阿法骨化醇对2型糖尿病患者胰岛β细胞功能、高敏C反应蛋白及糖脂代谢影响的研究

Clinical study on the effect of 1α-hydroxyvitamin D_3 on β cell function,hsC-RP and lipoprotein metabolism in T2DM patients

目的通过观察血糖平稳、治疗方案稳定的T2DM患者补充小剂量阿法骨化醇后血清C-P、糖基化血红蛋白(GHbA1c)、高敏C反应蛋白(hsC-RP)、VLDL-C、LDL-C及大载脂蛋白a(Lpa)水平变化,探讨维生素D(VitD)对T2DM患者胰岛β细胞功能、hsC-RP及糖脂代谢的影响。方法随机选择45例T2DM患者,根据血清25-羟维生素D3(25-OH-D3)水平分为低血清VitD组(LSVD,26例)和正常VitD组(NVSD,19例),两组均给予0.25μg阿法骨化醇1次/d,分别在给药前、给药后4、8、12周观察上述各指标变化。结果 (1)与治疗前比较,LSVD组给予阿法骨化醇4周后,各项指标均下降,但仅hsC-RP治疗前后下降差异有统计学意义(P<0.05);8、12周时除C-P升高外,其他指标均下降、差异有统计学意义(P均<0.005)。(2)两组间不同时段对应指标差值比较,除8周时VLDL-C及12周时C-P差异有统计学意义外(P均<0.01),其余指标差值组间差异均无统计学意义(P均>0.05)。结论 T2DM患者补充VitD具有改善胰岛β细胞功能、调节血糖、血脂代谢,抑制炎症及氧化应激作用。

Objective To study the effect of vitamin D on β cell function, hsC-RP, and the lipoprotein metabolism in T2DM patients through an observation on the changes in the serum levels of C-P, glycosylated hemoglobin A1 c （GHbA1c）, hyper-sensitive C-reaction protein （hsC-RP）, VLDL-C, LDL-C, and large lipoprotein （a） （Lpa） of the patients with well-controlled blood glucose treated by 1α- hydroxyvitamin Yh in small dosage. Methods Forty-five T2DM patients, according to their serum levels of 25-OH-D3, were divided into low serwn vitamin D group （LSVD group, n=26） and normal vitamin D group （NSVD group, n=19）, Both groups were treated with 0. 25μg lwhydroxyvitamin I：h once a day. Before treatment, the 4th, 8th, and 12th weeks after the treatment, the changes in the serum levels of C-P, GHbA1c, bsC-RP, VLDL-C, LDL-C, and Lpa were detected for observation, Results （1） Compared with pratreatment, 1α-hydroxyvitamin D3-treated LSVD group showed that at 4-weeks of therapy, hsC-RP level was significant decreased （P〈0. 05） ,hut the levels of the other parametes were not（P〈0.05）, and at 4-and 12-weeks of the therapy, all levels of parameters except for the increased C-peptide（P〈0. 05） were significantly decreased（P〈0. 05）. （2） In the comparison of the corresponding indices of the different periods of time, the result was that the difference in the level of VLDL-C in the 8th week and the level of C-P at the 12th week was statistically significant between the two groups（P〈0.01）, while the difference in other indices was not statistically significant （P〉0. 05）. Conclusion Administration of vitamin D for the T2DM patients is effective in improving the function of pancreatic β cells, regulating the lipoprotein metabolism, and inhibiting the inflammation and oxidative stress.