2型糖尿病患者维生素D缺乏的影响因素及补充维生素D的临床效果分析

Clinical effect of deficiency and supplementation of vitamin D in patients with type 2 diabetes mellitus

目的:探讨2型糖尿病(T2DM)患者维生素D缺乏的影响因素及维生素D在T2D M发生发展中的作用,明确补充维生素D在提升T2D M患者治疗及预后效果中的作用。方法:分析2020年6月—2021年12月凉山彝族自治州第一人民医院收治的488例T2D M患者,按照是否合并维生素D缺乏分为维生素D缺乏组(n=379)和非维生素D缺乏组(n=109);再将维生素D缺乏组分为对照1组(n=312)和观察1组(n=67)两个亚组;非维生素D缺乏组分为对照2组(n=91)和观察2组(n=18)两个亚组。对照组(对照1组和对照2组)患者均遵医嘱降糖治疗,观察组(观察1组和观察2组)患者在对照组治疗基础上补充维生素D。对比两组效果。结果:高龄、每日晒太阳时间短、未补钙均为T2DM患者维生素D缺乏的危险因素(P<0.05);干预前各组内亚组间糖化血红蛋白(HbA1c)、餐前血糖(FBG)、餐后2 h血糖(2 hPBG)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)水平比较,差异无统计学意义(P>0.05);干预后,各组内观察组HbA1c、FBG、2 hPBG、HOMA-IR、HOMA-β水平优于对照组,差异有统计学意义(P<0.05)。结论:T2D M患者维生素D缺乏与年龄、晒太阳时间及是否补钙均有一定关系;在药物治疗基础上及时补充维生素D可有效控制血糖,还可改善胰岛功能,值得临床应用。

Objective To explore vitamin D deficiency in patients with type 2 diabetes mellitus(T2DM)and the role of vitamin D in the occurrence and development of T2DM,and to clarify the role of vitamin D supplementation in improving the treatment and prognosis of patients with T2DM.Methods A retrospective analysis of 488 patients with T2DM admitted to the First People’s Hospital of Liangshan Yi Autonomous Prefecture from June 2020 to December 2021 was used as the research object.Vitamin D deficiency group(n=109);Vitamin D deficiency T2DM patients were divided into two subgroups,control group 1(n=312)and observation group 1(n=67)according to whether vitamin D supplementation Vitamin D supplementation was divided into two subgroups:control group 2(n=91)and observation group 2(n=18).All the patients in the control group were given hypoglycemic treatment as prescribed by the doctor,and the patients in the observation group were supplemented with vitamin D on the basis of the control group.Compare the effects of the two groups.Results Old age,short daily sun exposure,and lack of calcium supplementation were all risk factors for vitamin D deficiency in T2DM patients(P<0.05),2 h postprandial blood glucose(2 hPBG),insulin resistance index(HOMA-IR),islet beta cell function index(HOMA-β)levels,there was no significant difference(P>0.05);After intervention,the observation group in each group The levels of HbA1c,FBG,2 hPBG,HOMA-IR and HOMA-βwere higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Vitamin D deficiency in T2DM patients is related to age,sun exposure time and calcium supplementation.Timely supplementation of vitamin D on the basis of drug treatment can effectively control blood sugar and improve islet function,which is worthy of clinical application.