Al-Shoumer Kamal Abdul Aziz Sulaiman, Al-Asoosi Adnan Ali, Ali Aida Hussain, Nair Vasanthy Sudheer
Division of Endocrinology & Metabolic Medicine, Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait; Mubarak Al Kabeer Hospital, Jabriya, Kuwait.
Prim Care Diabetes. 2013 Dec;7(4):283-7. doi: 10.1016/j.pcd.2013.04.008. Epub 2013 May 17.
Data on changes of vitamin D due to insulin resistance are conflicting. We assessed vitamin D concentrations and parameters of glycemia and mineral homeostasis in patients with insulin resistant type 2 diabetes and in matched normal controls.
Sixty-nine patients with type 2 diabetes and 60 matched normal control subjects were studied. After an overnight fast, blood was collected for measuring the parameters of glycemia (glucose, insulin and HbA1c), mineral profile (corrected calcium, phosphate and alkaline phosphatase), total 25(OH) vitamin D and parathyroid hormone (PTH) levels.
Patients had significantly elevated fasting glucose (P=0.0001), insulin (P=0.0003) and HbA1c (P=0.0005) than the controls had. They had significantly raised calculated insulin resistance compared with control subjects (P=0.0001). Patients and controls had similar levels of serum corrected calcium and ALP, whereas serum phosphate was significantly lower in the patients compared with controls (P=0.001). Patients and controls had similar levels of 25(OH)D, but the levels of 25(OH)D in both were in the deficiency range. Intact PTH was similar in the patients and controls. Levels of 25(OH)D did not demonstrate any relation with fasting insulin, insulin resistance, or HbA1c, but correlated negatively with intact PTH (r=-0.4, P=0.02).
This study demonstrated prevalent vitamin D deficiency in insulin resistant type 2 diabetic and normal subjects. Insulin resistance did not influence the status of vitamin D.
关于胰岛素抵抗导致维生素D变化的数据相互矛盾。我们评估了胰岛素抵抗的2型糖尿病患者和匹配的正常对照者的维生素D浓度、血糖和矿物质稳态参数。
对69例2型糖尿病患者和60例匹配的正常对照者进行研究。过夜禁食后,采集血液以测量血糖参数(葡萄糖、胰岛素和糖化血红蛋白)、矿物质谱(校正钙、磷酸盐和碱性磷酸酶)、总25(OH)维生素D和甲状旁腺激素(PTH)水平。
患者的空腹血糖(P = 0.0001)、胰岛素(P = 0.0003)和糖化血红蛋白(P = 0.0005)显著高于对照组。与对照受试者相比,他们计算出的胰岛素抵抗显著升高(P = 0.0001)。患者和对照组的血清校正钙和碱性磷酸酶水平相似,而患者的血清磷酸盐水平显著低于对照组(P = 0.001)。患者和对照组的25(OH)D水平相似,但两者的25(OH)D水平均处于缺乏范围内。患者和对照组的完整甲状旁腺激素相似。25(OH)D水平与空腹胰岛素、胰岛素抵抗或糖化血红蛋白无任何关系,但与完整甲状旁腺激素呈负相关(r = -0.4,P = 0.02)。
本研究表明胰岛素抵抗的2型糖尿病患者和正常受试者普遍存在维生素D缺乏。胰岛素抵抗不影响维生素D状态。