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Received:September 15, 2019 Published Online:June 20, 2020
Received:September 15, 2019 Published Online:June 20, 2020
中文摘要: 目的 探讨血清25羟维生素D[25-(OH)D]水平与2型糖尿病(T2DM)患者血糖、胰岛β细胞功能相关性及阿法骨化醇片干预作用。方法 选取2017年11月至2019年3月无锡市太湖医院门诊诊治T2DM患者106例,抽取血液样本测定25-(OH)D水平、糖化血红蛋白(HbA1c)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR),统计分析25-(OH)D与HbA1c、HOMA-β、HOMA-IR间关联性,应用简单随机化分组方法分为研究组和对照组,各53例。对照组采取甘精胰岛素联合沙格列汀片,研究组于对照组基础上加用阿法骨化醇片,均治疗2个月。比较两组治疗前后血糖[HbA1c、空腹血糖(FPG)、餐后2 h血糖(2hPG)]、胰岛β功能指标(HOMA-β、HOMA-IR)、25-(OH)D水平、不良反应。结果 25-(OH)D水平与HbA1c、HOMA-IR存在显著负相关,与HOMA-β存在明显正相关(P<0.01);治疗后研究组HbA1c、FPG、2hPG低于对照组(P<0.01);治疗后研究组HOMA-IR低于对照组,FINS、HOMA-β高于对照组(P<0.05,P<0.01);研究组治疗4周及8周后25-(OH)D水平高于对照组(P<0.05);研究组不良反应发生率(11.32%)与对照组(7.55%)间无明显差异(P>0.05)。结论 25-(OH)D水平与T2DM患者HbA1c、HOMA-IR存在负相关,与HOMA-β存在正相关,阿法骨化醇片可提高患者机体维生素D水平,改善患者血糖水平、胰岛β细胞功能,且安全可靠。
Abstract:Objecitve To investigate the associations of serum 25-hydroxyvitamin D [25-(OH)D] level with blood glucose and islet β-cell function and the effect of alfacalcidol tablets in patients with type 2 diabetes mellitus (T2DM). Methods A total of 106 patients with T2DM treated in outpatient from November 2017 to March 2019 were enrolled and divided into study group and control group(n=53, each). Blood samples were taken to determine the levels of 25-(OH)D, glycosylated hemoglobin (HbA1c), islet β-cell function index (HOMA-β) and insulin resistance index (HOMA-IR), and the correlations of 25-(OH)D with HbA1c, HOMA-β, HOMA-IR were statistically analyzed. Insulin glargine combined with salgliptin tablets was given in control group, and alfacalcitol tablets were added in study group based on the regimen of control group.The treatment lasted for 2 months in both groups. The levels of HbA1c, fasting plasma glucose (FPG), 2 h postprandial blood glucose (2hPG), fasting insulin (FINS), HOMA-β, HOMA-IR and 25-(OH)D before and after treatment and adverse reactions were compared between two groups. Results 25-(OH)D was significantly negatively correlated with HbA1c and HOMA-IR and was positively correlated with HOMA-β (all P<0.05). After treatment, the levels of HbA1c, FPG, 2hPG and HOMA-IR were significantly lower in study group than those in control group (P<0.05), and levels of FINS and HOMA-β were higher than those in control group(P<0.05). Compared with control group, 25-(OH)D level increased significantly in study group at 4-and 8-week after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (11.32% vs 7.55%, P>0.05). Conclusion In T2DM patients, 25-(OH)D level is negatively correlated with HbA1c and HOMA-IR and positively correlated with HOMA-β.Alfacalcidol tablets can improve vitamin D level, blood glucose level and islet β-cell function with safety and reliability.
keywords: 25-hydroxyvitamin D Type 2 diabetes mellitus Glycosylated hemoglobin Islet β cell function Insulin resistance index Alfacalcitol
文章编号: 中图分类号: 文献标志码:B
基金项目:江苏省无锡市医院管理中心面上项目(YGZXM1401)
Author Name | Affiliation |
HAO Yan, ZHOU Qian-yun | Department of Endocrinology, Taihu Hospital, Wuxi, Jiangsu 221044, China |
Author Name | Affiliation |
HAO Yan, ZHOU Qian-yun | Department of Endocrinology, Taihu Hospital, Wuxi, Jiangsu 221044, China |
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