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维生素D受体rs7975232、rs731236和rs1544410单核苷酸多态性以及埃及1型糖尿病儿童的25-羟基维生素D水平:维生素D联合治疗的效果

Vitamin D receptor rs7975232, rs731236 and rs1544410 single nucleotide polymorphisms, and 25-hydroxyvitamin D levels in Egyptian children with type 1 diabetes mellitus: effect of vitamin D co-therapy.

作者信息

Ahmed Ahmed El-Abd, Sakhr Hala M, Hassan Mohammed H, El-Amir Mostafa I, Ameen Hesham H

机构信息

Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt.

Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt.

出版信息

Diabetes Metab Syndr Obes. 2019 May 14;12:703-716. doi: 10.2147/DMSO.S201525. eCollection 2019.

Abstract

We aimed to examine the possible association role of vitamin D and vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) in type 1 diabetes mellitus (T1DM) development, glycemic control and complications among a cohort of Egyptian children. A prospective case-control study has been conducted on 50 Egyptian children with T1DM who were comparable with 50 controls. Vitamin D and HbA1c were measured. VDR-SNPs [I (rs7975232), I (rs731236) and I (rs1544410)] detection was done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) technique. Vitamin D supplements were given to the included T1DM children with low vitamin D and reassessments of both HbA1c% and 25(OH)D serum levels were performed in those children three months later. Eighty percent of the included diabetic patients have poor glycemic control. Vitamin D was deficient in 68% and insufficient in 16% of diabetic patients. Significant improvements in both vitamin D and glycemic status among T1DM children, who have low vitamin D and received vitamin D supplementations. There were significantly negative correlations between serum levels of vitamin D with both HbA1c % (r= -0.358, ˂0.05) and daily insulin dose (r=-0.473, ˂0.05). Compared with controls, T1DM children presented more commonly with I a allele (OR: 2.87; 95%CI: 1.39-5.91, ˂0.05) and I b allele (OR: 4.38; 95%CI: 2.30-8.33, ˂0.05). I t allele wasn't significantly differing among patients and controls (˃0.05). Aa+aa and Bb+bb genotypes were significantly higher among T1DM vs the controls (OR: 3.08;, 95%CI: 1.33-7.15, ˂0.05 and OR: 9.33; 95%CI: 3.61-24.17, ˂0.05respectively). I and I were associated with risk of T1DM development among Egyptian children. Low vitamin D status was frequently occurring among T1DM with significant improvement in the glycemic control of such children when adding vitamin D supplements to the standard insulin therapy.

摘要

我们旨在研究维生素D和维生素D受体(VDR)单核苷酸多态性(SNP)在一组埃及儿童1型糖尿病(T1DM)发生、血糖控制及并发症方面可能的关联作用。对50例埃及T1DM儿童和50例对照儿童进行了一项前瞻性病例对照研究。检测了维生素D和糖化血红蛋白(HbA1c)。通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测VDR-SNP [I(rs7975232)、I(rs731236)和I(rs1544410)]。给维生素D水平低的纳入研究的T1DM儿童补充维生素D,3个月后对这些儿童的HbA1c%和血清25(OH)D水平进行重新评估。纳入研究的糖尿病患者中80%血糖控制不佳。68%的糖尿病患者维生素D缺乏,16%不足。维生素D水平低且接受维生素D补充的T1DM儿童的维生素D和血糖状况均有显著改善。维生素D血清水平与HbA1c%(r = -0.358,P<0.05)和每日胰岛素剂量(r = -0.473,P<0.05)均呈显著负相关。与对照组相比,T1DM儿童中I a等位基因(比值比:2.87;95%置信区间:1.39 - 5.91,P<0.05)和I b等位基因(比值比:4.38;95%置信区间:2.30 - 8.33,P<0.05)出现更为常见。I t等位基因在患者和对照组之间无显著差异(P>0.05)。T1DM患者中Aa + aa和Bb + bb基因型显著高于对照组(比值比分别为:3.08;95%置信区间:1.33 - 7.15,P<0.05和比值比:9.33;95%置信区间:3.61 - 24.17,P<0.05)。I和I与埃及儿童T1DM发生风险相关。T1DM患者中维生素D水平低的情况常见,在标准胰岛素治疗基础上加用维生素D补充剂可显著改善这类儿童的血糖控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4ab/6526182/29191dd8d0a1/DMSO-12-703-g0001.jpg

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