新发2型糖尿病患者维生素D与胰岛素抵抗的相关性

Correlation between vitamin D and insulin resistance in newly diagnosed type 2 diabetes patients

目的探讨新发2型糖尿病(type 2 diabetes mellitus,T2DM)患者25-羟基维生素D3[25(OH)D3]水平与胰岛素抵抗、尿pH值等因素的相关性。方法分别测定325例非糖尿病患者(对照组)及208例新发T2DM患者(新发T2DM组)的25(OH)D_(3)水平,并根据25(OH)D_(3)水平将新发T2DM患者分成新发T2DM患者维生素D缺乏组(n=92)及新发T2DM患者维生素D非缺乏组(n=116)。非缺乏组25(OH)D_(3)水平为20~100 ng/mL;缺乏组25(OH)D_(3)水平为<20 ng/mL;25(OH)D_(3)与胰岛素抵抗、尿pH值等的相关性采用SPSS 26.0统计软件来进行统计分析。结果新发T2DM组25(OH)D_(3)水平低于对照组(P<0.01);新发T2DM患者维生素D缺乏组的年龄、糖化血红蛋白、胰岛素抵抗指数、尿pH值、游离三碘甲状腺原氨酸(FT_(3))和游离甲状腺素(FT_(4))均高于非缺乏组(P<0.05),而组间的胰岛功能指数、空腹C肽、血清钙、促甲状腺激素(TSH)差异无统计学意义(P>0.05)。Logistic回归分析显示,糖化血红蛋白(OR=1.776,P<0.05)、胰岛素抵抗指数(OR=1.289,P<0.05)是新发T2DM患者维生素D缺乏的危险因素。结论新发T2DM患者25(OH)D_(3)水平低于对照组。较高的糖化血红蛋白和胰岛素抵抗指数是T2DM合并维生素D缺乏的危险因素。

Objective To investigate the correlation between 25-hydroxyvitamin D,[25(OH)D,]J levels and in-sulin resistance,urine pH,and other factors in newly diagnosed type 2 diabetes mellitus(T2DM)patients.Methods The levels of 25(OH)D_(3) were measured in 325 non-diabetic patients(normal control group,n=325)and 208 newly di-agnosed T2DM patients(newly diagnosed T2DM group,n=208).Based on the levels of 25(OH)D_(3),newly diagnosed T2DM patients were divided into vitamin D deficiency group(n=92)and non-deficiency group(n=116).The level of 25(OH)D_(3) was considered deficient if it was<20 ng/mL and sufficient if it was 20-100 ng/mL.The correlation be-tween 25(OH)D_(3)and insulin resistance,urine pH,etc.,was analyzed using SPSS 26.0.Results The level of 25(OH)D_(3)in the newly diagnosed T2DM group was higher than that in the normal control group(P<0.01);the age,glycated hemo-globin,insulin resistance index,urine pH,free triodothyronine(FT_(3)),and free thyroxine(FT_(4))in the deficiency group were higher than those in the non-deficiency group(P<0.05),while there was no statistically significant difference in pancreatic function index,fasting C-peptide,serum calcium,and thyroid-stimulating hormone(TSH)between the two groups(P>0.05).Logistic regression analysis showed that glycated hemoglobin(OR=1.776,P<0.05)and insulin resistance index(OR=1.289,P<0.05)were risk factors for vitamin D deficiency in newly diagnosed T2DM patients.Conclusion The level of 25(OH)D_(3)in the newly diagnosed T2DM group was lower than that in the normal control group.Higher glycated hemoglobin and insulin resistance index are risk factors for vitamin D deficiency in patients with T2DM.