CAJ | 학술논문

目的：观察2型糖尿病及糖调节受损患者血清25(OH)D3与胰岛素抵抗及尿微量白蛋白的相关性。方法：对820例健康体检人员进行筛查,共筛选出104例2型糖尿病患者(T2DM组),其中初发糖尿病患者40例,既往诊断2型糖尿病患者64例,同时筛选出糖调节受损患者(IGR组)94例,选择同期170例非糖尿病血糖正常体检者为对照组(NGT组)。所有参与者记录身高、体重计算体重指数( BMI)、并行口服糖耐量及胰岛素释放试验检测；留取血清,运用ELISA法检测血清25(OH)D3水平；放免法检测尿微量白蛋白(尿MA)；分析血清25(OH)D3与胰岛素抵抗及尿MA的相关性。结果：T2DM组及IGR组中25(OH)D3水平与对照组相比明显降低(P<0.05),2型糖尿病中有63.16%的患者维生素D缺乏,较非糖尿病患者(42.35%)明显增高(P<0.05)；相关分析显示,血清25(OH)D3水平与空腹胰岛素呈正相关,而与年龄、BMI、空腹血糖水平、HOMA-IR、尿微量白蛋白呈负相关。结论：2型糖尿病患者血清维生素D缺乏非常严重,维生素D缺乏可能会加重胰岛素抵抗及促进尿微量白蛋白分泌。维生素D缺乏可能是2型糖尿病及糖尿病肾病发病中重要的危险因素。
목적：관찰2형당뇨병급당조절수손환자혈청25(OH)D3여이도소저항급뇨미량백단백적상관성。방법：대820례건강체검인원진행사사,공사선출104례2형당뇨병환자(T2DM조),기중초발당뇨병환자40례,기왕진단2형당뇨병환자64례,동시사선출당조절수손환자(IGR조)94례,선택동기170례비당뇨병혈당정상체검자위대조조(NGT조)。소유삼여자기록신고、체중계산체중지수( BMI)、병행구복당내량급이도소석방시험검측；류취혈청,운용ELISA법검측혈청25(OH)D3수평；방면법검측뇨미량백단백(뇨MA)；분석혈청25(OH)D3여이도소저항급뇨MA적상관성。결과：T2DM조급IGR조중25(OH)D3수평여대조조상비명현강저(P<0.05),2형당뇨병중유63.16%적환자유생소D결핍,교비당뇨병환자(42.35%)명현증고(P<0.05)；상관분석현시,혈청25(OH)D3수평여공복이도소정정상관,이여년령、BMI、공복혈당수평、HOMA-IR、뇨미량백단백정부상관。결론：2형당뇨병환자혈청유생소D결핍비상엄중,유생소D결핍가능회가중이도소저항급촉진뇨미량백단백분비。유생소D결핍가능시2형당뇨병급당뇨병신병발병중중요적위험인소。
Objective: This study is to investigate the relationship between 25-Hydroxyvitamin D,insulin resistance and Urine micro-albumin under different glucose tolerance statuses. Methods:Subjects included total 820,(455 males,365 females). aged 40~65 years. Serum25(OH)D3,Ca2+,P3-,Parathyroid hormone(PTH),Fasting plasma glucose(FPG),2hPBG,INS. TG,TC were measured by ELISA and electrochemiluminescence, respectively. , Urine micro -albumin were measured by RIA. Homeostasis model ( Homa-IR) assessment,insulin acuity index ( IAI) were determined for insulin resistance. The current study has been carried out to assess association of serum 25-hydroxyvitamin D and the function of the insulin resistance and urine micro-albumin. Results:The levels of 25(OH)D3,in the T2DM group and IGR group were significantly lower than that in NGT group (P<0. 05). 63. 16% of the patients with T2DM had 25(OH)D3 deficiency (≤15 ng/ml) as compared to non-diabetic population of which 42. 35% patients had 25(OH)D3 deficiency. Multiple stepwise regression analysis showed that 25(OH)D3 was one of the influential factors of insulin resistance in patients with type 2 diabetes mellitus and Diabetic nephropathy. Conclusion:Our results suggest that 25(OH)D3 is close-ly related with insulin resistance and urine micro-albumin;It is maybe one of the influential factors of T2DM and diabetic nephropa-thy.