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在 2 型糖尿病患者中,25-羟维生素 D 和甲状旁腺激素水平与葡萄糖稳态之间无关联 - 来自梅加拉亚邦的希隆研究。

No association of 25-hydroxyvitamin D and parathormone levels with glucose homeostasis in type 2 diabetes - a study from Shillong, Meghalaya.

机构信息

Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India.

ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, India.

出版信息

Int J Vitam Nutr Res. 2019 Nov;89(5-6):285-292. doi: 10.1024/0300-9831/a000567. Epub 2019 Mar 11.

Abstract

Although inadequate vitamin D and altered parathyroid hormone (PTH) are implicated in deranged glucose metabolism and risk of future diabetes, their role in regulating glucose homeostasis in established cases of diabetes is unclear. We aimed to (i) evaluate vitamin D status, and (ii) determine if vitamin D and PTH were associated with parameters of glucose homeostasis in type 2 diabetes (T2D) patients from Meghalaya, India. We determined 25-hydroxyvitamin D (25-OH-D) and PTH concentrations in 251 T2D patients (not on insulin), and examined their associations with the following parameters of glucose homeostasis: fasting blood sugar (FBS), post-prandial blood sugar (PPBS), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR) and β-cell function (HOMA-β). None of the patients had adequate vitamin D (mean 25-OH-D = 19.3 ng/mL); 47.8% patients were deficient (25-OH-D < 20 ng/mL), while 52.2% were insufficient (25-OH-D < 30 ng/mL) vitamin D. Significant ( < 0.05) univariate associations were observed between: 25-OH-D and FI ( = 0.14); 25-OH-D and HOMA-β ( = 0.13); PTH and FI ( = -0.18), and PTH and HOMA-β ( = -0.11). However these associations disappeared after controlling for potential confounders. The 25-OH-D and PTH levels were not associated with any of the tested parameters of glucose homeostasis. There was widespread prevalence of vitamin D deficiency/insufficiency in our sample T2D patients. However, neither vitamin D nor PTH appeared to play a major role in influencing glucose homeostasis in this present selection of T2D cases.

摘要

尽管维生素 D 不足和甲状旁腺激素 (PTH) 改变与葡萄糖代谢紊乱和未来发生糖尿病的风险有关,但它们在调节已确诊糖尿病患者的葡萄糖稳态中的作用尚不清楚。我们的目的是:(i) 评估维生素 D 状况,以及 (ii) 确定维生素 D 和 PTH 是否与来自印度梅加拉亚邦的 2 型糖尿病 (T2D) 患者的葡萄糖稳态参数相关。我们测定了 251 例未使用胰岛素的 T2D 患者的 25-羟维生素 D (25-OH-D) 和 PTH 浓度,并检查了它们与以下葡萄糖稳态参数的相关性:空腹血糖 (FBS)、餐后血糖 (PPBS)、糖化血红蛋白 (HbA1c)、空腹胰岛素 (FI)、胰岛素抵抗的稳态模型评估 (HOMA-IR) 和 β 细胞功能 (HOMA-β)。没有患者有足够的维生素 D(平均 25-OH-D = 19.3ng/mL);47.8%的患者存在维生素 D 缺乏症(25-OH-D < 20ng/mL),而 52.2%的患者存在维生素 D 不足(25-OH-D < 30ng/mL)。在 25-OH-D 和 FI 之间(= 0.14)、25-OH-D 和 HOMA-β 之间(= 0.13)、PTH 和 FI 之间(= -0.18)和 PTH 和 HOMA-β 之间(= -0.11)观察到显著的(< 0.05)单变量相关性。然而,在控制潜在混杂因素后,这些相关性消失了。25-OH-D 和 PTH 水平与测试的任何葡萄糖稳态参数均无关。在我们的 T2D 患者样本中,维生素 D 缺乏/不足的患病率很高。然而,在本研究选择的 T2D 病例中,维生素 D 和 PTH 似乎都没有在影响葡萄糖稳态方面发挥主要作用。

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