长期补充维生素D对2型糖尿病患者冠状动脉钙化的影响研究

Effects of long-term vitamin D supplementation on coronary artery calcification in patients with type 2 diabetes

目的探讨2型糖尿病(T2DM)患者长期补充维生素D对冠状动脉钙化造成的影响。方法选取2017年3月至2020年3月本院收治的100例T2DM患者作为研究对象,采用随机数字法分为研究组与参照组,每组50例。参照组采用口服降糖药物和控制饮食治疗,研究组在参照组基础上联合补充维生素D治疗。比较两组治疗前后超敏C反应蛋白(hs-CRP)、血清25羟基维生素D_(3)[25-(OH)D_(3)]水平、血糖指标和冠状动脉钙化积分,并分析各相关指标与血清25-(OH)D_(3)的相关性。结果治疗后,两组HbA1c、FPG、BMI、HOMA-IR、hs-CRP均低于治疗前,且研究组均低于参照组,差异有统计学意义(P<0.05)。治疗后,两组冠状动脉积分均低于治疗前,且研究组低于参照组,差异有统计学意义(P<0.05)。治疗后,与血清25-(OH)D_(3)≥25 nmol/L的患者比较,血清25-(OH)D_(3)<25 nmol/L患者HbA1c、FPG、BMI、HOMA-IR、hs-CRP、冠状动脉钙化积分均明显较低(P<0.05)。血清25-(OH)D_(3)与HbA1c、FPG、BMI、HOMA-IR、hs-CRP、冠状动脉钙化积分均呈负相关(P<0.05)。结论T2DM患者长期补充维生素D有利于抑制炎性反应,对减轻冠状动脉钙化、降低胰岛素抵抗、控制血糖的稳定具有显著作用。

Objective To investigate the effect of long-term vitamin D supplementation on coronary artery calcification in patients with type 2 diabetes mellitus(T2 DM).Methods 100 patients with T2 DM who were admitted to our hospital from March 2017 to March 2020 were selected as the research subjects and they were divided into study group and reference group by random number method,with 50 cases in each group.The referencegroup was treated with oral hypoglycemic drugs and diet control,while the study group was treated with vitamin D supplementation on the basis of the control group.Hypersensitive C-reactive protein(hs-CRP),serum 25-(OH)D_(3) levels,blood glucose indexes and coronary artery calcification scores were compared between the two groups before and after treatment,and the correlation between the related indexes and serum 25-(OH)D_(3) was analyzed.Results After treatment,HbA1 c,FPG,BMI,HOMA-IR,hs-CRP in both groups were lower than before treatment,and the study group were lower than the reference group,the difference was statistically significant(P<0.05).After treatment,the coronary scores of both groups were lower than before treatment,and the study group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,compared with the patients with serum 25-(OH)D_(3)≥25 nmol/L,the HbA1 c,FPG,BMI,HOMA-IR,hs-CRP and coronary artery calcification scores were significantly lower in the patients with serum 25-(OH)D_(3)<25 nmol/L(P<0.05).Serum 25-(OH)D_(3) was negatively correlated with HbA1 c,FPG,BMI,HOMA-IR,hs-CRP and coronary artery calcification scores(P<0.05).Conclusion Long-term vitamin D supplementation in patients with T2 DM is beneficial to inhibit inflammatory response,reduce coronary artery calcification,reduce insulin resistance,and control the stability of blood glucose.