2型糖尿病新发患者血清25羟维生素D_3的水平及临床意义

目的探讨2型糖尿病(T2DM)新发患者血清25羟维生素D_325-(OH)D_3]的水平,以及25-(OH)D_3与B细胞功能、胰岛素抵抗的关系。方法选取2013年1月至2016年6月于南京市中医院住院的T2DM新发患者48例为观察组,同时选取同期年龄匹配的健康体检者40例为对照组,留取血清及血浆标本测定空腹血糖(FBG)、空腹胰岛素(FIns)、血脂、糖化血红蛋白(HbA1c)以及血清25-(OH)D_3水平。比较两组间胰岛素抵抗指数(HOMA-IR)、胰岛B细胞功能指数(HOMA-β)及25-(OH)D_3等指标的差异,并分析25-(OH)D_3与HOMA-IR、HOMA-β的相关性。结果观察组FBG、血脂、HbA1c、HOMA-IR均高于对照组,且差异具有统计学意义(P0.05),而血清25-(OH)D_3水平、HOMA-β均低于对照组,且差异具有统计学意义(P0.05)。新发T2DM组患者血清25-(OH)D_3水平与FBG、HbA1c、HOMA-IR呈负相关(r值分别为-0.30,-0.34,-0.23,P0.05),与HOMA-β呈正相关(r=0.27,P0.05)。结论新发T2DM患者较对照组存在25-(OH)D_3水平低下,且血清25-(OH)D_3水平的降低与胰岛素抵抗和胰岛B细胞分泌功能下降有关。补充维生素D可能使患者获益。

Serum levels of 25-(OH)D3 in patients with type 2 diabetes mellitus and its clinical significance

Objective To examine the level of serum 25-hydroxyvitamin D3 25-(OH)D3] and investigate the relationship be tween 25-(OH)D3 and islet B cell function as well as the insulin resistance in the newly diagnosed T2DM patients.Methods The general data and laboratory results of 48 newly diagnosed T2DM inpatients and 40 healthy subjects in the Nanjing Hospital of Chinese Medicine were collected.The laboratory parameters including fasting plasma glucose (FBG),serum insulin,serum lipids,HbA1c,25-(OH)D3,insulin homeostasis model assessment of insulin resistance(HOMA-IR) and function of β-cell(HOMA-β) were compared between the two groups.The linear analyses were conducted between serum 25-(OH)D3 level and HOMA-IR and HO MA-β.Results The level of FBG,serum lipid,HbA1c and HOMA-IR in T2DM group were significantly higher than those in the healthy subjects(P＜0.05),while the level of serum 25-(OH)D3 and HOMA-β were dramatically lower than the control group(P＜ 0.05).The 25-(OH)D3 level in the patients with T2DM was negatively correlated with FBG,HbA1c and HOMA-IR,(r=-0.30,-0.34,-0.23,P＜0.05),and positively correlated with HOMA-β(r=0.27,P＜0.05).Conclusion The insufficiency of 25-(OH) D3 is present in the newly diagnosed T2DM patients,which is correlated with insulin resistance and the decline of islet B cell function.These patients would benefit from supplementation of vitamin D.