活性维生素D_3对2型糖尿病患者胰岛素抵抗的影响研究

Effect of active vitamin D_3 on insulin resistance in patients with type 2 diabetes mellitus

目的探讨活性维生素D3对2型糖尿病患者胰岛素抵抗的影响。方法选取2型糖尿病患者50例,患者在继续常规降糖治疗的基础上,给予活性维生素D_30.25μg口服,1次/d,治疗3个月。观察并比较患者治疗前后糖代谢指标、炎症指标、骨代谢指标的变化。结果活性维生素D_3治疗后,患者血清肌酐、空腹血糖、胰岛素抵抗指数、TNF-α、IL-6水平均低于治疗前(均P<0.05),25-羟基维生素D[25-(OH)D]水平高于治疗前(均P<0.05)。患者治疗前后甲状旁腺激素、血钙、血磷、钙磷乘积、胰岛素样生长因子-1等骨代谢指标比较差异均无统计学意义(均P>0.05)。结论 2型糖尿病患者补充活性维生素D_3治疗可以减轻胰岛素抵抗和炎症反应,改善糖代谢。活性维生素D3可能是通过抑制炎症反应起到减轻2型糖尿病患者胰岛素抵抗的作用。

Objective To investigate the effect of active vitamin D3 on insulin resistance in patients with type 2 diabetes mellitus(T2 DM). Methods Fifty patients with T2 DM were given active vitamin D3(calcitriol) 0.25μg q.d. orally for 3 months in addition to routine hypoglycemic therapy. The changes of glycometabolism, inflammation and bone metabolism were determined before and after treatment.Results After treatment with active vitamin D3, serum creatinine, fasting blood sugar, insulin resistance index, TNF-αand IL-6 were lower than those before treatment(all P<0.05). There was no significant difference in bone metabolic indexes such as parathyroid hormone, blood calcium, blood phosphorus, calcium-phosphorus product and insulin-like growth factor-1 before and after treatment(all P<0.05). Conclusion Active vitamin D3 supplementation can alleviate insulin resistance and inflammation and improve glucose metabolism in T2 DM patients, and its effect of reducing insulin resistance may be associated with inhibition of inflammation.