Miñambres Inka, Sánchez-Quesada Jose Luis, Vinagre Irene, Sánchez-Hernández Joan, Urgell Eulalia, de Leiva Alberto, Pérez Antonio
Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain .
Endocr Res. 2015;40(3):160-5. doi: 10.3109/07435800.2014.982326. Epub 2014 Dec 23.
To assess the association of hypovitaminosis D with clinical and biochemical characteristics of type 2 diabetic patients and to determine the effect of glycemic control optimization on 25-hydroxyvitamin D (25(OH)D) concentrations.
Cross-sectional study of 63 patients with type 2 diabetes (mean age 60 ± 9.8 years, 69.8% men). Twenty of the 63 patients were also studied before and after glycemic control optimization.
Mean 25(OH)D concentrations were 63.64 ± 25.51 nmol/L and 74.6% of patients had hypovitaminosis D. Compared with patients with vitamin D sufficiency, patients with hypovitaminosis D had higher prevalence of overweight or obesity (72.3% versus 37.5%; p = 0.012) and higher VLDL cholesterol (VLDL-c) (0.71 (0.24-3.59) versus 0.45 (0.13-1.6) mmol/L; p = 0.011) and C-reactive protein (3.28 (0.36-17.69) versus 1.87 (0.18-17.47) mg/L; p = 0.033) concentrations. The composition of HDL particles also differed in both groups, with higher relative content of triglycerides and lower of cholesterol in patients with hypovitaminosis D. After adjustment for age, seasonality and BMI, differences remained significant for VLDL-c and triglyceride content of HDL. No differences were found regarding other diabetes characteristics. Improvement of glycemic control (HbA1c 9.4 (7.6-14.8) versus 7.3 (6.2-8.7)%; p = 0.000) was accompanied by a decrease in 25(OH)D concentrations (72.7 ± 33.3 to 59.0 ± 21.0 nmol/L; p = 0.035). Correlation analysis revealed that changes in 25(OH)D concentrations were negatively associated to changes in HbA1c (r - 0.482; p = 0.032).
Hypovitaminosis D is associated with features of the metabolic syndrome in type 2 diabetes and improvement of glycemic control decreases 25(OH)D concentrations.
评估维生素D缺乏与2型糖尿病患者临床及生化特征的相关性，并确定血糖控制优化对25-羟维生素D（25(OH)D）浓度的影响。
对63例2型糖尿病患者（平均年龄60±9.8岁，男性占69.8%）进行横断面研究。63例患者中有20例在血糖控制优化前后也进行了研究。
25(OH)D平均浓度为63.64±25.51nmol/L，74.6%的患者存在维生素D缺乏。与维生素D充足的患者相比，维生素D缺乏的患者超重或肥胖的患病率更高（72.3%对37.5%；p=0.012），极低密度脂蛋白胆固醇（VLDL-c）水平更高（0.71（0.24 - 3.59）对0.45（0.13 - 1.6）mmol/L；p=0.011），C反应蛋白水平更高（3.28（0.36 - 17.69）对1.87（0.18 - 17.47）mg/L；p=0.033）。两组高密度脂蛋白（HDL）颗粒的组成也有所不同，维生素D缺乏患者的HDL中甘油三酯相对含量更高，胆固醇相对含量更低。在调整年龄、季节和体重指数（BMI）后，VLDL-c和HDL中甘油三酯含量的差异仍然显著。在其他糖尿病特征方面未发现差异。血糖控制改善（糖化血红蛋白[HbA1c]从9.4（7.6 - 14.8）%降至7.3（6.2 - 8.7）%；p=0.000）伴随着25(OH)D浓度的降低（从72.7±33.3降至59.0±21.0nmol/L；p=0.035）。相关性分析显示，25(OH)D浓度的变化与HbA1c的变化呈负相关（r=-0.482；p=0.032）。
维生素D缺乏与2型糖尿病的代谢综合征特征相关，血糖控制的改善会降低25(OH)D浓度。
