维生素A对1型糖尿病患儿糖脂代谢的影响

Effects of Vitamin A on Glucose and Lipid Metabolism in Children with Type 1 Diabetes

目的:观察维生素A对1型糖尿病患儿成纤维细胞生长因子-19(FGF19)、白细胞介素-17(IL-17)、C肽和脂蛋白-a(LPa)水平的影响,探讨维生素A对患儿残存胰岛β细胞功能及糖脂代谢的影响。方法:选取2018年1月30日至2019年6月30日在我院接受治疗的110例1型糖尿病患儿作为研究对象,按随机数表法分为未干预组(55例)及干预组(55例),两组患儿均接受常规胰岛素治疗,干预组增加维生素A治疗,观察两组患儿治疗前后血糖控制情况、糖化血红蛋白(HbA1C)、C肽、LPa、FGF19、IL-17及血清维生素A水平。选取同期我院体检结果健康的55例儿童作为对照组。结果:对照组维生素A和C肽水平高于干预组和未干预组治疗前水平,而IL-17、LPa以及FGF19水平低于干预组和未干预组治疗前水平,差异均有统计学意义(P<0.05)。治疗后未干预组每日胰岛素用量高于干预组,差异有统计学意义(P<0.05)。治疗后干预组维生素A、C肽水平高于未干预组,IL-17、LPa、FGF19水平低于未干预组,差异有统计学意义(P<0.05)。结论:1型糖尿病患儿存在维生素A缺乏、胰岛β细胞功能受损及糖脂代谢异常,补充维生素A可保护残存胰岛β细胞功能,改善糖脂代谢。

Objective:To observe the effects of vitamin A on levels of fibroblast growth factor-19(FGF19),interleukin-17(IL-17),C peptide and lipoprotein-a(LPa)in children with type 1 diabetes,and to probe into the effects of vitamin A on the function of residual pancreatic isletβ-cells and glucose and lipid metabolism in children.Methods:A total of 110 children with type 1 diabetes admitted into our hospital from Jan.30th,2018 to Jun.30th,2019 were extracted to be divided into the non-intervention group(n=55)and the intervention group(n=55)via the random number table.Both groups received conventional insulin therapy,and the intervention group was given vitamin A.Serum levels of vitamin A,C-peptide,LPa,FGF19 and IL-17,blood glucose,glycosylated hemoglobin(HbA1C)before and after treatment in two groups were observed.A total of 55 children with healthy physical examination results in our hospital were selected as the control group.Results:The levels of vitamin A and C-peptide in the control group were higher than those in the intervention group and the non-intervention group before treatment,while the levels of IL-17,LPa and FGF19 were lower than those in the intervention group and the non-intervention group before treatment,with statistically significant differences(P<0.05).After treatment,the daily insulin consumption of the non-intervention group was higher than that of the intervention group,and the difference was statistically significant(P<0.05).After treatment,the levels of vitamin A and C-peptide in the intervention group were higher than those in the non-intervention group,and the levels of IL-17,LPa,and FGF19 were lower than those in the non-intervention group,with statistically significant differences(P<0.05).Conclusion:Vitamin A deficiency,impaired isletβ-cells function,abnormal glucose and lipid metabolism were found in children with type 1 diabetes.Vitamin A supplementation can protect the residual isletβ-cell function and improve glucose and lipid metabolism.