糖尿病患者血清25-羟维生素D水平与甲状腺功能及胰岛素抵抗的相关性

Correlation of serum 25 hydroxyvitamin D level with thyroid function and insulin resistance in patients with diabetes

目的探讨血清25-羟维生素D[25-(OH)D]在糖尿病患者中的表达及与甲状腺功能、胰岛素抵抗的相关性。方法选择广东省英德市人民医院2018年5月至2022年2月糖尿病患者74例为观察组;选择同期健康体检者66例为对照组。通过测定两组人员的血清25-(OH)D、促甲状腺素(TSH)、空腹血糖水平(FPG)、胰岛素(FINS),并计算出相应的β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR);根据25-(OH)D水平分为缺乏组、不足组、充足组和中毒组,比较不同分组下甲状腺功能和胰岛素抵抗水平,并进行与25-(OH)D水平的相关性分析。结果观察组血清25-(OH)D水平低于对照组,TSH、HOMA-IR及空腹血糖高于对照组,HOMA-β低于对照组,差异有统计学意义(P<0.05)。25-(OH)D缺乏组TSH、HOMA-IR、空腹血糖高于不足组、充足组和中毒组,HOMA-β低于不足组、充足组和中毒组,差异有统计学意义(P<0.05)。Pearson相关性分析,糖尿病患者25-(OH)D水平与空腹血糖、TSH、HOMA-IR水平呈负相关性(P<0.05);与HOMA-β呈正相关性(P<0.05)。结论糖尿病患者常伴有25-(OH)D水平降低,其表达水平不同患者甲状腺功能、胰岛素抵抗存在差异性,且与胰岛素抵抗存在较强的相关性。

Objective To investigate the expression of serum 25 hydroxyvitamin D(25-[OH]D)in patients with diabetes and its correlation with thyroid function and insulin resistance.Methods A total of 74 patients with diabetes from May 2018 to February 2022 in People's Hospital of Yingde City were selected as the observation group;66 health examinees in the same period were selected as the control group.By measuring the serum 25-(OH)D,thyroid stimulating hormone(TSH),fasting blood glucose(FPG)and fasting insulin(FINS)of the two groups,the correspondingβcell function(HOMA-β),insulin resistance index(HOMA-IR).According to the 25-(OH)D level,the patients were divided into deficiency group,deficiency group,sufficiency group and poisoning group.The thyroid function and insulin resistance levels in different groups were compared,and the correlation analysis with the 25-(OH)D level was completed.Results The serum 25-(OH)D level in the observation group was lower than that in the control group,TSH,HOMA-IR and fasting blood glucose were higher than those in the control group,HOMA-βwas lower than that in the control group,with statistical significances(P<0.05).TSH,HOMA-IR and fasting blood glucose in 25-(OH)D deficiency group were higher than those in insufficient group,adequate group and poisoning group,HOMA-βwas lower than that in the insufficient group,sufficient group and poisoning group,with statistical significances(P<0.05).Pearson correlation analysis showed that 25-(OH)D levels were negatively correlated with fasting blood glucose,TSH and HOMA-IR levels in diabetic patients,and positively correlated with HOMA-β(P<0.05).Conclusion The level of 25-(OH)D is often decreased in patients with diabetes.There are differences in thyroid function and insulin resistance in patients with different levels of its expression,and there is a strong correlation with insulin resistance.