Karras Spyridon N, Anagnostis Panagiotis, Antonopoulou Vasiliki, Tsekmekidou Xanthippi, Koufakis Theocharis, Goulis Dimitrios G, Zebekakis Pantelis, Kotsa Kalliopi
1 Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
2 Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Diab Vasc Dis Res. 2018 Mar;15(2):150-153. doi: 10.1177/1479164117738443. Epub 2017 Nov 8.
The combined effect of vitamin D and parathyroid hormone on glucose homeostasis has not been adequately investigated. The aim of this study was to examine the role of parathyroid hormone/vitamin D axis on glucose homeostasis in elderly persons with prediabetes.
Patients with prediabetes ( n = 144) and healthy age-matched controls ( n = 81) were included in this cross-sectional study. Study parameters included anthropometric characteristics, morning fasting glucose (fasting plasma glucose), insulin (fasting plasma insulin), parathyroid hormone, 25-hydroxyvitamin D, homeostasis model assessment of insulin resistance and homeostasis model assessment of β-cell function. Both groups were stratified into subgroups according to vitamin D status and tertiles of parathyroid hormone.
Both groups were comparable in terms of body mass index, 25-hydroxyvitamin D and parathyroid hormone status. In the prediabetes group, fasting plasma glucose differed significantly across parathyroid hormone tertiles, increasing from the first to the third tertile ( p = 0.011). There were higher fasting plasma glucose values in participants with vitamin D deficiency/parathyroid hormone third tertile compared to all other groups ( p = 0.031, 0.027 and 0.039, respectively).
Parathyroid hormone status is associated with impaired glucose homeostasis; hypovitaminosis D combined with high parathyroid hormone concentrations are associated with glycaemic dysregulation in elderly patients with prediabetes.
维生素D和甲状旁腺激素对葡萄糖稳态的联合作用尚未得到充分研究。本研究的目的是探讨甲状旁腺激素/维生素D轴在老年糖尿病前期患者葡萄糖稳态中的作用。
本横断面研究纳入了糖尿病前期患者（n = 144）和年龄匹配的健康对照者（n = 81）。研究参数包括人体测量学特征、空腹血糖（空腹血浆葡萄糖）、胰岛素（空腹血浆胰岛素）、甲状旁腺激素、25-羟基维生素D、胰岛素抵抗稳态模型评估和β细胞功能稳态模型评估。两组均根据维生素D状态和甲状旁腺激素三分位数分层为亚组。
两组在体重指数、25-羟基维生素D和甲状旁腺激素状态方面具有可比性。在糖尿病前期组中，空腹血浆葡萄糖在甲状旁腺激素三分位数之间存在显著差异，从第一三分位数到第三三分位数逐渐升高（p = 0.011）。与所有其他组相比，维生素D缺乏/甲状旁腺激素第三三分位数的参与者空腹血浆葡萄糖值更高（分别为p = 0.031、0.027和0.039）。
甲状旁腺激素状态与葡萄糖稳态受损有关；维生素D缺乏与高甲状旁腺激素浓度相结合与老年糖尿病前期患者的血糖失调有关。
