血清25(OH)D3水平与2型糖尿病患者周围神经病变的相关性

目的探究血清25羟维生素D3〔25(OH)D3〕与2型糖尿病患者周围神经病变的相关性。方法 2型糖尿病患者120例,根据患者病情分为单纯糖尿病组(A组)50例和糖尿病合并周围神经病变组(B组)70例,收集患者临床资料,检测血清25(OH)D3水平与四肢末梢神经传导功能。以周围神经病变为因变量,年龄、病程、血清25(OH)D3含量、糖化血红蛋白、空腹C肽为自变量进行Logistics回归分析。结果两组患者临床资料对比,B组年龄、病程、糖化血红蛋白高于A组(P<0.05),空腹C肽低于A组(P<0.05)。Logistic逐级回归分析结果显示,25(OH)D3、空腹C肽同周围神经病变呈负相关(P<0.05)、年龄、病程、糖化血红蛋白与周围神经病变呈正相关(P<0.05)。结论 25(OH)D3的水平变化对糖尿病并发症周围神经病变的发生具有较大影响,糖尿病患者适度补充25(OH)D3可在某种程度上预防周围神经病变的发生。     

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.     

2型糖尿病合并肺部感染60例临床分析

2型糖尿病患者易发生感染，且合并感染多较严重，不易控制，往往加重糖尿病的代谢紊乱。急慢性感染是糖尿病主要的死亡原因之一。现将我院2005—2007年收治60例2型糖尿病合并肺部感染患者报告如下。     

中老年2型糖尿病合并骨质疏松患者血清25(OH)D3水平

目的了解中老年2型糖尿病(T2DM)合并骨质疏松(OP)患者血清25(OH)D3水平及与相关因素的关系。方法分别测定中老年T2DM合并OP组(A组)、单纯T2DM组(B组)、单纯OP组(C组)和健康对照组(D组)的血清25(OH)D3水平,并与年龄、体重指数(BMI)、糖尿病患者病程、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹C肽(FCP)、25(OH)D3、碱性磷酸酶(ALP)、血钙(Ca2+)、磷(P)、血脂及骨密度等相关因素进行比较和分析。结果四组血清25(OH)D3的平均水平差异显著(P0.05)。多因素相关分析显示,血清25(OH)D3水平与年龄、Hb A1c呈负相关(r=-0.381,P=0.002;r=-0.378,P=0.011);与骨密度呈正相关(r=0.239,P=0.047)。结论中老年人普遍存在维生素D缺乏,DM合并OP患者维生素D缺乏更为严重。25(OH)D3与年龄、Hb A1c密切相关;高龄、血糖控制差、25(OH)D3缺乏均是中老年T2DM合并OP的危险因素。     

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.     

维生素D与2型糖尿病研究进展

维生素D的主要作用是维持骨健康,自20世纪70年代以来,大量研究发现,维生素D可作用于多种组织器官,与癌症、自身免疫性疾病、糖尿病、高血压、结核的发生密切相关。补充维生素D可增加骨密度,降低结肠癌、部分自身免疫性疾病及糖尿病等的风险。也有部分研究未发现维生素D与2型     

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与2型糖尿病合并高血压患者的关系

目的探讨血清25羟维生素D3与2型糖尿病(T2DM)合并高血压的关系。方法选取该院96例T2DM患者,分成单纯组(单纯T2DM,46例)、合并组(T2DM合并高血压,50例),选取同期50例健康志愿者为对照组,测定三组血糖、血压、血脂和25羟维生素D3,两组服用维生素D前后测定血糖、血压、血脂和25羟维生素D3水平。结果合并组的收缩压、总胆固醇水平均明显高于单纯组和对照组,单纯组和合并组空腹血糖水平无统计学差异(P<0.05)。单纯组、合并组的25羟维生素D3水平明显低于对照组,且合并组最低。25羟维生素D3和收缩压、总胆固醇呈负相关。单纯组、合并组服用维生素D后血糖、血压、血脂和25羟维生素D3水平均得到改善。结论血清25羟维生素D3可能是T2DM并高血压的影响因素。     

