骨化三醇对不同VitD水平糖尿病前期患者胰岛功能影响的研究

Effect study of calcitriol on islet function in prediabetic patients with different VitD levels

目的探讨骨化三醇对不同VitD水平糖尿病前期患者胰岛功能的影响。方法选取2018年1~8月我院糖尿病前期人群为研究组(n=91)、健康人群为对照组(n=30),测血清25(OH)VitD、空腹血糖及胰岛素。研究组予骨化三醇0.25μg/d治疗,3个月后复测空腹血糖及胰岛素,计算治疗前后HOMA-IR、HOMA-IS、HOMA-β,比较治疗前后胰岛B细胞功能。结果研究组血清25(OH)VitD水平显著低于对照组(P<0.01),其治疗后HOMA-IR显著下降(P<0.01),HOMA-IS显著升高(P<0.01),HOMA-β、空腹血糖无显著改变(P>0.05);将其根据25(OH)VitD为轻度低下组(A组,≥15 ng/mL)和重度低下组(B组,<15 ng/mL),发现A组治疗前后HOMA-IR、HOMA-IS、HOMA-β无明显变化(P>0.05),B组治疗后HOMA-IR显著下降(P<0.01),HOMA-IS、HOMA-β显著升高(P<0.01、P<0.05)。结论低25(OH)VitD可能是糖尿病前期的危险因素,骨化三醇可改善重度低25(OH)VitD者胰岛B细胞功能,可预防或延缓糖尿病的发生。

Objective To explore the effect of calcitriol on islet function in prediabetic patients with different VitD levels.Methods From January to August 2018,the pre diabetes population in our hospital was selected as the study group(n=91)and the healthy population as the control group(n=30).Serum 25(OH)VitD,fasting blood sugar and insulin in the two groups were measured.Calcitriol 0.25μg/d was given to the research group.Fasting blood sugar and insulin were reexamined after 3 months.The levels of HOMA-IR,HOMA-IS and HOMA-βbefore and after treatment were calculated,and the islet B-cell function before and after treatment were compared.Results It was found that the level of Serum 25(OH)VitD in the research group was significantly lower than that in the control group(P<0.01).The HOMA-IR level after treatment was significantly declined(P<0.01).The HOMA-IS level after treatment was significantly elevated(P<0.01).There were no significant changes in the levels of HOMA-βand fasting blood sugar(P>0.05).The patients were divided into the mild low group(group A,≥15 ng/mL)and the severe low group(group B,<15 ng/mL)according to the 25(OH)VitD level.There was no significant change in HOMA-IR,HOMA-IS or HOMA-βin group A before and after treatment.The level of HOMA-IR in group B was significantly declined after treatment(P<0.01),and the levels of HOMA-IS and HOMA-βin group B were significantly elevated after treatment(P<0.01,P<0.05).Conclusion Low 25(OH)VitD might be a risk for predisbete.Calcitriol can improve the islet B-cell function in patients with severe low 25(OH)VitD,and prevent or delay the occurrence of diabetes.