不同剂量钙尔奇D对维生素D缺乏的糖耐量减低患者胰岛素抵抗的影响

Effects of different doses of Caltrate D supplementation on insulin resistance in patients with impaired glucose tolerance and vitamin D deficiency

目的探讨不同剂量钙尔奇D对维生素D缺乏的糖耐量减低(IGT)患者胰岛素抵抗的影响。方法将糖耐量减低的116例患者根据维生素D水平分为维生素D充足组和维生素D缺乏组。再将维生素D缺乏组随机分为常规剂量组(给予钙尔奇D 1片/d)、双倍剂量组(给予钙尔奇D 2片/d)、对照组(不给予钙尔奇D)。检测血液生化指标,并计算稳态模型胰岛素抵抗指数及稳态模型胰岛素β细胞功能指数,1年后复查。结果治疗1年后,FBG、Hb A1C、BMI、HOMA-IR、25(OH)D均较治疗前有明显改善(P<0.05),且与常规剂量相比较,双倍剂量组的Hb A1C、25(OH)D改善更明显(P<0.05)。将25(OH)D水平作为因变量,将BMI、Hb A1C等其他指标作为自变量,采取多元回归分析显示,血25(OH)D水平与HOMA-β、Ca呈正相关,与Hb A1C、FPG呈负相关。结论补充维生素D可以更好地改善维生素D缺乏的IGT患者胰岛素抵抗状况,且改善程度与维生素D剂量有相关性。

ObjectiveTo observe the effects of different doses of Caltrate D supplementation on insulin resistance in patients with impaired glucose tolerance（IGT） and vitamin D deficiency. MethodsA total of 116 IGT patients were divided into vitamin D sufficient group and vitamin D deficient group based on vitamin D level. And vitamin D deficient group were randomly divided into conventional dose group（Caltrate D for one tablet daily）, double doses group（Caltrate D for tablet daily） and control group（without Caltrate D）. The blood biochemical indicators was detected, HOMA IR, HOMA β were calculated, and the patients were reexamined after one year. ResultsAfter one year of treatment, FBG, HbA1C, BMI, HOMA IR, 25 （OH） D were significantly improved compared with treatment before （P〈0.05）, and compared with the single dose, the double doses group had better improvement in HbA1C, 25 （OH） D. Taking the 25 （OH） D level as a dependent variable, BMI, HbA1C, and other indicators as independent variables, multiple regression analysis showed that blood 25（OH） D level was positively correlated with HOMA β and Ca, and negatively correlated with HbA1C and FPG. ConclusionVitamin D supplementation can improve insulin resistance for patients with impaired glucose tolerance and vitamin D deficiency, and the degree of improvement is correlated with vitamin D doses.