老年2型糖尿病患者维生素D水平的表达及与胰岛β细胞功能的相关性

目的探讨老年2型糖尿病(T2DM)患者维生素D(VD)水平的表达以及与胰岛素β细胞功能的相关性。方法选取2012年9月至2014年5月该院收治的老年T2DM患者600例,采用酶联免疫吸附法测定患者血清中的25-羟维生素D含量,采用稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(IAI)、胰岛β细胞功能指数(HBCI)以及空腹胰岛β细胞功能指数(FBCI),评估胰岛β细胞的功能以及HOMA-IR,并分析研究组25-羟维生素D水平与上述参数的相关性。结果 T2DM患者血清中的25-羟维生素D水平显著低于正常水平(P=0.018);T2DM患者25-羟维生素D与HOMA-IR呈正相关关系(r=0.438,P=0.019),与IAI呈负相关关系(r=-0.392,P=0.023),与HBCI、FBCI无相关关系。线性回顾分析显示25-羟维生素D是IAI和HOMA-IR的影响因素。结论老年T2DM患者血清中的25-羟维生素D水平较低,补充25-羟维生素D对T2DM的治疗和预防均有帮助。     

老年2型糖尿病合并肺部感染76例临床分析

76例老年2形糖尿病合并肺部感染住院病人的临床资料。结果6例高渗性昏迷及3例酮症酸中毒患着经治疗后，有2例因诱发多脏器功能衰竭死亡外，其余7例经治疗症状好转，其它67例患者平均住院8．5天，基本康复出院。结论老年人2型糖尿病合并肺部感染近年较多见，临床表现不典型，治疗上较特殊，需使用胰岛素控制肺部感染，改善通气功能，控制其它并发症等。     

血清25羟维生素D3与2型糖尿病周围神经病变的相关性

目的：探讨血清25OH维生素D3（25OHD3）水平与2型糖尿病周围神经病变的关系。方法收集114例2型糖尿病患者,根据临床症状、体征和电生理检查,将患者分为糖尿病合并周围神经病变组（63例）和非糖尿病周围神经病变组（51例）,抽取所有受试者空腹静脉血检测血清25OHD3水平,比较2组患者血清25OHD3水平,分析25OHD3与2型糖尿病临床指标间的相关性。结果糖尿病周围神经病变组较非糖尿病周围神经病变组患者维生素D3缺乏发生率分别是79.4％和41.2％,差异有统计学意义（P＜0.01）;糖尿病周围神经病变组患者25OHD3水平低于非糖尿病周围神经病变组,分别为（40.1±12.7）nmol/L与（54.4±18.4）nmol/L,差异有统计学意义（P＜0.01）;25OHD3水平与2型糖尿病患者糖化血红蛋白（HbA1c）及糖尿病病程负相关（P值分别为0.01和0.044）。结论低25OHD3水平是2型糖尿病周围神经病变的危险因素,25OHD3水平与2型糖尿病患者病程和HbA1c相关。     

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.

2型糖尿病患者血清25-羟维生素D和甲状旁腺激素水平与高血压病的相关性

目的探讨2型糖尿病患者血清25-羟基维生素D[25-(OH)D]、甲状旁腺激素(PTH)水平与其发生高血压的相关性。方法回顾性分析128例2型糖尿病住院患者,按照其是否合并原发性高血压病分为合并高血压组(89例)、无高血压组(39例)。收集研究对象的一般资料及检测血清PTH、25-(OH)D水平。分析25-(OH)D、PTH与2型糖尿病是否罹患高血压之间的关系。结果合并高血压组患者血清25-(OH)D水平低于无高血压组(P0.001)。两组间PTH水平差异无统计学意义(P=0.132)。Pearson相关性分析显示,25-(OH)D与PTH呈负相关(r=-0.182,P0.05)。二元Logistic回归分析显示25-(OH)D降低是2型糖尿病伴发高血压的危险因素(OR=0.935,95%CI 0.883～0.991,P=0.023),而PTH升高不是糖尿病患者易患高血压的危险因素。结论糖尿病患者易合并25-(OH)D降低,且25-(OH)D降低是糖尿病患者罹患高血压病的危险因素。     

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。     

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.     

肥胖与血清维生素D水平的关系研究

测定不同肥胖类型者血清25-羟维生素D3[25-(OH)D3]水平.发现超重或肥胖者及腹型肥胖者血清25-(OH)D3水平降低(P＜0.01);血清25-(OH)D3与体重指数及腰围呈独立负相关.提示肥胖与维生素D水平下降密切相关.

Abstract：

Serum 25-(OH)D3concentration was determined in subjects with different types of obesity. The serum 25-(OH)D3levels in overweight or obese and central obese subjects were lower than that in non-obese subjects.(P＜0.01). In a multiple linear regression analysis serum 25-(OH)D3was independently and negatively correlated with body mass index and waist circumference.     

