补充维生素D对初诊2型糖尿病患者血糖及胰岛素抵抗的影响

Effect of vitamin D supplementation on blood glucose and insulin resistance in patients newly diagnosed with type 2 diabetes mellitus

目的探讨补充维生素D对初诊2型糖尿病(T2DM)患者血糖及胰岛素抵抗的影响。方法选取120例初诊T2DM患者,随机分为对照组和研究组,每组60例,对照组患者给予二甲双胍治疗,研究组患者给予二甲双胍+骨化三醇治疗,两组均连续治疗6个月。比较两组患者治疗前及治疗6个月后空腹血糖、空腹胰岛素(FINS)、血清钙、血清磷、ALP、全段甲状旁腺激素(iPTH)、糖化血红蛋白(HbA1c)、血清25-羟维生素D 3[25-(OH)D 3]水平及稳态模型胰岛素抵抗(HOMA-IR)指数等指标。结果治疗后,两组患者空腹血糖、FINS、HOMR-IR指数、HbA1c均较治疗前降低,且研究组低于对照组;研究组25-(OH)D 3水平较治疗前升高,且与HbA1c、空腹血糖、HOMA-IR指数均呈负相关(均P<0.05)。结论补充维生素D可以改善初诊T2DM患者的胰岛素抵抗,更好地控制血糖。

Objective To explore the effect of vitamin D supplementation on blood glucose and insulin resistance in patients newly diagnosed with type 2 diabetes mellitus(T2DM).Methods A total of 120 patients newly diagnosed with T2DM were randomly divided into control group and study group,with 60 cases in each group.Patients in the control group were given metformin,whereas patients in the study group were treated with metformin plus calcitriol.The treatment lasted for six months in both groups.The levels of FBG,fasting insulin(FINS),serum calcium,serum phosphorus,ALP,intact parathyroid hormone(iPTH),hemoglobin A1c(HbA1c),serum 25-hydroxyvitamin D 3[25-(OH)D 3]as well as homeostasis model assessment-insulin resistance(HOMA-IR)index were compared between the two groups before and six months after treatment.Results After treatment,the levels of FBG,FINS,HOMR-IR index and HbA1c were decreased in both groups compared with those before treatment,and the study group had lower levels than the control group;the level of 25-(OH)D 3 was increased in the study group compared with that before treatment,and negatively correlated with HbA1c,FBG,and HOMR-IR index(all P<0.05).Conclusion Vitamin D supplementation can improve insulin resistance and better control blood glucose in patients newly diagnosed with T2DM.