初诊2型糖尿病患者血清活性维生素D3水平的变化及其临床意义

目的：观察初诊2型糖尿病患者血清活性维生素D3水平的变化情况，为临床治疗和干预提供理论依据。方法选取2014年1月至2015年6月期间就诊于我院干部病科和内分泌科的200例2型糖尿病患者设为观察组，选取同期就诊于我院的100健康查体者作为对照组。比较两组受检者的年龄、病程、体质指数(BMI)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及胰岛素分泌指数(HOMR-β)、胰岛素抵抗指数(HOMR-IR)、血清活性维生素D3水平，以及谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(CRE)、血钙、血磷水平。结果(1)两组受检者的血清TG、TC、ALT、AST、CRE、血钙、血磷水平比较差异均无统计学意义(P>0.05)；(2)与对照组比较，观察组患者的FPG (9.85±2.50) mmol/L vs (4.84±0.54) mmol/L]、2 hPG (10.28±2.28) mmol/L vs (5.21±0.56) mmol/L]、HbA1c (7.66±2.36)% vs (4.62±0.47)%]明显升高，FINS (7.40±5.06)μU/ml vs (11.87±6.81)μU/ml ]、HOMR-β(25.81±20.13) vs (254.33±102.14)]、1,25-(OH)D3(15.57±3.58) ng/ml vs (51.72±8.96) ng/ml]水平明显降低，差异具有统计学意义(P<0.05)，而HOMR-IR(3.40±2.83) vs (2.32±0.63)]与对照组比较差异无统计学意义(P>0.05)；(3)1,25-(OH)D3与HOMR-β呈正相关(r=0.72，P<0.05)，与HOMR-IR无明显相关性(r=-0.11，P>0.05)。结论初诊2型糖尿病患者血清1,25-(OH)D3降低，低1,25-(OH)D3水平影响患者的胰岛素β细胞的分泌功能。

Changes of serum active vitamin D3 levels in newly diagnosed type 2 diabetic patients and its clinical significance

Objective To analyze the changes of serum active vitamin D3 levels in newly diagnosed type 2 dia-betic patients, and to provide theoretical basis for clinical treatment and intervention. Methods Two hundred patients with type 2 diabetes mellitus who were treated in our hospital from Jan. 2014 to Jun. 2015 were selected as the observa-tion group, and 100 healthy individuals who came to our hospital for physical examination during the same period were enrolled as the control group. The age, course of disease, body mass index (BMI), triglyceride (TG), high-density lipo-protein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), HOMR-β, HOMR-IR, and serum active vita-min D3 levels were compared between the two groups, as well as alanine aminotransferase (ALT), aspartate aminotransfer-ase (AST), creatinine (CRE), serum calcium, serum phosphorus levels. Results (1) There were no statistically significant difference in serum TG, TC, ALT, AST, CRE, serum calcium, serum phosphorus levels between the two groups (P>0.05). (2) Compared with the control group, FPG (9.85±2.50) mmol/L vs (4.84±0.54) mmol/L], 2 hPG (10.28±2.28) mmol/L vs (5.21±0.56) mmol/L], HbA1c (7.66±2.36)%vs (4.62±0.47)%] of the observation group were significantly higher, while FINS (7.40±5.06)μU/ml vs (11.87±6.81)μU/ml], HOMR-β(25.81±20.13) vs (254.33±102.14)], 1,25-(OH)D3 (15.57± 3.58) ng/ml vs (51.72 ± 8.96) ng/ml] were significantly lower (P<0.05). There was no significant difference between the observation group and the control group in HOMR-IR levels (3.40±2.83) vs (2.32±0.63)] (P>0.05). (3) 1,25-(OH)D3 was positively correlated with HOMR-β(r=0.73, P<0.05), but it showed no significant correlation with HOMR-IR (r=-0.11, P>0.05). Conclusion 1,25-(OH)D3 decreases in patients with newly diagnosed type 2 diabetes mellitus, and low 1, 25-(OH)D3 levels affect the secretion of insulin beta cells in patients.