Variability in vitamin D assays impairs clinical assessment of vitamin D status

Background: Measuring serum 25(OH)D concentration is common in clinical practice despite the questionable reliability of assays. Aims: The aim of the present study was to examine agreement in 25(OH)D concentrations measured by different assays and laboratories, and consider related clinical implications. Methods: Serum samples from 813 participants in the Australian Multicentre Study of Environment and Immune Function (the Ausimmune Study) were assayed for 25(OH)D concentration. Duplicate samples from subsets of subjects were sent to different laboratories, two using DiaSorin Liaison (Laboratory A and B) and one using Liquid Chromatography‐Tandem Mass Spectrometry (LC‐MS/MS – selected here as the nominal gold standard). Pairwise within‐assay (both within‐laboratory and between‐laboratories) and between‐assay agreement was examined using Deming regression and Bland‐Altman plots. Common 25(OH)D cut‐points for classification of vitamin D deficiency were used to compare the different assays. Results: 25(OH)D concentrations measured using Liaison were substantially lower at Laboratory A than at Laboratory B (mean bias ?11.60 nmol/L, 95% limits of agreement ?46.39, 23.18). Both Liaison assays returned much lower 25(OH)D concentrations than LC‐MS/MS (mean bias up to ?26.05 nmol/L, 95% limits of agreement of ?13.21, 65.31). For Laboratory A participants, 46% (355/765) were classified as vitamin D deficient (25(OH)D <50 nmol/L) using Liaison compared with 17% (128/765) using LC‐MS/MS. For Laboratory B participants, the respective figures were 36% (76/209) and 20% (41/209). Hence, between 1‐in‐5 and 1‐in‐3 participants were misclassified as ‘deficient’. Conclusion: Bias and variability in 25(OH)D measurements sufficient to affect significantly clinical decision‐making were found both between‐laboratories and between‐assays. The adoption of common standards to allow assay calibration is required urgently.     

The relationship between balance and vitamin 25(OH)D in fibromyalgia patients

Introduction: Fibromyalgia syndrome (FMS) is a chronic disease characterized by diffuse pain of unknown cause, fatigue, sleep disorders, cognitive dysfunction, and sensitivity. Fibromyalgia was shown to be associated with balance problems and increased incidence of falls. There are many theoretical mechanisms related to the impact of vitamin D on postural control. The aim of the current study was to investigate the relationship between vitamin 25(OH)D levels and pain, balance and daily activities in patients with FMS.

Method: Patients aged 35–65 years who were diagnosed with FMS according to 1990 ACR diagnostic criteria were screened. Seventy patients diagnosed with FMS and 60 healthy controls with comparable age and gender were included in the study. Fibromyalgia impact scale (FIQ), Berg Balance Scale (BBS), the Nottingham Health Profile (NHP), and visual analog scale (VAS) were applied to the subjects. The subjects were divided into two groups by vitamin 25(OH)D level being above or below 30?ng/ml.

Results: A statistically significant difference was established between VAS, BBS value and all NHP subscale and NHP total values of FMS patients and those of healthy control group. The relationship between BBS and the level of vitamin 25(OH)D of all participants was investigated, a positive statistically significant relationship was found with Vit-D at r?=?0.481 level (p?Conclusion:: It was observed that low vitamin D levels affected balance in both FMS group and healthy control group. It should be kept in mind that vitamin D level is likely to negatively affect balance and VAS values in FMS.     

Oxidative stress,type 2 diabetes and vitamin D: past,present and future

Oxidative stress refers to an imbalance between potentially harmful free radicals and the body's mechanisms to efficiently detoxify them in favor of the free radicals. Consequently, excess free radicals can attack and damage a wide range of biomolecules including proteins, lipids and nucleic acids. Antioxidant mechanisms of the body are under the influence of genetic and environmental (including dietary) factors. Diabetes is one of the most common metabolic disorders around the world. A huge body of evidence indicates a role for oxidative stress in development of many human diseases including diabetes. In this article, the latest information on the possible links of oxidative stress with diabetes development, control and complications as well as the newest results of antioxidant supplementation trials is reviewed. In addition, the possible role of vitamin D, as a newly recognized antioxidant in diabetes is discussed. Finally, concluding remarks on pivotal issues and future studies are presented. Copyright © 2015 John Wiley & Sons, Ltd.     

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.