Kiskac Muharrem, Zorlu Mehmet, Cakirca Mustafa, Karatoprak Cumali, Kesgin Sıdıka, Büyükaydın Banu, Yavuz Erdinc, Ardic Cuneyt, Camli Ahmet Adil, Cikrikcioglu Mehmet Ali
Internal Medicine Clinic, Bezmialem Vakif University, Faculty of Medicine, 34093 Fatih, Istanbul, Turkey.
Department of Biochemisty, Bezmialem Vakif University, Faculty of Medicine, 34093 Fatih, Istanbul, Turkey.
Ann Endocrinol (Paris). 2014 Sep;75(4):200-5. doi: 10.1016/j.ando.2014.07.112. Epub 2014 Aug 23.
It was reported that Vitamin D deficiency was associated with a greater risk of cardiometabolic diseases, obesity, impaired glucose tolerance and diabetes mellitus type 2, arterial hypertension, and dyslipidemia. Apelin is an adipocytokine suspected to have a role in skeletal muscle glucose utilization and glycemic regulation which may be a promising treatment modality for diabetes. It was recently reported that increased mean platelet volume (MPV) was emerging as an independent risk factor for thromboembolism, stroke, and myocardial infarction. In patients with diabetes, MPV was higher compared with the normal glycemic controls; in addition, it has been proposed that an increase in MPV may play a role in the micro- and macro-vascular complications related to diabetes. We postulated that deficiency in Vitamin D levels might be associated with higher MPV and lower serum apelin levels leading a further increase in insulin resistance in diabetic patients. So, we aimed to investigate Vitamin D levels, MPV and serum apelin levels in diabetic patients and their correlations between each other.
This is a cross-sectional study design. Seventy-eight patients with Diabetes Mellitus type 2, admitted to our outpatient clinic of internal medicine department at Bezmialem Vakif University, were included in our study. Forty-one patients were female; 37 patients were male. Serum apelin levels, fasting glucose levels, urea, creatinine, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting serum insulin level, HbA1c, free T3, free T4, TSH, vitamin D (25-OH Vitamin D) and complete blood counts were analyzed in all subjects.
Each sex was analyzed separately. We found that a positive correlation existed between serum apelin levels and BMI in female patients. (r: 0.380, P: 0.014) There was also a significant positive correlation between MPV and HbA1c and fasting glucose levels and a negative correlation between MPV and PLT. (r: 0.377, P: 0.021; r: 0.395, P: 0.014; r: -0.401, P: 0.011; respectively) We failed to show a significant relationship between serum vitamin D levels, serum apelin levels and MPV in patients with diabetes mellitus type 2.
We failed to show an association between vitamin D, apelin and MPV higher volumes of which may have a role in cardiovascular complications related to diabetes by increasing platelet activation.
据报道，维生素D缺乏与发生心脏代谢疾病、肥胖、糖耐量受损和2型糖尿病、动脉高血压及血脂异常的风险增加有关。Apelin是一种脂肪细胞因子，被怀疑在骨骼肌葡萄糖利用和血糖调节中起作用，这可能是一种有前景的糖尿病治疗方式。最近有报道称，平均血小板体积（MPV）升高正成为血栓栓塞、中风和心肌梗死的独立危险因素。在糖尿病患者中，MPV高于血糖正常的对照组；此外，有人提出MPV升高可能在与糖尿病相关的微血管和大血管并发症中起作用。我们推测维生素D水平缺乏可能与较高的MPV和较低的血清Apelin水平相关，从而导致糖尿病患者胰岛素抵抗进一步增加。因此，我们旨在研究糖尿病患者的维生素D水平、MPV和血清Apelin水平及其相互之间的相关性。
这是一项横断面研究设计。纳入了78例在贝兹米阿勒姆瓦基夫大学内科门诊就诊的2型糖尿病患者。其中41例为女性，37例为男性。分析了所有受试者的血清Apelin水平、空腹血糖水平、尿素、肌酐、甘油三酯、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、空腹血清胰岛素水平、糖化血红蛋白（HbA1c）、游离三碘甲状腺原氨酸（free T3）'、游离甲状腺素（free T4）、促甲状腺激素（TSH）、维生素D（25-羟基维生素D）和全血细胞计数。
对每种性别分别进行分析。我们发现女性患者血清Apelin水平与体重指数（BMI）之间存在正相关。（r：0.380，P：0.014）MPV与HbA1c、空腹血糖水平之间也存在显著正相关，与血小板计数（PLT）之间存在负相关。（分别为r：0.377，P：0.021；r：0.395，P：0.014；r：-0.401，P：0.011）我们未能在2型糖尿病患者中显示出血清维生素D水平、血清Apelin水平和MPV之间存在显著关系。
我们未能显示出维生素D、Apelin和较高的MPV之间存在关联，而较高的MPV可能通过增加血小板活化在与糖尿病相关的心血管并发症中起作用。
