血清1,25-二羟维生素D_3水平与糖尿病肾病的关系研究

Relationship between Serum 1,25-Dihydroxyvitamin D_3 and Diabetic Nephropathy

目的探讨血清1,25-二羟维生素D3水平与2型糖尿病(T2DM)的关系及其在糖尿病肾病(DN)发生发展中的意义。方法选择64例2型糖尿病患者和20名正常对照者,根据尿清蛋白肌酐比值(ACR)及血肌酐值将糖尿病患者分为糖尿病正常蛋白尿组、微量蛋白尿组、大量蛋白尿组及肾功能不全组。采用ELISA法测定血清1,25-二羟维生素D3水平,同时常规测定血糖、血脂、糖化血红蛋白、肌酐、血钙、血磷、体质指数及胰岛素等指标。结果 (1)2型糖尿病组的血清1,25-二羟维生素D3水平明显低于正常对照组,差异有统计学意义(P<0.05)。(2)正常蛋白尿组、微量蛋白尿组、大量蛋白尿组及肾功能不全组的血清1,25-二羟维生素D3水平逐渐降低,组间比较差异均有统计学意义(P<0.05)。(3)血清1,25-二羟维生素D3与体质指数、血肌酐、胰岛素抵抗指数(HOMA-IR)呈负相关(P<0.05)。结论血清1,25-二羟维生素D3水平可能与2型糖尿病及糖尿病肾病相关,可能是2型糖尿病和糖尿病肾病发生发展中的重要因素。

Objective To explore the association of serum 1,25-Dihydroxyvitamin D3 level with type 2 diabetes mellitus（T2DM） and its role in development of diabetic nephropathy（DN）. Methods Totally 64 T2DM patients and 20 healthy subjects were recruited.The patients were further divided as groups of non-albuminuria,micro-albuminuria,poly-albuminuria,and renal insufficiency according to the urinary albumin to creatinine ratio（ACR） and serum creatinine level.The level of serum 1,25-Dihydroxyvitamin D3 was detected by enzyme linked immunosorbent assay（ELISA）,and the levels of blood glucose,lipid,glycosylated hemoglobin（HbA1c）,creatinine,calcium,phosphorus,body mass index,and insulin were measured. Results（1）The T2DM patients had lower serum 1,25-Dihydroxyvitamin D3 levels than healthy subjects and the difference was statistically significant（P〈0.05）.（2） Serum 1,25-Dihydroxyvitamin D3 levels of the four groups were gradually decreased and significant differences were observed（P〈0.05）.（3） Serum 1,25-Dihydroxyvitamin D3 levels was negatively correlated with BMI,serum creatinine and HOMA insulin resistance index（HOMA-IR）（P〈0.05）. Conclusion The level of serum 1,25-Dihydroxyvitamin D3 may be associated with type 2 diabetes mellitus and diabetic nephropathy,playing an important role in their procedures.