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维生素D水平对绝经后2型糖尿病女性血糖控制及骨密度的影响。

The impact of vitamin D levels on glycemic control and bone mineral density in postmenopausal women with type 2 diabetes.

作者信息

Perez-Diaz I, Sebastian-Barajas G, Hernandez-Flores Z G, Rivera-Moscoso R, Osorio-Landa H K, Flores-Rebollar A

出版信息

J Endocrinol Invest. 2015 Dec;38(12):1365-72. doi: 10.1007/s40618-015-0394-4.

Abstract

OBJECTIVES

Whether glycemic control contributes to a decreased number of fractures or favorably impacts bone density in patients with type 2 diabetes mellitus (T2DM)has not been well established. Vitamin D (25 (OH) D3) deficiency appears to be related to glycemic control in patients with T2DM. The aim of this study was to determine the relationship between 25 (OH) D3 levels, glycemic control, bone mineral density (BMD), and the development of osteoporotic fractures (OPF) in postmenopausal women with T2DM.

METHODS

We reviewed the charts of 110 postmenopausal women diagnosed with T2DM. Glycosylated hemoglobin A1c (HbA1c) values over the previous 5 years were recorded and an average was obtained. Based on these values,the patients were divided into three groups: optimal,suboptimal, and poor control. Bone mineral density and 25(OH) D3 levels were also recorded.

RESULTS

In the group of patients with poorly controlled T2DM, 25 (OH) D3 levels were not significantly lower in comparison with the optimal control group 19.29 ± 7.70 vs 17.26 ± 6.93 (p = 0.53). No statistically significant linear relationship between HbA1c and 25 (OH) D3 levels( r(s) = −0.17, p = 0.06) was established. The frequency of osteoporosis and osteopenia was not significantly different between groups. The group with optimal glycemic control had an increased number of OPF events (p = 0.04).

CONCLUSIONS

We do not appreciate a significant relationship between 25 (OH) D3 levels and glucose control or OPF. Therefore, more studies are needed to identify the specific effect of 25 (OH) D3 in T2DM physiopathology.

摘要

目的

血糖控制是否有助于降低2型糖尿病(T2DM)患者的骨折数量或对骨密度产生有利影响,目前尚未明确。维生素D(25(OH)D3)缺乏似乎与T2DM患者的血糖控制有关。本研究的目的是确定绝经后T2DM女性中25(OH)D3水平、血糖控制、骨矿物质密度(BMD)与骨质疏松性骨折(OPF)发生之间的关系。

方法

我们回顾了110例诊断为T2DM的绝经后女性的病历。记录过去5年的糖化血红蛋白A1c(HbA1c)值并计算平均值。根据这些值,将患者分为三组:最佳控制组、次优控制组和控制不佳组。同时记录骨矿物质密度和25(OH)D3水平。

结果

在T2DM控制不佳的患者组中,25(OH)D3水平与最佳控制组相比无显著降低(19.29±7.70 vs 17.26±6.93,p = 0.53)。未建立HbA1c与25(OH)D3水平之间的统计学显著线性关系(r(s)= -0.17,p = 0.06)。各组之间骨质疏松和骨质减少的发生率无显著差异。血糖控制最佳的组OPF事件数量增加(p = 0.04)。

结论

我们未发现25(OH)D3水平与血糖控制或OPF之间存在显著关系。因此,需要更多研究来确定25(OH)D3在T2DM病理生理学中的具体作用。

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