呈负相关(P<0.05)。多因素Logistic回归分析显示,Hb A1c、LDL-C、Lp-PLA2、25(OH)D、Hcy均为T2DM合并LEAD的危险因素。结论血清Lp-PLA2、Hcy及25(OH)D可能共同参与T2DM合并LEAD的发生发展。     

Vitamin D deficiency, vitamin D receptor gene polymorphisms and cardiovascular risk factors in Caribbean patients with type 2 diabetes

Aim

The prevalence of diabetes in the French West Indies is three times higher than in mainland France. We aimed to assess the associations between vitamin D deficiency, vitamin D receptor (VDR) gene polymorphisms and cardiovascular risk factors in Caribbean patients with type 2 diabetes (T2D).

Methods

In this cross-sectional study of 277 patients, 25-hydroxyvitamin D was measured by radioimmunoassay. FokI, BsmI, ApaI and TaqI single nucleotide polymorphisms (SNPs) of the VDR gene were genotyped. Analysis of covariance and logistic regression were performed.

Results

The study included 76 patients of Indian descent and 201 patients of African descent. The prevalence of vitamin D deficiency (< 20 ng/mL) was 42.6%. When patients were classified into groups with (G1) and without (G2) vitamin D deficiency, there were no significant differences in age, systolic blood pressure, low-density lipoprotein cholesterol and HbA_1c, although body mass index was significantly higher in G1. Vitamin D deficiency was significantly associated with increased diastolic blood pressure and triglyceride levels, and reduced high-density lipoprotein cholesterol (P < 0.05). Prevalence of vitamin D deficiency was decreased in patients carrying the f allele of FokI (OR: 0.52; P = 0.02) and the aa genotype of ApaI (OR: 0.46; P = 0.05). BsmI and TaqI SNPs were not associated with vitamin D deficiency.

Conclusion

The rate of vitamin D deficiency was high in our T2D patients, and was associated with the VDR gene FokI and ApaI polymorphisms and cardiovascular risk profile. Measurements of vitamin D may help to detect T2D patients with cardiovascular risk, and VDR polymorphisms might explain why vitamin D deficiency is so frequently seen in some T2D patients.     

维生素D3对2型糖尿病患者血管内皮功能的保护作用

目的 探讨1,25-二羟维生素D3对2型糖尿病患者血管内皮功能的影响.方法 选取我科2009～2011年住院的2型糖尿病患者80例,随机分为治疗组和对照组各40例,在血糖稳定1周后,治疗组给予常规治疗＋骨化三醇胶丸,对照组给予常规治疗,两组患者疗程均为12周.治疗前后行内皮依赖性血管舒张功能检测,同时检测其血C反应蛋白（CRP）、白细胞介素（IL）-6水平.结果 经过12周的治疗,治疗组患者体内CRP、IL-6低于对照组（P均＜0.05）;且治疗组患者内皮依赖性血管内径变化率高于对照组（P＜0.05）.结论 维生素D3可显著改善2型糖尿病患者体内的炎症状态,并改善2型糖尿病患者血管内皮功能.     

Vitamin D deficiency in patients with diabetes and COVID- 19 infection

Background and aimsData show that vitamin D deficiency may play a role in patients with diabetes mellitus and COVID-19 infection. In this article, we review evidence of vitamin D deficiency and COVID-19 infection in context of diabetes mellitus.MethodsA literature search was carried out by using the key term ‘COVID 19’ combined with ‘Diabetes’, ‘Vitamin D’, ‘Extra skeletal effects’, ‘immunity’, ‘infection’, ‘India’ from Pub Med (National Library of Medicine, Bethesda, MD and Google Scholar from December 2019 to May 2020. A manual search of the references was also carried out.ResultsVitamin D deficiency has been linked to increased morbidity and mortality in COVID -19 infections but convincing data on diabetic subgroup of patients in particular is still awaited.ConclusionRobust studies are required to ascertain if Vitamin D supplementation could be beneficial in patients with diabetes and COVID-19.