Choi Dug-Hyun, Jung Chan-Hee, Mok Ji-Oh, Kim Chul-Hee, Kang Sung Koo, Kim Bo-Yeon
Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
J Obes Metab Syndr. 2018 Mar 30;27(1):53-60. doi: 10.7570/jomes.2018.27.1.53.
Vitamin D deficiency is known to increase the incidence of metabolic syndrome. Nonalcoholic fatty liver disease is a common metabolic disease in patients with type 2 diabetes. This study evaluated nonalcoholic fatty liver disease and abdominal fat accumulation according to 25-hydroxyvitamin D status in patients with type 2 diabetes.
The study comprised 302 patients with type 2 diabetes. Patients were divided into three groups based upon their 25-hydroxyvitamin D status: vitamin D deficient group (<10 ng/mL), vitamin D insufficient group (≥10 to <20 ng/mL) and vitamin D sufficient group (≥20 ng/mL). Patient clinical and laboratory markers were evaluated retrospectively.
Visceral fat thickness was significantly higher in the vitamin D deficient group. There were no differences in glycemic control, body mass index, and subcutaneous fat thickness correlated with 25-hydroxyvitamin D status. The prevalence of nonalcoholic fatty liver disease was significantly higher in the vitamin D deficient group compared to the vitamin D sufficient and vitamin D insufficient groups. In multivariate logistic analysis, after adjustment for age, sex, body mass index, glycated hemoglobin and homeostasis model assessment of insulin resistance, patients with type 2 diabetes in the vitamin D sufficient group showed significantly lower odds ratio for nonalcoholic fatty liver disease than those within the vitamin D deficient group.
In type 2 diabetes, the vitamin D deficient group showed thicker visceral fat thickness and higher nonalcoholic fatty liver disease prevalence.
已知维生素D缺乏会增加代谢综合征的发病率。非酒精性脂肪性肝病是2型糖尿病患者中常见的代谢性疾病。本研究根据2型糖尿病患者的25-羟维生素D状态评估非酒精性脂肪性肝病和腹部脂肪堆积情况。
该研究纳入了302例2型糖尿病患者。根据患者的25-羟维生素D状态将其分为三组:维生素D缺乏组(<10 ng/mL)、维生素D不足组(≥10至<20 ng/mL)和维生素D充足组(≥20 ng/mL)。对患者的临床和实验室指标进行回顾性评估。
维生素D缺乏组的内脏脂肪厚度显著更高。血糖控制、体重指数和皮下脂肪厚度与25-羟维生素D状态无关。与维生素D充足组和维生素D不足组相比,维生素D缺乏组的非酒精性脂肪性肝病患病率显著更高。在多因素逻辑回归分析中,在调整年龄、性别、体重指数、糖化血红蛋白和胰岛素抵抗的稳态模型评估后,维生素D充足组的2型糖尿病患者患非酒精性脂肪性肝病的比值比显著低于维生素D缺乏组。
在2型糖尿病中,维生素D缺乏组的内脏脂肪厚度更厚,非酒精性脂肪性肝病患病率更高。