维生素D与肥胖相关2型糖尿病临床意义的相关性

N. Tahir, H. Ahmed, R. Hashim, Teba D. Soluiman
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摘要

背景:肥胖和2型糖尿病在过去一段时间内迅速增加,并且正在以令人不安的速度持续增加。一些临床和流行病学研究表明,循环维生素D水平、中枢性肥胖和胰岛素抵抗和糖尿病的进展之间存在反向关联。目的:阐明维生素D在肥胖相关代谢缺陷中的复杂作用及糖尿病的临床意义。受试者和方法:本研究纳入了2019年6月至2020年1月期间在国家糖尿病中心/ Al-Mustansiriyah大学就诊的90例糖尿病患者(45例肥胖和45例非肥胖);年龄在(35-60)岁之间。所有的参与者都进行了临床和生化检查。结果:肥胖糖尿病患者腰臀比、体重指数、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇与非肥胖组相比均显著升高(p= 0.01)。此外,肥胖组糖化血红蛋白、血清胰岛素和胰岛素抵抗稳态模型评估均升高,但不显著。与非肥胖组相比,肥胖糖尿病患者血清高密度脂蛋白、胆固醇和维生素D3显著降低(p= 0.01)。此外,与非肥胖患者相比,肥胖糖尿病患者D3缺乏症的比例(61%)更高。结论:本研究发现维生素D水平降低的个体血糖明显升高,这与胰岛素抵抗、β细胞功能下降、肥胖有关。
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The Correlation between Vitamin D and Clinical Implications for Obesity-Related Type 2 Diabetes Mellitus
Background: Obesity and type 2 diabetes have both rapidly raised during the last periods and are ongoing to increase at a disturbing rate universal. Several clinical and epidemiological researches demonstrated a reverse association between circulating vitamin D levels, central adiposity and the progress of insulin resistance and diabetes. Objective: The target of this work was to elucidate the complex role of vitamin D and the clinical implications of diabetes on metabolic defects related with obesity. Subjects and Methods: This study encompassed 90 diabetic patients (45 obese and 45 non obese) who were attending the National Diabetic Center/ Al-Mustansiriyah University during the period from June 2019 to January 2020; their age range was (35-60) years. All participant underwent clinical and biochemical examinations. Results: A substantial rise (p= 0.01) in waist/hip ratio, body mass index, fasting serum glucose, total cholesterol, triacylglycerol, and low density lipoprotein cholesterol in obese diabetic patients as paralleled to non-obese group. Moreover, there was an elevation in glycated hemoglobin, serum insulin, and homeostasis model assessment for insulin resistance in obese group, but it was not significant. A substantial decrease (p= 0.01) in serum high density lipoprotein cholesterol and vitamin D3 were detected in obese diabetic patients as paralleled to non-obese group.       Also, obese diabetic patients had the higher percent (61%) of D3 deficiency as paralleled to non-obese patients. Conclusions: In the present study, it is found that there is significant increase in blood sugar in the individuals with decreased vitamin D levels, which was related with insulin resistance, decreased β-cell function, and obesity.  
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