2型糖尿病合并维生素D缺乏患者血浆中胆固醇调节元件结合蛋白1C的表达与25羟维生素D水平的相关性研究

Relationship between plasma SREBP-1C expression and 25(OH)D level in patients with type 2diabetes mellitus and vitamin D deficiency

目的探讨T2DM合并VitD缺乏患者血浆中胆固醇调节元件结合蛋白1C(SREBP-1C)表达与25羟维生素D[25(OH)D]水平的关系。方法选取遵义医学院附属医院内分泌科新诊断单纯T2DM患者(T2DM组)63例,T2DM合并VitD缺乏患者(T2DM+VitD缺乏组),正常人群合并VitD缺乏者(NC+VitD缺乏组)64例及健康对照者(NC组)70名。比较各组25(OH)D水平,RT-PCR、Western blot检测SERBP-1CmRNA及蛋白的表达。结果T2DM+VitD缺乏组与T2DM组比较,血浆中SERBP-1CmRNA及蛋白表达、FPG、HbA_1c、TG、FIns、胰岛素抵抗指数(HOMA-IR)升高,25(OH)D水平减低(P<0.05);Pearson相关分析显示,血浆中25(OH)D水平与HbA_1c、HOMA-IR、FIns、FPG、2hPG、TG、SREBP-1CmRNA及蛋白表达均呈负相关(P<0.05)。结论 T2DM合并VitD缺乏患者血浆中25(OH)D水平明显减低,SREBP-1C的表达及TG升高,推测血浆中25(OH)D水平降低可能引起外周血SREBP-1C表达升高,致脂代谢异常,加重IR,导致糖尿病。

Objective To investigate the relationship between plasma SREBP-1 Cexpression and 25（OH）D level in patients with type 2 diabetes mellitus andvitamin D deficiency. Methods All the subjects were enrolled from Department of Endocrinology outpatient and inpatient in Zunyi Medical College Hospital,and divided into four groups：type2 diabetes（T2DM）with vitamin D deficiency（T2DM＋VitD deficiency group,n=61）,T2DM with normal vitamin D（T2DM group,n=63）,normal glucose with vitamin D deficiency（NC＋VitD deficiency group,n=64）and normal glucose with normal vitamin D group（NC group,n=70）.The 25（OH）D levels were compared between each group.The expression of SREBP-1 CmRNA and protein levels were tested by Real Time PCR and Western blot respectively. ResultsSERBP-1 CmRNA and protein expression,FPG,HbA1 c,TG,Fins and HOMA-IR are elevated（P0.05）,while 25（OH）D level is reduced in T2DM＋VitD deficiency group than in T2DM group（P0.05）.Pearson correlation analysis indicated that serum 25（OH）D levels were negatively correlated with HbA1 c,HOMA-IR,Fins,FPG,2 hPG,TG,SREBP-1 C mRNA and protein expression（P 0.05）.Conclusion Serum 25（OH）D level decreased,while the expression of SREBP-1 Cand TG increasedin patients with T2DM and vitamin D deficiency.It could be speculated that serum 25（OH）D leveldegradation may lead to peripheral blood SREBP-1 Crise,resulting in lipid metabolism disorder,causing high blood triglycerides,increase insulin resistance and lead to diabetes.