新诊断2型糖尿病患者血清25羟维生素D与胰岛β细胞第一时相分泌关系的观察

The relationship between serum 25-hydroxy vitamin D and the first-phase insulin secretion of β cell in newly diagnosed type 2 diabetic patients

目的观察新诊断T2DM患者血清中25羟维生素D[25（OH）D]与胰岛β细胞第一时相分泌的关系。方法选取新诊断T2DM患者（T2DM组）188例及正常对照（NGT组）组190名,测定临床资料和生化指标。以葡萄糖刺激后3-5min急性胰岛素反应（AIR3-5）表示第一时相胰岛素分泌功能指数,并进行比较分析。结果 T2DM组25（OH）D和AIR3-5均低于NGT组[25（OH）D：（14.70±9.40）vs（36.70±11.30）ng/ml;AIR3-5：（7.58±2.25）vs（57.38±9.34）mU/L,P〈0.05];AIR3-5与25（OH）D、HDL-C呈正相关（P〈0.05）,与TC、TG、LDL-C、BMI、WHR、FFA、2hFA、FPG、2hPG、FIns均呈负相关（P均〈0.05）。25（OH）D、TG和BMI是AIR3-5的独立影响因素（β=0.351、-0.328、-0.238,P均〈0.05）。结论新诊断T2DM患者25（OH）D和AIR3-5水平均降低,且呈正相关,25（OH）D可预测胰岛素分泌功能。

Objective To evaluate the relationship between serum 25‐hydroxy vitamin D [25（OH） D] and the first‐phase insulin secretion of beta cell in newly diagnosed type 2 diabetic patients.Methods Clinical characteristics and laboratory data were collected in 188 newly diagnosed type 2 diabetic patients （T2DM group） and 190 normal glucose tolerance subjects （NGT group）.AIR3-5 （3-5 minutes acute insulin response） was calculated as the average internal insulin concentration during 3 to 5 minutes after the glucose loading and the results were compared between two groups. Results The levels of serum 25（OH）D and AIR3-5 were lower in T2DM group than in NGT group[25（OH）D ：（14.7 ± 9.4） vs （36.7 ± 11.3）ng/ml;AIR3-5 ：（7.58 ± 2.25） vs （57.38 ± 9.34）mU/L ,P〈 0.05].AIR3-5 was positively associated with 25（OH）D and HDL‐C（P〈0.05） ,and negatively correlated with TC ,TG ,LDL‐C ,BMI , WHR ,FFA ,2 hFA ,FPG ,2 hPG and FIns （all P〈 0.05）.The 25 （OH）D ,TG and BMI were the independent relative factors for AIR3-5. Conclusion The levels of 25（OH）D and AIR3-5 are decreased in newly diagnosed type 2 diabetes mellitus.AIR3-5 is positively correlated with 25（OH）D ,and 25（OH）D may predict insulin secretion capability.