血清25羟基维生素D水平与糖代谢异常的关系探讨

The study on relationship between serum 25-hydroxyvitamin D and abnormal glucose metabolism

目的:探讨人群不同糖代谢状态与血清25羟基维生素D[25(OH)D]水平的相关关系。方法:采用横断面调查研究,对2008—2014年于深圳市南山区人民医院体检的300例成年人进行口服葡萄糖耐量试验(OGTT),将其分为6组:正常糖耐量(NGT)组、空腹血糖受损(IFG)组、1h高血糖(1hHPG)组、糖耐量异常(IGT)组、IFG合并IGT组及2型糖尿病(T2DM)组,每组50例。检测一般生化指标、空腹血糖(FPG)及糖负荷后0.5h、1h、2h、3h血糖、真胰岛素(FTI),计算糖负荷后0.5h胰岛素增量与葡萄糖增量的比值(△I30/△G30)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HBCI)、校正胰岛素抵抗后的胰岛β细胞功能(HBCI/IR),分析血清25(OH)D水平与糖代谢的关系。结果:6组血清25(OH)D水平比较差异具有统计学意义(F=2.43,P=0.035);其中NGT组血清25(OH)D水平最高,T2DM组最低。校正年龄、性别、体重指数(Ibm)等因素后,25(OH)D与FPG、糖负荷后各时间点(1h、2h、3h)血糖、糖化血红蛋白(HbA1c)呈负相关关系(r=-0.221、-0.223、-0.224、-0.231、-0.191,均P<0.05),与HBCI/IR呈正相关关系(r=0.205,P<0.01)。多因素Logistic回归分析结果显示25(OH)D是糖代谢异常的保护因素(P<0.05)。结论:血清25(OH)D水平与血糖水平呈负相关关系,是糖代谢异常的保护因素。

Objective. To investigate the relationship between different glucose metabolism and serum level of 25-hydroxyvitamin D 1-25 （OH） D]. Methods： By cross-sectional study, subjects were selected from physical examination in Nanshan hospital of Shenzhen from 2008-2014, following 75 g oral glucose tolerance test （OGTT）, and divided into six groups： normal glucose tolerance （NGT）, impaired fasting glucose （IFG）, 1 h hyperglycemia （1 h HPG）, impaired glucose tolerance （IGT）, IFG combined with IGT, and type 2 diabetes mellitus （T2DM） groups, 50 cases in each group. Fasting blood-glucose （FPG） and post glucose load 0.5 h, 1 h, 2 h, 3 h plasma glucose, and true insulin levels were measured. △I30/△G30, HOMA-IR, HBCI and HBCI/IR were calculated accordingly to evaluate islet function. The relationship between 25 （OH） D and glucose metabo lism was analyzed. Results： The differences of serum 25 （OH） D among the six groups were significant （P d0.05）. The NGT group exerted the highest level of 25（OH） D, while the T2DM group were found to have the lowest level of 25（OH）D. Adjusted for age, sex and body mass index, the level of 25（OH）Dwas negatively correlated to FPG, glycosylated hemoglobin and blood glucose level after OGTT（r= 0. 221, -0. 223, -0. 224, -0. 231 and -0. 191 ,All P〈0.05）, and was positively correlated to HBCI/IR（r=0. 205, P〈0.01）. Multivariate logistic regression analysis showed that 25 （OH）D was independent protective factor for the occurrence of abnormal glucose （P〈0.05）. Conclusion： The level of 25（OH）D was negatively correlated to the blood glucose level, and 25（OH）D was independent protective factor for the occurrence of abnormal glucose.