Yazan Ceyda Dincer, Yaman Ali, Haklar Goncagul, Sirikci Onder, Deyneli Oguzhan
Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey.
Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey.
J Diabetes Metab Disord. 2022 Apr 5;21(1):689-695. doi: 10.1007/s40200-022-01032-0. eCollection 2022 Jun.
Vitamin D deficiency is known to be associated with metabolic bone diseases. The aim of this study is to evaluate vitamin D and calculated free and bioactive vitamin D levels of type 1 diabetic patients and to evaluate the association with bone turnover markers.
This cross-sectional study includes 60 patients admitted to endocrinology outpatient clinic with diagnosis of type 1 diabetes mellitus and 60 controls. Weight, height and waist circumference were recorded and blood samples were taken for measurement of 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (VDBP), osteocalcin, bone alkaline phosphatase (bone-ALP), c-telopeptide. Free and bioavailable vitamin D levels were calculated with formula.
Vitamin D levels of type 1 diabetic patients were significantly higher (p = 0.01). Parathormone levels of the group with vitamin D level under 20 ng/ml was significantly higher (p = 0.029). VDBP levels were similar in both groups. Correlation analysis of free and bioavailable vitamin D level with osteocalcin, c-telopeptide, bone alkaline phosphatase revealed only a weak significant correlation between free vitamin D and osteocalcin (r = -0.201; p = 0.028). A negative correlation was determined between 25(OH)D and parathormone levels (r = -0.294; p < 0.005). Serum osteocalcin, bone alkaline phosphatase and c-telopeptide levels of control group were significantly higher.
25(OH)D levels of the study population was extremely low. The measurement of VDBP and calculated free and bioactive vitamin D levels did not show a better correlation with bone turnover markers according to 25(OH)D levels.
已知维生素D缺乏与代谢性骨病相关。本研究旨在评估1型糖尿病患者的维生素D以及计算得出的游离和生物活性维生素D水平，并评估其与骨转换标志物的相关性。
这项横断面研究纳入了60例被诊断为1型糖尿病的内分泌门诊患者以及60例对照。记录体重、身高和腰围，并采集血样以测定25-羟维生素D（25(OH)D）、维生素D结合蛋白（VDBP）、骨钙素、骨碱性磷酸酶（骨ALP）、c-末端肽。使用公式计算游离和生物可利用维生素D水平。
1型糖尿病患者的维生素D水平显著更高（p = 0.01）。维生素D水平低于20 ng/ml组的甲状旁腺激素水平显著更高（p = 0.029）。两组的VDBP水平相似。游离和生物可利用维生素D水平与骨钙素、c-末端肽、骨碱性磷酸酶的相关性分析显示，仅游离维生素D与骨钙素之间存在微弱的显著相关性（r = -0.201；p = 0.028）。25(OH)D与甲状旁腺激素水平之间存在负相关（r = -0.294；p < 0.005）。对照组的血清骨钙素、骨碱性磷酸酶和c-末端肽水平显著更高。
研究人群的25(OH)D水平极低。根据25(OH)D水平，VDBP的测量以及计算得出的游离和生物活性维生素D水平与骨转换标志物并未显示出更好的相关性。
