不同体质指数新诊断男性2型糖尿病患者25-羟维生素D水平及相关性分析

Analysis of 25-hydroxyvitamin D level and its correlation in newly diagnosed type 2 diabetes mellitus with different body mass indexfor male

目的分析新诊断男性2型糖尿病(T2DM)患者体内25-羟维生素D[25(OH)D3]水平的变化,探讨其与体质指数(BMI)、胰岛素抵抗(IR)和胰岛β细胞功能的关系。方法收集2018年1月至2019年12月中国科学技术大学附属第一医院(安徽省立医院)内分泌科住院新诊断男性T2DM患者84例作为T2DM组,选择同期在医院健康体检中心的男性体检者30例作为对照组。检测血清25(OH)D3、空腹血糖(FPG)、空腹胰岛素水平(FIns)等指标,并于75 g葡萄糖耐量试验(OGTT)或馒头餐试验后30、60和120 min采集静脉血检测血糖和胰岛素。结果T2DM组血清25(OH)D 3水平低于对照组,差异有统计学意义(P<0.05)。随着BMI水平增高,25(OH)D 3水平降低,胰岛β细胞功能指数(HOMA-β)呈下降趋势(P<0.05),胰岛素抵抗指数(HOMA-IR)呈上升趋势(P<0.05)。T2DM组行馒头餐或OGTT试验后不同时间的血糖、胰岛素、C肽水平差异有统计学意义(P<0.05)。随时间的推移各数值均有上升趋势,组别和时间因素对血糖、胰岛素、c肽水平变化有交互作用(P<0.05)。25(OH)D3与BMI、糖化血红蛋白(HbA1c)、HOMA-IR、HOMA-β呈负相关(P<0.05)。结论低水平25(OH)D3可能与导致T2DM发病的IR及胰岛素敏感性下降有关。

Objective To explore the relationship of 25-hydroxyvitamin D[25(OH)D3]and body mass index(BMI),insulin resistance(IR)andβ-cell function in patients with newly diagnosed T2DM for male.Methods This study included 84 newly diagnosed T2DM for patients of male and 30 subjects with NGT in the Department of Endocrinology,the First Affiliated Hospital of China University of Science and Technology(Anhui Provincial Hospital)from January 2018 to December 2019.Venous blood samples were collected and serum 25(OH)D3,fasting blood glucose levels(FPG),fasting insulin levels(FIns)and other biochemical parameters were assayed.Postprandial venous blood samples were collected at 30,60 and 120 minutes after 75g glucose tolerance test or steamed bun meal.Results The level of serum 25(OH)D3 in group of T2DM was significantly lower than that in control group(P<0.05).With the increase of BMI level,25(OH)D3 level decreased,isletβcell function index(HOMA-β)showed a downward trend(P<0.05),insulin resistance index(HOMA-IR)showed an upward trend(P<0.05).There was a statistically significant difference in blood glucose,insulin and C-peptide levels at different timepoints after the steamed bun meal or OGTT test in T2DM group(P<0.05).Each value had an upward trend over time.Group and time factors had an interactive effect on the changes of blood glucose,insulin and c-peptide levels(P<0.05).Correlation analysis showed that 25(OH)D3 was negatively correlated with BMI,glycated hemoglobin(HbA1c),HOMA-IR and HOMA-β(P<0.05).Conclu sions The low level of 25(OH)D3 may be related to the IR and decrease of insulin sensitivity leading to the onset of T2DM.