Yilmaz Hakki, Kaya Mustafa, Sahin Mustafa, Delibasi Tuncay
Dışkapı Yıldırım Beyazıt Training and Researching Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
Diabetes Metab Syndr. 2012 Jan-Mar;6(1):28-31. doi: 10.1016/j.dsx.2012.05.007. Epub 2012 Jun 6.
To evaluate vitamin D as a predictor of glycaemic regulation in type 2 diabetes mellitus patients.
In observational study 171 type 2 diabetic patients who are followed for median (range) of 10.15 (3-18) years. Mean ± SD age was 56 ± 10. Plasma 25-hydroxyvitamin D3 levels were determined by high-performance liquid chromatography/tandem mass spectrometry on baseline samples. Vitamin D deficiency was defined as a 25-OHD level of less than 20 ng/ml. Vitamin D levels between 20 and 30 ng/ml are termed 'insufficient'. Vitamin D levels greater than 30 ng/ml are termed 'optimal'.
125 patients have vitamin D deficiency, 14 patients have insufficient and the others have optimal. Vitamin D levels were not associated with sex, age, BMI, HDL, LDL, kreatinin, hypertension and smoking. But vitamin D deficiency patients had more longer duration (p=0.011), more higher uric acid (p=0.021), fasting glucose (p=0.037), postprandial glucose (p=0.001) and HbA1c (p=0.026).
In our study type 2 diabetic patients have 73% of vitamin D deficiency. Vitamin D deficiency predicts higher fasting and postprandial blood glucose and diabetes disregulation. Type 2 DM patients and low 25-OH vitamin D levels could increased cardiovascular disease directly or indirectly (low HDL and high uric acid in 25-OH vitamin D <20 ng/ml). Whether vitamin D substitution improves prognosis remains to be investigated.
评估维生素D作为2型糖尿病患者血糖调节预测指标的作用。
在一项观察性研究中,对171例2型糖尿病患者进行了为期中位数(范围)10.15(3 - 18)年的随访。平均年龄±标准差为56±10岁。采用高效液相色谱/串联质谱法测定基线样本中的血浆25-羟基维生素D3水平。维生素D缺乏定义为25-OHD水平低于20 ng/ml。20至30 ng/ml之间的维生素D水平称为“不足”。大于30 ng/ml的维生素D水平称为“最佳”。
125例患者存在维生素D缺乏,14例患者维生素D不足,其余患者维生素D水平最佳。维生素D水平与性别、年龄、体重指数、高密度脂蛋白、低密度脂蛋白、肌酐、高血压和吸烟无关。但维生素D缺乏的患者病程更长(p = 0.011),尿酸更高(p = 0.021),空腹血糖(p = 0.037)、餐后血糖(p = 0.001)和糖化血红蛋白(p = 0.026)更高。
在我们的研究中,2型糖尿病患者中有73%存在维生素D缺乏。维生素D缺乏预示着更高的空腹和餐后血糖以及糖尿病失控。2型糖尿病患者和低25-OH维生素D水平可能直接或间接增加心血管疾病风险(25-OH维生素D <20 ng/ml时高密度脂蛋白低和尿酸高)。维生素D替代是否能改善预后仍有待研究。