维生素D对老年男性2型糖尿病患者糖代谢的影响

Effect of vitamin D on glucose metabolism in male elderly patients with type 2 diabetes mellitus

目的探讨维生素D(骨化三醇)对老年男性2型糖尿病患者糖代谢的影响。方法选取2018年5月-2019年5月在新华医院老年医学科门诊就诊的老年男性2型糖尿病且近3个月未服用过维生素D及抗骨质疏松药物的患者共168例,根据数字表法随机分为观察组和对照组,每组84例。对照组维持原治疗方案,观察组在与对照组相同的原治疗方案上加口服骨化三醇,2组疗程均为6个月。评估并比较2组患者治疗前后的空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1C)、胰岛素抵抗指数(HOMA-IR)、胰岛素细胞功能指数(HOMA-)和25羟维生素D[25(OH)D]等指标值的情况。根据骨密度检测,将观察组分为糖尿病骨质疏松亚组(n=44)和糖尿病非骨质疏松亚组(n=40),比较2亚组治疗前后上述指标的变化。结果与治疗前比较,治疗后观察组HbA1C水平显著降低,25(OH)D水平显著升高(P<0.05);对照组25(OH)D水平显著降低(P<0.05)。治疗后糖尿病非骨质疏松亚组HbA1C水平较治疗前显著降低,25(OH)D水平显著升高(P<0.05);治疗后糖尿病骨质疏松亚组25(OH)D水平较治疗前显著升高(P<0.05)。结论补充维生素D可降低老年2型糖尿病患者的Hb A1C水平,且非骨质疏松患者比骨质疏松患者疗效更显著。

Objective To investigate the effect of vitamin D(calcitriol)on glucose metabolism in male elderly patients with type 2 diabetes mellitus.Methods From May 2018 to May 2019,168 elderly male patients with type 2 diabetes mellitus who had not taken vitamin D or anti-osteoporosis drugs in the past 3 months were selected.They were divided into the observation group and the control group by the random number table method,84 patients each group.The control group was treated with the original plan,and the observation group was treated with adding oral calcitriol besides the original plan as the control group.Both groups were observed for 6 months.The levels of the fasting blood glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin(HbA1 C),insulin resistance index(HOMA-IR),insulin beta cell function index(HOMA-),25 hydroxyvitamin D[25(OH)D]and other indicators before and after treatment were compared between two groups.According to bone mineral density(BMD)examination,the observation group was divided into diabetic osteoporosis group(n=44)and diabetic non-osteoporosis group(n=40),and the differences of the above indexes before and after treatment were compared between these two sub-groups.Results HbA1 C level in the observation group decreased significantly after treatment and 25(OH)D level increased significantly(P<0.05),while 25(OH)D level in the control group was significantly lower after treatment than before treatment(P<0.05).Hb A1 C level in diabetic non-Osteoporosis group decreased significantly after treatment and 25(OH)D level increased significantly(P<0.05),while the level of 25(OH)D in diabetic osteoporosis group was significantly increased after treatment(P<0.05).Conclusions Vitamin D supplementation can reduce HbA1 C level in elderly patients with type 2 diabetesmellitus,and non-osteoporosis patients have more obvious curative effect than osteoporosis patients.