Ahmed Ahmed El-Abd, Sakhr Hala M, Hassan Mohammed H, El-Amir Mostafa I, Ameen Hesham H
Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt.
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt.
Diabetes Metab Syndr Obes. 2019 May 14;12:703-716. doi: 10.2147/DMSO.S201525. eCollection 2019.
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.
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。