Cardoso-Sánchez Laura Ivonne, Gómez-Díaz Rita A, Wacher Niels H
Unidad de Investigación en Epidemiología Clínica, Centro Médico Nacional Siglo XXI, DF, Mexico.
Unidad de Investigación en Epidemiología Clínica, Centro Médico Nacional Siglo XXI, DF, Mexico.
Nutr Res. 2015 Aug;35(8):689-99. doi: 10.1016/j.nutres.2015.05.019. Epub 2015 Jun 3.
This study aimed to evaluate the relationship between vitamin D (vitD) intake and serum concentrations and insulin secretion (assessed by C-peptide serum concentration)/insulin resistance (determined by estimated glucose disposal rate [eGDR]) in patients with latent autoimmune diabetes in adults (LADA) and type 2 diabetes (T2DM). C-peptide, serum vitD, lipid profile, insulin, glucose, and glycosylated hemoglobin (HbA1c) were assessed; vitD intake was determined; and eGDR was calculated. Groups were compared using the Student t or Mann-Whitney U test. Correlations were performed between insulin secretion, insulin resistance, and vitD, and linear regression models were adjusted for confounding variables. Of 107 patients included, age was 55.3 ± 11.84 years old, and time since diabetes diagnosis was 13.23 ± 5.96 years. There were significant intergroup differences in age, body mass index (BMI), hip measurements, glucose, and HbA1c. The correlation between vitD intake and C-peptide for the whole group was significant (r = 0.213; P = .032) as well as for vitD deficiency/sufficiency in T2DM (P = .042), whereas neither was significant in eGDR. After adjustment for age, HbA1c, disease progression, physical activity, solar exposure, sex, and BMI, vitD intake was only significant in T2DM (P = .028). In serum vitD, only the correlation between eGDR and vitD in T2DM was significant and intragroup when comparing vitD sufficiency. After adjustments, significance was lost. Patients with LADA had lower intake of vitD, poorer metabolic control, lower BMI, and younger age compared to T2DM patients. There was no association between serum vitD or vitD intake and insulin secretion when analyzed by group, although vitD intake was associated with insulin resistance in T2DM, but not LADA.
本研究旨在评估成人隐匿性自身免疫性糖尿病(LADA)和2型糖尿病(T2DM)患者中维生素D(vitD)摄入量与血清浓度以及胰岛素分泌(通过血清C肽浓度评估)/胰岛素抵抗(由估计的葡萄糖处置率[eGDR]确定)之间的关系。评估了C肽、血清vitD、血脂谱、胰岛素、血糖和糖化血红蛋白(HbA1c);确定了vitD摄入量;并计算了eGDR。使用学生t检验或曼-惠特尼U检验对组间进行比较。对胰岛素分泌、胰岛素抵抗和vitD之间进行相关性分析,并针对混杂变量调整线性回归模型。纳入的107例患者中,年龄为55.3±11.84岁,糖尿病诊断后的时间为13.23±5.96年。年龄、体重指数(BMI)、臀围、血糖和HbA1c存在显著的组间差异。整个组中vitD摄入量与C肽之间的相关性显著(r = 0.213;P = 0.032),T2DM患者中vitD缺乏/充足时也是如此(P = 0.042),而在eGDR中两者均不显著。在调整年龄、HbA1c、疾病进展、身体活动、日照、性别和BMI后,vitD摄入量仅在T2DM中显著(P = 0.028)。在血清vitD中,仅T2DM中eGDR与vitD之间的相关性在比较vitD充足时组内显著。调整后,显著性消失。与T2DM患者相比,LADA患者的vitD摄入量较低、代谢控制较差、BMI较低且年龄较小。按组分析时,血清vitD或vitD摄入量与胰岛素分泌之间无关联,尽管vitD摄入量与T2DM患者的胰岛素抵抗相关,但与LADA患者无关。