老年2型糖尿病患者血清维生素D水平与同型半胱氨酸及胰岛素敏感性的相关性研究

Effects of serum vitamin D on homocysteine and insulin sensitivity of elderly patients with type 2 diabetes

目的探讨老年T2DM患者血清维生素D[25(OH)D_3]水平与同型半胱氨酸(Hcy)及IS的相关性。方法选取T2DM患者122例,按25(OH)D_3值分为正常(ND_3)组[25(OH)D_3≥30ng/ml]、不足(InsD_3)组[20≤25(OH)D_3<30 ng/ml]、缺乏(DefD_3)组[10≤25(OH)D_3<20 ng/ml]和严重缺乏(SdefD_3)组[25(OH)D_3<10 ng/ml],观察4组间Hcy,FPG、FIns,胰岛素敏感指数(ISI)和HbA_1c的差异。结果 4组Hcy、FPG、FIns、ISI、Hb A_1c、25(OH)D_3比较,差异有统计学意义(P<0.01),并随着25(OH)D_3的降低,Hcy,FPG,FIns、HBA_1c均随之升高,而ISI逐渐降低(P<0.05)。结论 FPG、FIns、ISI、HbA_(1C)、Hcy与老年T2DM患者25(OH)D_3水平密切相关。25(OH)D_3可降低FPG,增加IS,改善胰岛功能,对预防和更好地控制糖尿病并发症有一定的临床意义。

Objective To study the effects of serum vitamin D levels on homocysteine （Hcy） and insulin sensitivity of elderly patients with type 2 diabetes （T2DM）. Methods According to the levels of serum vitamin D,122 elderly T2DM patients were divided into four groups：serious deficient group [SdefD3,25（OH）D3＆lt;10 ng/ml],deficient group [DefD3,10≤（OH）D3＆lt;20 ng/ml],insufficient group [InsD3,20≤25（OH）D3＆lt;30 ng/ml],normal group [ND3,25（OH）D3≥30 ng/ml].The differences of Hcy,fasting blood glucose （FPG）,fasting insulin （FIns） and HbA1c were observed among four groups. Results There were significant differences among the four groups （P〈0.01）.The levels of 25（OH）D3 had positive correlation with insulin sensitivity,but negative correlation with Hcy,FPG,FIns and HbA1c. Hcy,FPG,Fins and ISI index were the influence factors on serum vitamin D levels in elderly T2DM patients. Conclusion Vitamin D can improve pancreatic island function and benefit to prevent and control diabetic complications.