Kamiński Mikołaj, Uruska Aleksandra, Rogowicz-Frontczak Anita, Lipski Dawid, Niedźwiecki Paweł, Różańska Olga, Skonieczna Paulina, Michalska Anna, Flotyńska Justyna, Araszkiewicz Aleksandra, Uruski Paweł, Pawlak Regina, Zozulińska-Ziółkiewicz Dorota
Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland.
Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Exp Clin Endocrinol Diabetes. 2021 May;129(5):396-402. doi: 10.1055/a-0895-5166. Epub 2019 May 2.
Type 1 diabetes mellitus (T1DM) is a disease characterized by an absolute deficiency of endogenous insulin secretion. Insulin resistance (IR) may develop among patients with T1DM. Vitamin D deficiency was reported to be a risk factor in the development of IR. The aim of the study was to assess the relationship between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and IR among patients with T1DM.
The test group consisted of 110 adult patients [males=65 (59%)] with T1DM. Participants were recruited in Poland between 1 October and 30 April in 2015/2016 and 2016/2017. VD serum level was assessed by ELISA array. IR was assessed by estimated Glucose Disposal Rate (eGDR).
In the study group 21 (19%) patients were recognized as IR according to eGDR cut-offs (<7.5 mg/kg/min), 52 (47.3%) patients had VD deficiency (25(OH)D<20 ng/ml), 16 (14.5%) patients had 25(OH)D<10 ng/ml. Only 6 (5%) participants reported VD supplementation. Patients with IR, according to eGDR cut-off revealed significantly lower 25(OH)D serum level 15.7 (9.2-28.4) vs. 22.1 (13.0-38.4) ng/ml; p=0.04 as compared to patients without IR. R Spearman analysis found a positive relationship between VD and eGDR (Rs=0.27; p<0.01). Logistic regression analysis revealed significant relationship between the presence of IR and VD serum level/presence of 25(OH)D serum level below 10 ng/ml, both models adjusted to sex, age, BMI, LDL and triglycerides, accordingly (OR=0.95, CI: 0.90-0.99; p=0.04) and (OR=4.19, CI: 1.04-16.93; p=0.04).
The serum concentration of Vitamin D is negatively associated with insulin resistance in patients with T1DM and may have clinical implications.
1型糖尿病（T1DM）是一种以内源性胰岛素分泌绝对缺乏为特征的疾病。T1DM患者可能会出现胰岛素抵抗（IR）。据报道，维生素D缺乏是IR发生的一个危险因素。本研究的目的是评估T1DM患者血清25-羟基维生素D（25(OH)D）浓度与IR之间的关系。
试验组由110例成年T1DM患者组成[男性65例（59%）]。研究对象于2015/2016年和2016/2017年10月1日至4月30日在波兰招募。采用酶联免疫吸附测定法检测血清维生素D水平。通过估计的葡萄糖处置率（eGDR）评估IR。
在研究组中，根据eGDR临界值（<7.5mg/kg/min），21例（19%）患者被认定为IR，52例（47.3%）患者存在维生素D缺乏（25(OH)D<20ng/ml），16例（14.5%）患者25(OH)D<10ng/ml。只有6例（5%）参与者报告补充过维生素D。根据eGDR临界值，IR患者的血清25(OH)D水平显著低于非IR患者，分别为15.7（9.2 - 28.4）ng/ml和22.1（13.0 - 38.4）ng/ml；p = 0.04。Spearman相关性分析发现维生素D与eGDR之间呈正相关（Rs = 0.27；p < 0.01）。逻辑回归分析显示，IR的存在与血清维生素D水平/血清25(OH)D水平低于10ng/ml之间存在显著相关性，两个模型均根据性别、年龄、体重指数、低密度脂蛋白和甘油三酯进行了校正，相应地（OR = 0.95，CI：0.90 - 0.99；p = 0.04）和（OR = 4.19，CI：1.04 - 16.93；p = 0.04）。
T1DM患者血清维生素D浓度与胰岛素抵抗呈负相关，可能具有临床意义。
