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肥胖青少年中 25-羟维生素 D 水平与葡萄糖耐量谱的相关性,从正常糖耐量到糖尿病前期再到 2 型糖尿病。

25-Hydroxyvitamin D in obese youth across the spectrum of glucose tolerance from normal to prediabetes to type 2 diabetes.

机构信息

Division of Pediatric Metabolism, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain.

出版信息

Diabetes Care. 2013 Jul;36(7):2048-53. doi: 10.2337/dc12-1288. Epub 2013 Jan 22.

DOI:10.2337/dc12-1288
PMID:23340897
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3687316/
Abstract

OBJECTIVE

To 1) determine if plasma 25-hydroxyvitamin D (25[OH]D) concentrations differ among obese youth with normal glucose tolerance (NGT) versus prediabetes versus type 2 diabetes and 2) assess the relationships between 25(OH)D and in vivo insulin sensitivity and β-cell function in this cohort.

RESEARCH DESIGN AND METHODS

Plasma 25(OH)D concentrations were examined in banked specimens in 9- to 20-year-old obese youth (n = 175; male 42.3%, black 46.3%) (NGT, n = 105; impaired glucose tolerance [IGT], n = 43; type 2 diabetes, n = 27) who had in vivo insulin sensitivity and secretion measured by hyperinsulinemic-euglycemic and hyperglycemic clamp techniques and had an assessment of total body composition and abdominal adiposity.

RESULTS

The mean age and BMI of the subjects were 14.3 ± 2.1 years and 35.7 ± 5.6 kg/m(2), respectively. BMI, plasma 25(OH)D, and the proportion of vitamin D-deficient and -insufficient children did not differ across the three groups. Furthermore, there was no association between 25(OH)D and in vivo insulin sensitivity or β-cell function relative to insulin sensitivity (disposition index) in all groups combined or in each group separately.

CONCLUSIONS

Our data in obese youth show 1) no differences in plasma 25(OH)D concentrations across the glucose tolerance groups and 2) no relationship between 25(OH)D and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity in any of the groups. It remains uncertain if enhancement of the vitamin D status could improve pathophysiological mechanisms of prediabetes and type 2 diabetes in obese youth.

摘要

目的

1)确定肥胖青少年中血糖正常(NGT)、糖尿病前期和 2 型糖尿病患者之间的血浆 25-羟维生素 D(25[OH]D)浓度是否存在差异,以及 2)评估该队列中 25(OH)D 与体内胰岛素敏感性和β细胞功能之间的关系。

研究设计和方法

在 9 至 20 岁肥胖青少年(男性占 42.3%,黑人占 46.3%)(NGT,n=105;糖耐量受损[IGT],n=43;2 型糖尿病,n=27)的储存标本中检测血浆 25(OH)D 浓度,这些青少年已经通过高胰岛素正葡萄糖和高血糖钳夹技术测量了体内胰岛素敏感性和分泌功能,并评估了全身成分和腹部脂肪堆积。

结果

受试者的平均年龄和 BMI 分别为 14.3±2.1 岁和 35.7±5.6kg/m²。三组间 BMI、血浆 25(OH)D 以及维生素 D 缺乏和不足儿童的比例无差异。此外,在所有组或每组中,25(OH)D 与体内胰岛素敏感性或相对于胰岛素敏感性(处置指数)的β细胞功能之间均无相关性。

结论

我们在肥胖青少年中的数据显示 1)在血糖耐量组之间血浆 25(OH)D 浓度无差异,以及 2)在任何组中,25(OH)D 与体内胰岛素敏感性和β细胞功能与胰岛素敏感性之间均无关系。目前尚不确定增强维生素 D 状态是否能改善肥胖青少年糖尿病前期和 2 型糖尿病的病理生理机制。

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Vitamin D, insulin secretion, sensitivity, and lipids: results from a case-control study and a randomized controlled trial using hyperglycemic clamp technique.维生素 D、胰岛素分泌、敏感性和脂质:来自病例对照研究和使用高血糖钳夹技术的随机对照试验的结果。
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