Gong Tong, Di Hongjie, Han Xue, Hu Xin, Liu Chao, Chen Guofang
Department of Endocrinology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210019, China.
Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China.
Endocrine. 2022 May;76(2):304-311. doi: 10.1007/s12020-022-03009-8. Epub 2022 Mar 5.
Vitamin D has been identified to have a relation to the development of insulin resistance-related diseases, such as type 2 diabetes (T2D). T2D is often associated with obesity and dyslipidemia. Our study aimed to analyze the relationship between vitamin D and lipid profile in patients with T2D.
A total of 446 T2D patients who were hospitalized from January 2015 to December 2016 were recruited. Baseline characteristics were recorded, including body mass index (BMI), serum level of 25 hydroxy vitamin D (25(OH)D), and other biochemical indicators. T2D patients were divided into normal-weight group and overweight/obese group according to their BMI. Subgroup analysis was conducted after patients were subdivided using the quartet-method according to serum level of 25(OH)D. Differences in glucose and lipid metabolism indicators were analyzed. The correlation between serum 25(OH)D and lipid profiles was assessed by the multiple linear regression.
The levels of serum 25(OH)D and high-density lipoprotein cholesterol in T2D patients of overweight/obesity group were significantly lower than those in normal-weight group, while the levels of triglyceride (TG) and HOMA-IR were significantly higher (P < 0.05). Subgroup analysis uncovered that total cholesterol (TC) and TG levels were lower with higher 25(OH)D in normal weight T2D patients. In overweight/obese T2D patients, TG level was lower in patients with higher 25(OH)D (P < 0.05). There were no significant differences in low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting insulin (FINS), and hemoglobin Alc (HbAlc) among Q1-Q4 in both normal weight and overweight/obese groups. Pearson test showed that serum 25(OH)D was positively correlated with high density lipoprotein cholesterol (HDL-C), and negatively correlated with TC and TG. Serum 25(OH)D was unrelated to low density lipoprotein cholesterol (LDL-C) in both groups. Multiple linear regression analysis only demonstrated an independent negative correlation between 25(OH)D and TG levels in the overweight/obese group (P < 0.01).
In overweight/obese patients with T2D, serum 25(OH)D was independently, negatively correlated with TG. Vitamin D supplementation should be guaranteed in patients with diabetes, especially with obese T2D.
已证实维生素D与胰岛素抵抗相关疾病(如2型糖尿病(T2D))的发生有关。T2D常与肥胖和血脂异常相关。本研究旨在分析T2D患者中维生素D与血脂谱之间的关系。
招募了2015年1月至2016年12月期间住院的446例T2D患者。记录基线特征,包括体重指数(BMI)、血清25羟维生素D(25(OH)D)水平及其他生化指标。根据BMI将T2D患者分为正常体重组和超重/肥胖组。根据血清25(OH)D水平采用四分位数法对患者进行细分后进行亚组分析。分析糖脂代谢指标的差异。采用多元线性回归评估血清25(OH)D与血脂谱之间的相关性。
超重/肥胖组T2D患者的血清25(OH)D和高密度脂蛋白胆固醇水平显著低于正常体重组,而甘油三酯(TG)水平和HOMA-IR显著更高(P<0.05)。亚组分析发现,正常体重的T2D患者中,25(OH)D水平越高,总胆固醇(TC)和TG水平越低。在超重/肥胖的T2D患者中,25(OH)D水平较高的患者TG水平较低(P<0.05)。正常体重组和超重/肥胖组的Q1-Q4之间,低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、空腹胰岛素(FINS)和糖化血红蛋白(HbAlc)无显著差异。Pearson检验显示,血清25(OH)D与高密度脂蛋白胆固醇(HDL-C)呈正相关,与TC和TG呈负相关。两组中血清25(OH)D与低密度脂蛋白胆固醇(LDL-C)均无相关性。多元线性回归分析仅显示超重/肥胖组中25(OH)D与TG水平之间存在独立的负相关(P<0.01)。
在超重/肥胖的T2D患者中,血清25(OH)D与TG呈独立负相关。糖尿病患者,尤其是肥胖的T2D患者应保证补充维生素D。