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糖尿病成年患者血清25-羟维生素D、糖化血红蛋白与空腹血糖水平之间的关联

Association between serum 25-hydroxyvitamin D, hemoglobin A1c and fasting blood glucose levels in adults with diabetes mellitus.

作者信息

Alkhatatbeh Mohammad J, Abdul-Razzak Khalid K

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.

出版信息

Biomed Rep. 2018 Dec;9(6):523-530. doi: 10.3892/br.2018.1159. Epub 2018 Oct 17.

Abstract

In the present study, the aim was to investigate the association between serum 25-hydroxyvitamin D concentration and measures of glycemic control including hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) in adult patients with diabetes mellitus (DM) from the north of Jordan. Another aim was to compare serum levels of 25-hydroxyvitamin D between patients with good glycemic control and patients with uncontrolled DM. This was a cross-sectional study that included 261 participants with DM. The concentration of 25-hydroxyvitamin D was measured using electrochemiluminescence immunoassay, HbA1c was measured using turbidimetric inhibition immunoassay and FBG was measured using the hexokinase method. Data regarding other clinical variables were obtained from medical records or by self-reporting. Participants with good glycemic control exhibited significantly higher levels of 25-hydroxyvitamin D compared with participants with uncontrolled DM (P=0.03). Participants with sufficient vitamin D status (>30 ng/ml in serum) exhibited significantly lower HbA1c level compared with participants with deficient vitamin D (<20 ng/ml) status (P=0.02). Correlation analysis determined significant inverse correlations between 25-hydroxyvitamin D levels and HbA1c and FBG levels (r=-0.23 and -0.17, respectively, both P<0.01). There were also significant correlations between duration of DM and HbA1c and FBG levels (both r=0.21, P<0.01). HbA1c level was also inversely correlated with participants' age (r=-0.19, P<0.01). Further multiple linear regression analysis revealed an inverse significant association between HbA1c and 25-hydroxyvitamin D levels (F=12.95, R=0.48, P<0.01) but did not identify a similar association between FBG and 25-hydroxyvitamin D levels. These findings may encourage further research to identify if vitamin D supplementation may improve measures of glycemic control, and how vitamin D may affect glucose homeostasis in patients with DM.

摘要

在本研究中,目的是调查约旦北部成年糖尿病(DM)患者血清25-羟基维生素D浓度与血糖控制指标(包括糖化血红蛋白(HbA1c)和空腹血糖(FBG))之间的关联。另一个目的是比较血糖控制良好的患者与DM未控制患者之间的血清25-羟基维生素D水平。这是一项横断面研究,纳入了261名DM患者。采用电化学发光免疫分析法测定25-羟基维生素D浓度,采用比浊抑制免疫分析法测定HbA1c,采用己糖激酶法测定FBG。关于其他临床变量的数据通过病历或自我报告获得。与DM未控制的参与者相比,血糖控制良好的参与者的25-羟基维生素D水平显著更高(P = 0.03)。维生素D状态充足(血清中>30 ng/ml)的参与者与维生素D缺乏(<20 ng/ml)状态的参与者相比,HbA1c水平显著更低(P = 0.02)。相关性分析确定25-羟基维生素D水平与HbA1c和FBG水平之间存在显著负相关(r分别为-0.23和-0.17,均P<0.01)。DM病程与HbA1c和FBG水平之间也存在显著相关性(两者r = 0.21,P<0.01)。HbA1c水平也与参与者年龄呈负相关(r = -0.19,P<0.01)。进一步的多元线性回归分析显示HbA1c与25-羟基维生素D水平之间存在显著负相关(F = 12.95,R = 0.48,P<0.01),但未发现FBG与25-羟基维生素D水平之间存在类似关联。这些发现可能会促使进一步研究,以确定补充维生素D是否可以改善血糖控制指标,以及维生素D如何影响DM患者的葡萄糖稳态。

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